Search results for: heart failure reversal therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5170

Search results for: heart failure reversal therapy

3880 Enhancing Early Detection of Coronary Heart Disease Through Cloud-Based AI and Novel Simulation Techniques

Authors: Md. Abu Sufian, Robiqul Islam, Imam Hossain Shajid, Mahesh Hanumanthu, Jarasree Varadarajan, Md. Sipon Miah, Mingbo Niu

Abstract:

Coronary Heart Disease (CHD) remains a principal cause of global morbidity and mortality, characterized by atherosclerosis—the build-up of fatty deposits inside the arteries. The study introduces an innovative methodology that leverages cloud-based platforms like AWS Live Streaming and Artificial Intelligence (AI) to early detect and prevent CHD symptoms in web applications. By employing novel simulation processes and AI algorithms, this research aims to significantly mitigate the health and societal impacts of CHD. Methodology: This study introduces a novel simulation process alongside a multi-phased model development strategy. Initially, health-related data, including heart rate variability, blood pressure, lipid profiles, and ECG readings, were collected through user interactions with web-based applications as well as API Integration. The novel simulation process involved creating synthetic datasets that mimic early-stage CHD symptoms, allowing for the refinement and training of AI algorithms under controlled conditions without compromising patient privacy. AWS Live Streaming was utilized to capture real-time health data, which was then processed and analysed using advanced AI techniques. The novel aspect of our methodology lies in the simulation of CHD symptom progression, which provides a dynamic training environment for our AI models enhancing their predictive accuracy and robustness. Model Development: it developed a machine learning model trained on both real and simulated datasets. Incorporating a variety of algorithms including neural networks and ensemble learning model to identify early signs of CHD. The model's continuous learning mechanism allows it to evolve adapting to new data inputs and improving its predictive performance over time. Results and Findings: The deployment of our model yielded promising results. In the validation phase, it achieved an accuracy of 92% in predicting early CHD symptoms surpassing existing models. The precision and recall metrics stood at 89% and 91% respectively, indicating a high level of reliability in identifying at-risk individuals. These results underscore the effectiveness of combining live data streaming with AI in the early detection of CHD. Societal Implications: The implementation of cloud-based AI for CHD symptom detection represents a significant step forward in preventive healthcare. By facilitating early intervention, this approach has the potential to reduce the incidence of CHD-related complications, decrease healthcare costs, and improve patient outcomes. Moreover, the accessibility and scalability of cloud-based solutions democratize advanced health monitoring, making it available to a broader population. This study illustrates the transformative potential of integrating technology and healthcare, setting a new standard for the early detection and management of chronic diseases.

Keywords: coronary heart disease, cloud-based ai, machine learning, novel simulation techniques, early detection, preventive healthcare

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3879 Imaginal and in Vivo Exposure Blended with Emdr: Becoming Unstuck, an Integrated Inpatient Treatment for Post-Traumatic Stress Disorder

Authors: Merrylord Harb-Azar

Abstract:

Traditionally, PTSD treatment has involved trauma-focused cognitive behaviour therapy (TF CBT) to consolidate traumatic memories. A piloted integrated treatment of TF CBT and eye movement desensitisation reprocessing therapy (EMDR) of eight phases will fasten the rate memory is being consolidated and enhance cognitive functioning in patients with PTSD. Patients spend a considerable amount of time in treatment managing their traumas experienced firsthand, or from aversive details ranging from war, assaults, accidents, abuse, hostage related, riots, or natural disasters. The time spent in treatment or as inpatient affects overall quality of life, relationships, cognitive functioning, and overall sense of identity. EMDR is being offered twice a week in conjunction with the standard prolonged exposure as an inpatient in a private hospital. Prolonged exposure for up to 5 hours per day elicits the affect response required for EMDR sessions in the afternoon to unlock unprocessed memories and facilitate consolidation in the amygdala and hippocampus. Results are indicating faster consolidation of memories, reduction in symptoms in a shorter period of time, reduction in admission time, which is enhancing the quality of life and relationships, and improved cognition. The impact of events scale (IES) results demonstrate a significant reduction in symptoms, trauma symptoms inventory (TSI), and posttraumatic stressor disorder check list (PCL) that demonstrates large effect sizes to date. An integrated treatment approach for PTSD achieves a faster resolution of memories, improves cognition, and reduces the amount of time spent in therapy.

Keywords: EMDR enhances cognitive functioning, faster consolidation of trauma memory, integrated treatment of TF CBT and EMDR, reduction in inpatient admission time

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3878 Reversible and Irreversible Wrinkling in Tube Hydroforming Process

Authors: Ali Abd El-Aty, Ahmed Tauseef, Ahmad Farooq

Abstract:

This research aims at analyzing and optimizing the hydroforming process parameters to achieve a sound bulged tube without failure. Theoretical constitutive model is formulated to develop a working diagram including process window, which represents the optimize region to carry out the hydroforming process and predict the type of tube failure during the process accurately. The model is applied into different bulging ratios for low carbon steel (C1010). From this study, it is concluded that the tubes with bulging ratios up to 50% and 70% are successfully formed without defects. The tubes with bulging ratio of 90% are successfully formed by hydroforming with optimized the loading path (axial feed versus internal pressure) within the process window. The working diagram is modified due to different types of formation of wrinkling during the hydroforming process. The formation of wrinkles with increasing axial feed can be useful in terms of the achievement of higher bulging ratio and/or less thinning and this type of wrinkles can be overcome through the internal pressure in the later stage of the hydroforming process. On the other hand, the formation of wrinkles may be harmful, if it cannot be reversed.

Keywords: finite element, hydroforming, process window, wrinkling

Procedia PDF Downloads 268
3877 Predictive Maintenance: Machine Condition Real-Time Monitoring and Failure Prediction

Authors: Yan Zhang

Abstract:

Predictive maintenance is a technique to predict when an in-service machine will fail so that maintenance can be planned in advance. Analytics-driven predictive maintenance is gaining increasing attention in many industries such as manufacturing, utilities, aerospace, etc., along with the emerging demand of Internet of Things (IoT) applications and the maturity of technologies that support Big Data storage and processing. This study aims to build an end-to-end analytics solution that includes both real-time machine condition monitoring and machine learning based predictive analytics capabilities. The goal is to showcase a general predictive maintenance solution architecture, which suggests how the data generated from field machines can be collected, transmitted, stored, and analyzed. We use a publicly available aircraft engine run-to-failure dataset to illustrate the streaming analytics component and the batch failure prediction component. We outline the contributions of this study from four aspects. First, we compare the predictive maintenance problems from the view of the traditional reliability centered maintenance field, and from the view of the IoT applications. When evolving to the IoT era, predictive maintenance has shifted its focus from ensuring reliable machine operations to improve production/maintenance efficiency via any maintenance related tasks. It covers a variety of topics, including but not limited to: failure prediction, fault forecasting, failure detection and diagnosis, and recommendation of maintenance actions after failure. Second, we review the state-of-art technologies that enable a machine/device to transmit data all the way through the Cloud for storage and advanced analytics. These technologies vary drastically mainly based on the power source and functionality of the devices. For example, a consumer machine such as an elevator uses completely different data transmission protocols comparing to the sensor units in an environmental sensor network. The former may transfer data into the Cloud via WiFi directly. The latter usually uses radio communication inherent the network, and the data is stored in a staging data node before it can be transmitted into the Cloud when necessary. Third, we illustrate show to formulate a machine learning problem to predict machine fault/failures. By showing a step-by-step process of data labeling, feature engineering, model construction and evaluation, we share following experiences: (1) what are the specific data quality issues that have crucial impact on predictive maintenance use cases; (2) how to train and evaluate a model when training data contains inter-dependent records. Four, we review the tools available to build such a data pipeline that digests the data and produce insights. We show the tools we use including data injection, streaming data processing, machine learning model training, and the tool that coordinates/schedules different jobs. In addition, we show the visualization tool that creates rich data visualizations for both real-time insights and prediction results. To conclude, there are two key takeaways from this study. (1) It summarizes the landscape and challenges of predictive maintenance applications. (2) It takes an example in aerospace with publicly available data to illustrate each component in the proposed data pipeline and showcases how the solution can be deployed as a live demo.

Keywords: Internet of Things, machine learning, predictive maintenance, streaming data

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3876 The Role of Pulmonary Resection in Complicated Primary Pediatric Pulmonary Tuberculosis: An Evidence-Based Case Report

Authors: Hendra Wibowo, Suprayitno Wardoyo, Dhama Shinta

Abstract:

Introduction: Pediatric pulmonary tuberculosis (TB) incidence was increasing, with many undetected cases. In complicated TB, treatment should consist of returning pulmonary function, preventing further complications, and eliminating bacteria. Complicated TB management was still controversial, and surgery was one of the treatments that should be evaluated in accordance with its role in the treatment of complicated TB. Method: This study was an evidence-based case report. The database used for the literature search were Cochrane, Medline, Proquest, and ScienceDirect. Keywords for the search were ‘primary pulmonary tuberculosis’, ‘surgery’, ‘lung resection’, and ‘children’. Inclusion criteria were studies in English or Indonesian, with children under 18 years old as subject, and full-text articles available. The assessment was done according to Oxford Centre for evidence-based medicine 2011. Results: Six cohort studies were analyzed. Surgery was indicated for patients with complicated TB that were unresponsive towards treatment. It should be noted that the experiments were done before the standard WHO antituberculosis therapy was applied; thus, the result may be different from the current application. Conclusion: Currently, there was no guideline on pulmonary resection. However, surgery yielded better mortality and morbidity in children with complicated pulmonary TB.

Keywords: pediatric, pulmonary, surgery, therapy, tuberculosis

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3875 Proprioceptive Neuromuscular Facilitation Exercises of Upper Extremities Assessment Using Microsoft Kinect Sensor and Color Marker in a Virtual Reality Environment

Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

Abstract:

Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality

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3874 Study of the Protective Effects of Summer Savory against Multiple Organ Damage Induced by Lead Acetate in Rats

Authors: Bassant M. M. Ibrahim, Doha H. Abou Baker, Ahmed Abd Elghafour

Abstract:

Excessive exposure to heavy metals contributes to the occurrence of deleterious health problems that affect vital organs like the brain, liver, kidneys, and heart. The use of natural products that have antioxidant capabilities may contribute to the protection of these organs. In the present study, the essential oil of summer savory (Satureja hortensis) was used to evaluate its protective effects against lead acetate induced damaging effect on rats’ vital organs, due to its high contents of carvacrol, y-terpinene, and p-cymene. Forty female Wister Albino rats were classified into five equal groups, the 1st served as normal group, the 2nd served as positive control group was given lead acetate (60 mg/kg) intra-peritoneal (IP), the third to fifth groups were treated with calcium disodium (EDTA) as chelating agent and summer savory essential oil in doses of (50 and 100mg/kg) respectively. All treatments were given IP concomitant with lead acetate for ten successive days. At the end of the experiment duration electrocardiogram (ECG), an open field test for the evaluation of psychological state, rotarod test as for the evaluation of locomotor coordination ability as well as anti-inflammatory and oxidative stress biomarkers in serum and histopathology of vital organs were performed. The investigations in this study show that the protective effect of high dose of summer savory essential oil is more than the low dose and that the essential oil of summer savory is a promising agent that can contribute to the protection of vital organs against the hazardous damaging effects of lead acetate.

Keywords: brain, heart, kidneys, lead acetate, liver, protective, summer savory

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3873 Microbial Corrosion on Oil and Gas Facilities: A Case Study of Oil and Gas Facilities in the Niger-Delta

Authors: Frederick Otite Ighovojah

Abstract:

Corrosion in the oil and gas industries is one of the most common causes of failure. Such failure includes leaks in above-ground storage tanks (AGST). The involvement of microorganisms in the corrosion process in AGST systems is often ignored, and this outlines the need to investigate the effect of microbial corrosion in oil and gas facilities. This study's methodology comprised gathering generated water samples from a nearby AGST oil facility that was operating, which were then equally divided into two batch reactors, 1 and 2. Each batch reactor was filled with five prepared X60 coupons using sterilized forceps. To provide nutrients for the microorganisms in batch reactor 1 during the test period, 2g of NPK 15- 15-15 fertilizer was added on a weekly basis. To kill the microorganisms and significantly lower their concentration in the generated water, 5ml of dissolved ozone (a biocide) with a 0.5ppm concentration was added to batch reactor 2. The weight loss measurement (WLM) was used to evaluate for corrosion. Coupons were removed from each batch reactor, and weight loss was measured at every interval of 336 hrs for 2016 hrs. The overall results obtained indicated that coupons from the batch 1 reactor showed a higher corrosion rate and higher mass loss, and this was due to the metabolic production of an aggressive compound in the medium.

Keywords: AGST, microbial corrosion, reactor, X60 steel

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3872 Improvement of the Geometric of Dental Bridge Framework through Automatic Program

Authors: Rong-Yang Lai, Jia-Yu Wu, Chih-Han Chang, Yung-Chung Chen

Abstract:

The dental bridge is one of the clinical methods of the treatment for missing teeth. The dental bridge is generally designed for two layers, containing the inner layer of the framework(zirconia) and the outer layer of the porcelain-fused to framework restorations. The design of a conventional bridge is generally based on the antagonist tooth profile so that the framework evenly indented by an equal thickness from outer contour. All-ceramic dental bridge made of zirconia have well demonstrated remarkable potential to withstand a higher physiological occlusal load in posterior region, but it was found that there is still the risk of all-ceramic bridge failure in five years. Thus, how to reduce the incidence of failure is still a problem to be solved. Therefore, the objective of this study is to develop mechanical designs for all-ceramic dental bridges framework by reducing the stress and enhancing fracture resistance under given loading conditions by finite element method. In this study, dental design software is used to design dental bridge based on tooth CT images. After building model, Bi-directional Evolutionary Structural Optimization (BESO) Method algorithm implemented in finite element software was employed to analyze results of finite element software and determine the distribution of the materials in dental bridge; BESO searches the optimum distribution of two different materials, namely porcelain and zirconia. According to the previous calculation of the stress value of each element, when the element stress value is higher than the threshold value, the element would be replaced by the framework material; besides, the difference of maximum stress peak value is less than 0.1%, calculation is complete. After completing the design of dental bridge, the stress distribution of the whole structure is changed. BESO reduces the peak values of principle stress of 10% in outer-layer porcelain and avoids producing tensile stress failure.

Keywords: dental bridge, finite element analysis, framework, automatic program

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3871 Closed Incision Negative Pressure Therapy Dressing as an Approach to Manage Closed Sternal Incisions in High-Risk Cardiac Patients: A Multi-Centre Study in the UK

Authors: Rona Lee Suelo-Calanao, Mahmoud Loubani

Abstract:

Objective: Sternal wound infection (SWI) following cardiac operation has a significant impact on patient morbidity and mortality. It also contributes to longer hospital stays and increased treatment costs. SWI management is mainly focused on treatment rather than prevention. This study looks at the effect of closed incision negative pressure therapy (ciNPT) dressing to help reduce the incidence of superficial SWI in high-risk patients after cardiac surgery. The ciNPT dressing was evaluated at 3 cardiac hospitals in the United Kingdom". Methods: All patients who had cardiac surgery from 2013 to 2021 were included in the study. The patients were classed as high risk if they have two or more of the recognised risk factors: obesity, age above 80 years old, diabetes, and chronic obstructive pulmonary disease. Patients receiving standard dressing (SD) and patients using ciNPT were propensity matched, and the Fisher’s exact test (two-tailed) and unpaired T-test were used to analyse categorical and continuous data, respectively. Results: There were 766 matched cases in each group. Total SWI incidences are lower in the ciNPT group compared to the SD group (43 (5.6%) vs 119 (15.5%), P=0.0001). There are fewer deep sternal wound infections (14(1.8%) vs. 31(4.04%), p=0.0149) and fewer superficial infections (29(3.7%) vs. 88 (11.4%), p=0.0001) in the ciNPT group compared to the SD group. However, the ciNPT group showed a longer average length of stay (11.23 ± 13 days versus 9.66 ± 10 days; p=0.0083) and higher mean logistic EuroSCORE (11.143 ± 13 versus 8.094 ± 11; p=0.0001). Conclusion: Utilization of ciNPT as an approach to help reduce the incidence of superficial and deep SWI may be effective in high-risk patients requiring cardiac surgery.

Keywords: closed incision negative pressure therapy, surgical wound infection, cardiac surgery complication, high risk cardiac patients

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3870 Childhood Trauma and Identity in Adulthood

Authors: Aakriti Lohiya

Abstract:

This study examines the commonly recognised childhood trauma that can have a significant and enduring effect on a person's cognitive and psychological health. The purpose of this study was to look at the intricate interactions that exist between negative self-identity, cognitive distortions, and early trauma. For the study, a sample of (200 women were taken, who were socially active) was gathered. Standardised measures were utilised to evaluate the participants' experiences of childhood trauma, and validated psychological tools were employed to assess negative self-identity and cognitive distortions. The links and predicting correlations between childhood trauma, negative self-identity, and cognitive distortions were investigated using statistical techniques, such as correlation analysis and multiple regression modelling. The results demonstrated that there is no correlation between the degree of early trauma and the emergence of a negative self-identity and cognitive distortions. It examines whether cognitive distortion and events in childhood have any relationship with negative self-identity using various scales. Participants completed the Childhood Trauma Questionnaire, which assessed retrospective accounts of childhood trauma; the Cognitive Distortions Scale, which measured internal attributions and perceptions of controllability; and the attachment style questionnaire, which assessed the attachment attribute of their daily life, which will lead negative. The implications for therapy were also considered.

Keywords: cognitive distortion, therapy, childhood trauma, attachment

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3869 Magnetohemodynamic of Blood Flow Having Impact of Radiative Flux Due to Infrared Magnetic Hyperthermia: Spectral Relaxation Approach

Authors: Ebenezer O. Ige, Funmilayo H. Oyelami, Joshua Olutayo-Irheren, Joseph T. Okunlola

Abstract:

Hyperthermia therapy is an adjuvant procedure during which perfused body tissues is subjected to elevated range of temperature in bid to achieve improved drug potency and efficacy of cancer treatment. While a selected class of hyperthermia techniques is shouldered on the thermal radiations derived from single-sourced electro-radiation measures, there are deliberations on conjugating dual radiation field sources in an attempt to improve the delivery of therapy procedure. This paper numerically explores the thermal effectiveness of combined infrared hyperemia having nanoparticle recirculation in the vicinity of imposed magnetic field on subcutaneous strata of a model lesion as ablation scheme. An elaborate Spectral relaxation method (SRM) was formulated to handle equation of coupled momentum and thermal equilibrium in the blood-perfused tissue domain of a spongy fibrous tissue. Thermal diffusion regimes in the presence of external magnetic field imposition were described leveraging on the renowned Roseland diffusion approximation to delineate the impact of radiative flux within the computational domain. The contribution of tissue sponginess was examined using mechanics of pore-scale porosity over a selected of clinical informed scenarios. Our observations showed for a substantial depth of spongy lesion, magnetic field architecture constitute the control regimes of hemodynamics in the blood-tissue interface while facilitating thermal transport across the depth of the model lesion. This parameter-indicator could be utilized to control the dispensing of hyperthermia treatment in intravenous perfused tissue.

Keywords: spectra relaxation scheme, thermal equilibrium, Roseland diffusion approximation, hyperthermia therapy

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3868 Hypotensive effect of Cardiospermum halicacabum Linn. in Anesthetized Rats

Authors: Huma Shareef, Ghazala H. Rizwani, Ahsana Dar

Abstract:

In traditional medicine Cardiospermum halicacabum L. (Sapindeaceae) is used against various ailments. In current investigation searching a new remedy that will available easily, non expensive, able to lower hypertension and standardize blood pressure, made us to develop an herbal medicine. Crude ethanol extract of C. halicacabum and its various fractions ethyl acetate and butanol showed a dose-dependent hypotensive effect in anaesthetized rats. The trachea was exposed and freed from connective tissue and incubated by cannula to facilitate spontaneous respiration. The right carotid artery and left jugular vein were cannulated with polyethylene tubing PE-50 for monitoring blood pressure changes via pressure transducer (Gould P23 ID) connected to a Grass model 79D polygraph and for i.v. injection, respectively. Drugs or the plant extracts were administered at a constant volume of 0.5 ml/kg, followed by injection of 0.2 ml of saline that flushed the cannula. Systolic, diastolic and mean arterial blood pressure (MABP) was measured in mm Hg and heart rate in beats/min. Ethanol extract of C. halicacabum showed a significant activity at 50 mg/kg dose. Ethyl acetate fraction (10, 20, 30, 40, and 50 mg/kg) induced dose dependent fall in systolic and diastolic blood pressure, heart rate of rats. At 10-30 mg/kg the hypotensive effect was non significantly reduced by 10 -15%. However, the extract at 40 mg/kg induced significant hypotensive effect calculated as 30.95±3.2% MABP and this effect persists till 50 mg/kg. The higher polar fraction (butanol) of the whole plant failed to produce any significant response against MABP at all the tested doses (10-50 mg/kg). C. halicacabum lowers blood pressure, exerts a dose-dependent hypotensive effect, can be used as hypotensor.

Keywords: cardiospermum halicacabum, calcium channel blocker, hypotensive, various extracts

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3867 Antiprotozoal Activity of Peganum harmala against Babesiosis in Cattle

Authors: Muhammad Mustafa Jafar, Syed Ashar Mahfooz, Muhammad Ejaz Saleem, Muhammad Asif Raza, Asghar Abbas, Rao Zahid Abbas, Muhammad Kasib Khan, Hafiz Muhammad Ishaq

Abstract:

The Babesia gradually attained resistance against the synthetic medicines. To overcome the drug resistance, herbal therapy has gained more attention as compared to allopathic therapy. Peganumharmala (harmal) is a plant which has shown effective results against various protozoal diseases. Therefore, the present study was planned to monitor the efficacy of Peganumharmala (aqueous extract) against Babesiosis in cattle. For this purpose, a total of forty (n=40) infected animals were randomly divided into four equal groups (A, B, C, and D). Group A was treated with aqueous extract of Peganum harmala at 7.5 mg/kg, group B at 10 mg/kg and group C at 12.5 mg/kg of body weight. Group D served as a control group (normal). It was observed that there was a stabilization in hematological parameters (white and red blood cells, hemoglobin and Packed cell volume) in infected animals treated with Peganum harmala at different doses. Results of this study hence indicated that Peganum harmala extract at 12.5mg/kg BW is more effective against Babesiosis than lower doses.

Keywords: Babesiosis, cattle, control, Peganum harmala

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3866 Statistical Correlation between Ply Mechanical Properties of Composite and Its Effect on Structure Reliability

Authors: S. Zhang, L. Zhang, X. Chen

Abstract:

Due to the large uncertainty on the mechanical properties of FRP (fibre reinforced plastic), the reliability evaluation of FRP structures are currently receiving much attention in industry. However, possible statistical correlation between ply mechanical properties has been so far overlooked, and they are mostly assumed to be independent random variables. In this study, the statistical correlation between ply mechanical properties of uni-directional and plain weave composite is firstly analyzed by a combination of Monte-Carlo simulation and finite element modeling of the FRP unit cell. Large linear correlation coefficients between the in-plane mechanical properties are observed, and the correlation coefficients are heavily dependent on the uncertainty of the fibre volume ratio. It is also observed that the correlation coefficients related to Poisson’s ratio are negative while others are positive. To experimentally achieve the statistical correlation coefficients between in-plane mechanical properties of FRP, all concerned in-plane mechanical properties of the same specimen needs to be known. In-plane shear modulus of FRP is experimentally derived by the approach suggested in the ASTM standard D5379M. Tensile tests are conducted using the same specimens used for the shear test, and due to non-uniform tensile deformation a modification factor is derived by a finite element modeling. Digital image correlation is adopted to characterize the specimen non-uniform deformation. The preliminary experimental results show a good agreement with the numerical analysis on the statistical correlation. Then, failure probability of laminate plates is calculated in cases considering and not considering the statistical correlation, using the Monte-Carlo and Markov Chain Monte-Carlo methods, respectively. The results highlight the importance of accounting for the statistical correlation between ply mechanical properties to achieve accurate failure probability of laminate plates. Furthermore, it is found that for the multi-layer laminate plate, the statistical correlation between the ply elastic properties significantly affects the laminate reliability while the effect of statistical correlation between the ply strength is minimal.

Keywords: failure probability, FRP, reliability, statistical correlation

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3865 Outcome of Patients Undergoing Hemicraniectomy for Malignant Middle Cerebral Artery Infarction: A 5 Year Retrospective Study at Perpetual Succour Hospital, Cebu City, Philippines

Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

Abstract:

Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

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3864 Clash of Civilizations without Civilizational Groups: Revisiting Samuel P. Huntington´s Clash of Civilizations Theory

Authors: Jamal Abdi

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This paper is largely a response/critique of Samuel P. Huntington´s Clash of Civilizations thesis. The overriding argument is that Huntington´s thesis is characterized by failure to distinguish between ´groups´ and ´categories´. Multinational civilizations overcoming their internal collective action problems, which would enable them to pursue a unified strategy vis-à-vis the West, is a rather foundational assumption in his theory. Without assigning sufficient intellectual attention to the processes through which multinational civilizations may gain capacity for concerted action i.e. become a group, he contended that the post-cold-war world would be shaped in large measure by interactions among seven or eight major civilizations. Thus, failure in providing a convincing analysis of multi-national civilizations´ transition from categories to groups is a significant weakness in Huntington´s clash theory. It is also suggested that so-called Islamic terrorism and the war on terror is not to be taken as an expression of presence of clash between a Western and an Islamic civilization, as terrorist organizations would be superfluous in a world characterized by clash of civilizations. Consequences of multinational civilizations becoming a group are discussed in relation to contemporary Western superiority.

Keywords: categories, civilizations, clash, groups, groupness

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3863 New Chances of Reforming Pedagogical Approach In Secondary English Class in China under the New English Curriculum and National College Entrance Examination Reform

Authors: Yue Wang

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Five years passed since the newest English curriculum reform policy was published in China, hand-wringing spread among teachers who accused that this is another 'Wearing New Shoes to Walk the Old Road' policy. This paper provides a thoroughly philosophical policy analysis of serious efforts that had been made to support this reform and reveals the hindrances that bridled the reform to yield the desired effect. Blame could be easily put on teachers for their insufficient pedagogical content knowledge, conservative resistance, and the handicaps of large class sizes and limited teaching times, and so on. However, the underlying causes for this implementation failure are the interrelated factors in the NCEE-centred education system, such as the reluctant from students, the lack of school and education bureau support, and insufficient teacher training. A further discussion of 2017 to 2020’s NCEE reform on English prompt new possibilities for the authentic pedagogical approach reform in secondary English classes. In all, the pedagogical approach reform at the secondary level is heading towards a brighter future with the initiation of new NCEE reform.

Keywords: English curriculum, failure, NCEE, new possibilities, pedagogical, policy analysis, reform

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3862 Evaluating Perceived Usability of ProxTalker App Using Arabic Standard Usability Scale: A Student's Perspective

Authors: S. AlBustan, B. AlGhannam

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This oral presentation discusses a proposal for a study that evaluates the usability of an evidence based application named ProxTalker App. The significance of this study will inform administration and faculty staff at the Department of Communication Sciences Disorders (CDS), College of Life Sciences, Kuwait University whether the app is a suitable tool to use for CDS students. A case study will be used involving a sample of CDS students taking practicum and internship courses during the academic year 2018/2019. The study will follow a process used by previous study. The process of calculating SUS is well documented and will be followed. ProxTalker App is an alternative and augmentative tool that speech language pathologist (SLP) can use to customize boards for their clients. SLPs can customize different boards using this app for various activities. A board can be created by the SLP to improve and support receptive and expressive language. Using technology to support therapy can aid SLPs to integrate this ProxTalker App as part of their clients therapy. Supported tools, games and motivation are some advantages of incorporating apps during therapy sessions. A quantitative methodology will be used. It involves the utilization of a standard tool that was the was adapted to the Arabic language to accommodate native Arabic language users. The tool that will be utilized in this research is the Arabic Standard Usability Scale (A-SUS) questionnaire which is an adoption of System Usability Scale (SUS). Standard usability questionnaires are reliable, valid and their process is properly documented. This study builds upon the development of A-SUS, which is a psychometrically evaluated questionnaire that targets Arabic native speakers. Results of the usability will give preliminary indication of whether the ProxTalker App under investigation is appropriate to be integrated within the practicum and internship curriculum of CDS. The results of this study will inform the CDS department of this specific app is an appropriate tool to be used for our specific students within our environment because usability depends on the product, environment, and users.

Keywords: A-SUS, communication disorders practicum, evidence based app, Standard Usability Scale

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3861 The Effect of Cognitively-Induced Self-Construal and Direct Behavioral Mimicry on Prosocial Behavior

Authors: Czar Matthew Gerard Dayday, Danielle Marie Estrera, Philippe Jefferson Galban, Gabrielle Marie Heredia

Abstract:

The study aimed to examine the effects of self-construal and direct mimicry on prosocial behavior. The study made use of a 2 (Self-construal: independent or interdependent) x 2 (Mimicry: mimicry or non-mimicry) between subjects factorial design where effects of self-construal was cognitively-induced through a story with varying pronouns (We, Us, Ourselves vs. Me, I, Myself), and prosocial behavior was measured with the amount of money donated to a fabricated advocacy. The research was conducted with a convenience sampling comprised of 88 undergraduate students (58 Females, 33 Males) aged 16 to 26 years olds from the University of the Philippines, Diliman. Results from the experiment show that both factors do not have significant main effects on prosocial behavior. Additionally, their interaction also does not have a significant effect to prosocial behavior with No Mimicry x Independent ranking highest in amount of money donated and Mimicry x Interdependent ranking lowest. These results can be attributed to multiple factors, which include the collectivist orientation and sense of kapwa of Filipinos, a role reversal in the methodology and the lack of Chameleon Effect, and a weak priming of self-construal with respect to self-relatedness.

Keywords: behavior, mimicry, prosocial, self-construal

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3860 Development of a Delivery System for Statin Targeted Spray is a Breakthrough Therapy in Alzheimer’s Prevention

Authors: Fakhr Eddin Alnaal, Angela Dahdal, Duaa Aladib, Sabeen Ibrahim, Ibrahim Ghoraibi, Bissan Ahmed

Abstract:

Dementia is one of the diseases which had several stages and Alzheimer’s term was selected in respect for the first doctor Alzheimer who defined the first symptoms of this diseases in a woman whom was well treated by him. The fact that this is a type of a silent disease on which you have a long-term process of neurological degradation and suddenly gives symptoms which are most often irreversible, on clinical level likely we can consider it as a malignancy, one in terms of that it is sudden shocking irreversible and on the level of behavior and some mortality beside the lack of early detection tools for diagnosis. Therefore, the goal of our project is to test the concept of the ability of Statin in prevention of such disease and we investigated that both on experimental level and most importantly on clinical one, the clinical part was performed in a recognized house of aged people who had accidently a high cholesterol and were for years given Statin to treat that elevation, however after the symptoms of Alzheimer’s appeared and when diagnosed, they were well treated and rapidly recovered compared to Alzheimer’s patients in the same house who did not receive Statin had a mild improvement in their symptoms after the therapy, on the other hand we confirmed such observation by a well-organized experimental work.

Keywords: Alzheimer's, dementia, silent disease, statin

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3859 The Effectiveness of Exercise Therapy on Decreasing Pain in Women with Temporomandibular Disorders and How Their Brains Respond: A Pilot Randomized Controlled Trial

Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria

Abstract:

Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.

Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders

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3858 Analysis of Lift Arm Failure and Its Improvement for the Use in Farm Tractor

Authors: Japinder Wadhawan, Pradeep Rajan, Alok K. Saran, Navdeep S. Sidhu, Daanvir K. Dhir

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Currently, research focus in the development of agricultural equipment and tractor parts in India is innovation and use of alternate materials like austempered ductile iron (ADI). Three-point linkage mechanism of the tractor is susceptible to unpredictable load conditions in the field, and one of the critical components vulnerable to failure is lift arm. Conventionally, lift arm is manufactured either by forging or casting (SG Iron) and main objective of the present work is to reduce the failure occurrences in the lift arm, which is achieved by changing the manufacturing material, i.e ADI, without changing existing design. Effect of four pertinent variables of manufacturing ADI, viz. austenitizing temperature, austenitizing time, austempering temperature, austempering time, was investigated using Taguchi method for design of experiments. To analyze the effect of parameters on the mechanical properties, mean average and signal-to-noise (S/N) ratio was calculated based on the design of experiments with L9 orthogonal array and the linear graph. The best combination for achieving the desired mechanical properties of lift arm is austenitization at 860°C for 90 minutes and austempering at 350°C for 60 minutes. Results showed that the developed component is having 925 MPA tensile strength, 7.8 per cent elongation and 120 joules toughness making it more suitable material for lift arm manufacturing. The confirmatory experiment has been performed and found a good agreement between predicted and experimental value. Also, the CAD model of the existing design was developed in computer aided design software, and structural loading calculations were performed by a commercial finite element analysis package. An optimized shape of the lift arm has also been proposed resulting in light weight and cheaper product than the existing design, which can withstand the same loading conditions effectively.

Keywords: austempered ductile iron, design of experiment, finite element analysis, lift arm

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3857 Safety Study of Intravenously Administered Human Cord Blood Stem Cells in the Treatment of Symptoms Related to Chronic Inflammation

Authors: Brian M. Mehling, Louis Quartararo, Marine Manvelyan, Paul Wang, Dong-Cheng Wu

Abstract:

Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of anti-aging. They have been given one intravenous infusion of UC-MSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

Keywords: chronic inflammatory diseases, intravenous infusion, stem cell therapy, umbilical cord blood derived mesenchymal stem cells (UC-MSCs)

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3856 Experimental Study of Local Scour Downstream of Cylindrical Bridge Piers

Authors: Mohammed Traeq Shukri

Abstract:

Scour is a natural phenomenon caused by the erosive action of flowing stream on alluvial beds, which removes the sediment around or near structures located in flowing water. It means the lowering of the riverbed level by water erosions such that there is a tendency to expose the foundations of a structure. It is the result of the erosive action of flowing water, excavating and carrying away material from the bed and banks of streams and from around the piers of bridges. The failure of bridges due to excessive local scour during floods poses a challenging problem to hydraulic engineers. The failure of bridges piers is due to many reasons such as localized scour combined with general riverbed degradation. In this paper, we try to estimate the temporal variation of scour depth at non-uniform cylindrical bridge pier, by experimental work in civil engineering hydraulic laboratories of Gaziantep University on a channel have dimensions of 8.3m length, 0.8m width and 0.9m depth. The experiments will be carried on 20 cm depth of sediment layer having d50=0.4 mm. Three bridge pier shapes having different scaled models will be constructed in a 1.5m of test section in the channel.

Keywords: scour, local scour, bridge piers, scour depth, vortex, horseshoe vortex

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3855 Medical versus Non-Medical Students' Opinions about Academic Stress Management Using Unconventional Therapies

Authors: Ramona-Niculina Jurcau, Ioana-Marieta Jurcau, Dong Hun Kwak, Nicolae-Alexandru Colceriu

Abstract:

Background: Stress management (SM) is a topic of great academic interest and equally a task to accomplish. In addition, it is recognized the beneficial role of unconventional therapies (UCT) in stress modulation. Aims: The aim was to evaluate medical (MS) versus non-medical students’ (NMS) opinions about academic stress management (ASM) using UCT. Methods: MS (n=103, third year males and females) and NMS (n=112, males and females, from humanities faculties, different years of study), out of their academic program, voluntarily answered to a questionnaire concerning: a) Classification of the four most important academic stress factors; b) The extent to which their daily life influences academic stress; c) The most important SM methods they know; d) Which of these methods they are applying; e) the UCT they know or about which they have heard; f) Which of these they know to have stress modulation effects; g) Which of these UCT, participants are using or would like to use for modulating stress; and if participants use UTC for their own choose or following a specialist consultation in those therapies (SCT); h) If they heard about the following UCT and what opinion they have (using visual analogue scale) about their use (following CST) for the ASM: Phytotherapy (PT), apitherapy (AT), homeopathy (H), ayurvedic medicine (AM), traditional Chinese medicine (TCM), music therapy (MT), color therapy (CT), forest therapy (FT). Results: Among the four most important academic stress factors, for MS more than for NMS, are: busy schedule, large amount of information taught; high level of performance required, reduced time for relaxing. The most important methods for SM that MS and NMS know, hierarchically are: listen to music, meeting friends, playing sport, hiking, sleep, regularly breaks, seeing positive side, faith; of which, NMS more than MS, are partially applying to themselves. UCT about which MS and less NMS have heard, are phytotherapy, apitherapy, acupuncture, reiki. Of these UTC, participants know to have stress modulation effects: some plants, bee’s products and music; they use or would like to use for ASM (the majority without SCT) certain teas, honey and music. Most of MS and only some NMS heard about PT, AT, TCM, MT and much less about H, AM, CT, TT. NMS more than MS, would use these UCT, following CST. Conclusions: 1) Academic stress is similarly reflected in MS and NMS opinions. 2) MS and NMS apply similar but very few UCT for stress modulation. 3) Information that MS and NMS have about UCT and their ASM application is reduced. 4) It is remarkable that MS and especially NMS, are open to UCT use for ASM, following an SCT.

Keywords: academic stress, stress management, stress modulation, medical students, non-medical students, unconventional therapies

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3854 Efficacy and Safety of Inhaled Nebulized Chemotherapy in Treatment of Patients with Newly Diagnosed Pulmonary Tuberculosis in Comparison to Standard Antimycobacterial Therapy

Authors: M. Kuzhko, M. Gumeniuk, D. Butov, T. Tlustova, O. Denysov, T. Sprynsian

Abstract:

Abstract: The objective of this work was to study the efficacy and safety of inhaled nebulized chemotherapy in the treatment of patients with newly diagnosed pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 68 patients aged between 20 and 70 years with newly diagnosed pulmonary tuberculosis. Patients were allocated to two groups. The first (main, n=21) group of patients received standard chemotherapy and further 0.15 g of isoniazid and rifampicin 0.15 g inhaled through a nebulizer, also they received salmeterol 50 mcg + fluticasone propionate 250 mcg at 2 breaths twice a day for 2 months. The second (control, n=47) group of patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g) with a dose reduction after the intensive phase of the therapy. The anti-TB drugs were procured through the Ukraine’s centralized national supply system. Results: Intoxication symptoms in the first group reduced following 1.39±0.18 months, whereas in the second group, intoxication symptoms reduced following 2.7±0.1 months, p<.001. Moreover, respiratory symptoms regression in the first group was observed following 1.6±0.2 months, whereas in the second group – following 2.5±0.2 months, p<0.05. Bacillary excretion period evaluated within 1 month was reduced, as it was shown by 66.6±10.5% in the main group compared to 27.6±6.5%, p<0.05, in the control group. In addition, period of cavities healing was reduced to 2.9±0.2 months in the main group compared to 3.7±0.1 months, p<0.05, in the control group. Residual radiological lung damage findings (large residual changes) were observed in 22 (23.8±9.5 %) patients of the main group versus 24 (51.0±7.2 %) patients in the control group, p<0.05. After completion of treatment scar stenosis of the bronchi II-III art. diagnosed in 3 (14.2±7.8%) patients in main group and 17 (68.0±6.8%) - control group, p<0.05. The duration of hospital treatment was 2.4±0.4 months in main group and 4.1±0.4 months in control group, p<0.05. Conclusion: Administration of of inhaled nebulized chemotherapy in patients with newly diagnosed pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.

Keywords: inhaled nebulized chemotherapy, pulmonary tuberculosis, tuberculosis, treatment of tuberculosis

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3853 Nimart-trained Nurses' Perspectives Regarding Virally Unsuppressed Children HIV-positive on Antiretroviral Therapy and Missing Scheduled Clinic Visits: Mopani District, Limpopo Province

Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba

Abstract:

Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.

Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments

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3852 Managing Children with Autism Spectrum Disorder in Corona Age

Authors: Raju Singh, Shikha Singh

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This article is note for managing Autistic Child during the Corona time line. It becomes very critical for the primary caregiver as corona pandemic poses new challenges and completely variety of threats to line of treatment, growth, socialization, mental health for children with autism spectrum disorder (ASD), and, so for the family of the children. It is a highly distressful situation, where the line of treatment has shrunken, physical contact has reduced and therapies footprints reduced in several parts of the world. As children with ASD already face socialization challenges, isolation rules imposed by individuals (or social groups), government agencies have only made the situation worse for the children with ASD and their family. This note will try to touch the basics on understanding the ASD and related development disorders, challenges, impact, and suggest approaches to deal with such situation. This document also covers data analysis, deep dive into the increasing impact of ASD on children. This document can also act as a baseline for many researchers, psychiatrists, psychologists, therapists to view the problem statement and measure its impact.

Keywords: autism spectrum disorder, mental health, applied behavior therapy, occupational therapy, social anxiety

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3851 Person-Centered Approaches in Face-to-Face Interventions to Support Enrolment in Cardiac Rehabilitation: A Scoping Review Study

Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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