Search results for: vibration therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2737

Search results for: vibration therapy

1447 Prevalence and Correlates of Complementary and Alternative Medicine Use among Diabetic Patients in Lebanon: A Cross-Sectional Study

Authors: Farah Naja, Mohamad Alameddine

Abstract:

Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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1446 Applying the Eye Tracking Technique for the Evaluation of Oculomotor System in Patients Survived after Cerebellar Tumors

Authors: Marina Shurupova, Victor Anisimov, Alexander Latanov

Abstract:

Background: The cerebellar lesions inevitably provoke oculomotor impairments in patients of different age. Symptoms of subtentorial tumors, particularly medulloblastomas, include static and dynamic coordination disorders (ataxia, asynergia, imbalance), hypo-muscle tonus, disruption of the cranial nerves, and within the oculomotor system - nystagmus (fine or gross). Subtentorial tumors can also affect the areas of cerebellum that control the oculomotor system. The noninvasive eye-tracking technology allows obtaining multiple oculomotor characteristics such as the number of fixations and their duration, amplitude, latency and velocity of saccades, trajectory and scan path of gaze during the process of the visual field navigation. Eye tracking could be very useful in clinical studies serving as convenient and effective tool for diagnostics. The aim: We studied the dynamics of oculomotor system functioning in patients undergoing remission from cerebellar tumors removal surgeries and following neurocognitive rehabilitation. Methods: 38 children (23 boys, 15 girls, 9-17 years old) that have recovered from the cerebellar tumor-removal surgeries, radiation therapy and chemotherapy and were undergoing course of neurocognitive rehabilitation participated in the study. Two tests were carried out to evaluate oculomotor performance - gaze stability test and counting test. The monocular eye movements were recorded with eye tracker ArringtonResearch (60 Hz). Two experimental sessions with both tests were conducted before and after rehabilitation courses. Results: Within the final session of both tests we observed remarkable improvement in oculomotor performance: 1) in the gaze stability test the spread of gaze positions significantly declined compared to the first session, and 2) the visual path in counting test significantly shortened both compared to the first session. Thus, neurocognitive rehabilitation improved the functioning of the oculomotor system in patients following the cerebellar tumor removal surgeries and subsequent therapy. Conclusions: The experimental data support the effectiveness of the utilization of the eye tracking technique as diagnostic tool in the field of neurooncology.

Keywords: eye tracking, rehabilitation, cerebellar tumors, oculomotor system

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1445 Permanent Magnet Synchronous Generator: Unsymmetrical Point Operation

Authors: P. Pistelok

Abstract:

The article presents the concept of an electromagnetic circuit generator with permanent magnets mounted on the surface rotor core designed for single phase work. Computation field-circuit model was shown. The spectrum of time course of voltages in the idle work was presented. The cross section with graphically presentation of magnetic induction in particular parts of electromagnetic circuits was presented. Distribution of magnetic induction at the rated load point for each phase were shown. The time course of voltages and currents for each phases for rated power were displayed. An analysis of laboratory results and measurement of load characteristics of the generator was discussed. The work deals with three electromagnetic circuits of generators with permanent magnet where output voltage characteristics versus rated power were expressed.

Keywords: permanent magnet generator, permanent magnets, vibration, course of torque, single phase work, asymmetrical three phase work

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1444 Evaluation of Some Trace Elements in Biological Samples of Egyptian Viral Hepatitis Patients under Nutrition Therapy

Authors: Tarek Elnimr, Reda Morsy, Assem El Fert, Aziza Ismail

Abstract:

Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis, cirrhosis or liver cancer. Disease caused by the hepatitis virus, the virus can cause hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. A growing body of evidence indicates that many trace elements play important roles in a number of carcinogenic processes that proceed with various mechanisms. To examine the status of trace elements during the development of hepatic carcinoma, we determined the iron, copper, zinc and selenium levels in some biological samples of patients at different stages of viral hepatic disease. We observed significant changes in the iron, copper, zinc and selenium levels in the biological samples of patients hepatocellular carcinoma, relative to those of healthy controls. The mean hair, nail, RBC, serum and whole blood copper levels in patients with hepatitis virus were significantly higher than that of the control group. In contrast the mean iron, zinc, and selenium levels in patients having hepatitis virus were significantly lower than those of the control group. On the basis of this study, we identified the impact of natural supplements to improve the treatment of viral liver damage, using the level of some trace elements such as, iron, copper, zinc and selenium, which might serve as biomarkers for increases survival and reduces disease progression. Most of the elements revealed diverse and random distribution in the samples of the donor groups. The correlation study pointed out significant disparities in the mutual relationships among the trace elements in the patients and controls. Principal component analysis and cluster analysis of the element data manifested diverse apportionment of the selected elements in the scalp hair, nail and blood components of the patients compared with the healthy counterparts.

Keywords: hepatitis, hair, nail, blood components, trace element, nutrition therapy, multivariate analysis, correlation, ICP-MS

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1443 Metagenomic Analysis and Pharmacokinetics of Phage Therapy in the Treatment of Bovine Subclinical Mastitis

Authors: Vaibhav D. Bhatt, Anju P. Kunjadia, D. S. Nauriyal, Bhumika J. Joshi, Chaitanya G. Joshi

Abstract:

Metagenomic analysis of milk samples collected from local cattle breed, kankrej (Bos indicus), Gir (Bos indicus) and Crossbred (Bos indicus X Bos taurus) cattle harbouring subclinical mastitis was carried out by next-generation sequencing (NGS) 454 GS-FLX technology. Around 56 different species including members of Enterobacteriales, Pseudomonadales, Bacillales and Lactobacillales with varying abundance were detected in infected milk. The interesting presence of bacteriophages against Staphylococcus aureus, Escherichia coli, Enterobacter and Yersinia species were observed, especially Enterobacteria and E. coli phages (0∙32%) in Kankrej, Enterobacteria and Staphylococcus phages (1∙05%) in Gir and Staphylococcus phages (2∙32%) in crossbred cattle. NGS findings suggest that phages may be involved in imparting natural resistance of the cattle against pathogens. Further infected milk samples were subjected for bacterial isolation. Fourteen different isolates were identified, and DNA was extracted. Genes (Tet-K, Msr-A, and Mec-A) providing antibiotic resistance to the bacteria were screened by Polymerase Chain Reaction and results were validated with traditional antibiotic assay. Total 3 bacteriophages were isolated from nearby environment of the cattle farm. The efficacy of phages was checked against multi-drug resistant bacteria, identified by PCR. In-vivo study was carried out for phage therapy in mammary glands of female rats “Wister albino”. Mammary glands were infused with MDR isolates for 3 consecutive days. Recovery was observed in infected rats after intramammary infusion of sterile phage suspension. From day 4th onwards, level of C-reactive protein was significant increases up to day 12th . However, significant reduction was observed between days 12th to 18th post treatment. Bacteriophages have significant potential as antibacterial agents and their ability to replicate exponentially within their hosts and their specificity, make them ideal candidates for more sustainable mastitis control.

Keywords: bacteriophages, c-reactive protein, mastitis, metagenomic analysis

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1442 Serum Vitamin D and Carboxy-Terminal TelopeptideType I Collagen Levels: As Markers for Bone Health Affection in Patients Treated with Different Antiepileptic Drugs

Authors: Moetazza M. Al-Shafei, Hala Abdel Karim, Eitedal M. Daoud, Hassan Zaki Hassuna

Abstract:

Epilepsy is a common neurological disorder affecting all age groups. It is one of the world's most prevalent non-communicable diseases. Increased evidence suggesting that long term usage of anti-epileptic drugs can have adverse effects on bone mineralization and bone molding .Aiming to study these effects and to give guide lines to support bone health through early intervention. From Neurology Out-Patient Clinic kaser Elaini University Hospital, 60 Patients were enrolled, 40 patients on antiepileptic drugs for at least two years and 20 controls matched with age and sex, epileptic but before starting treatment both chosen under specific criteria. Patients were divided into four groups, three groups with monotherapy treated with either Phynetoin, Valporic acid or Carbamazipine and fourth group treated with both Valporic acid and Carbamazipine. Estimation of serum Carboxy-Terminal Telopeptide of Type I- Collagen(ICTP) bone resorption marker, serum 25(OH )vit D3, calcium ,magnesium and phosphorus were done .Results showed that all patients on AED had significant low levels of 25(OH) vit D3 (p<0.001) ,with significant elevation of ICTP (P<0.05) versus controls. In group treated with Phynotoin highly significant elevation of (ICTP) marker and decrease of both serum 25(OH) vit D3 (P<0, 0001) and serum calcium(P<0.05)versus control. Double drug group showed significant decrease of serum 25(OH) vit D3 (P<0.0001) and decrease in Phosphorus (P<0.05) versus controls. Serum magnesium showed no significant differences between studied groups. We concluded that Anti- epileptic drugs appears to be an aggravating factor on bone mineralization ,so therapeutically it can be worth wile to supplement calcium and vitamin D even before initiation of antiepileptic therapy. ICTP marker can be used to evaluate change in bone resorption before and during AED therapy.

Keywords: antiepileptic drugs, bone minerals, carboxy teminal telopeptidetype-1-collagen bone resorption marker, vitamin D

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1441 Comparative Efficacy of Angiotensin Converting Enzymes Inhibitors and Angiotensin Receptor Blockers in Patients with Heart Failure in Tanzania: A Prospective Cohort Study

Authors: Mark P. Mayala, Henry Mayala, Khuzeima Khanbhai

Abstract:

Background: Heart failure has been a rising concern in Tanzania. New drugs have been introduced, including the group of drugs called Angiotensin receptor Neprilysin Inhibitor (ARNI), but due to their high cost, angiotensin-converting enzymes inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) have been mostly used in Tanzania. However, according to our knowledge, the efficacy comparison of the two groups is yet to be studied in Tanzania. The aim of this study was to compare the efficacy of ACEIs and ARBs among patients with heart failure. Methodology: This was a hospital-based prospective cohort study done at Jakaya Kikwete Cardiac Institution (JKCI), Tanzania, from June to December 2020. Consecutive enrollment was done until fulfilling the inclusion criteria. Clinical details were measured at baseline. We assessed the relationship between ARBs and ACEIs users with N-terminal pro-brain natriuretic peptide (NT pro-BNP) levels at admission and at 1-month follow-up using a chi-square test. A Kaplan-Meier curve was used to estimate the survival time of the two groups. Results: 155 HF patients were enrolled, with a mean age of 48 years, whereby 52.3% were male, and their mean left ventricular ejection fraction (LVEF) was 37.3%. 52 (33.5%) heart failure patients were on ACEIs, 57 (36.8%) on ARBs, and 46 (29.7%) were neither using ACEIs nor ARBs. At least half of the patients did not receive a guideline-directed medical therapy (GDMT), with only 82 (52.9%) receiving a GDMT. A drop in NT pro-BNP levels was observed during admission and at 1-month follow-up on both groups, from 6389.2 pg/ml to 4000.1 pg/ml for ARB users and 5877.7 pg/ml to 1328.2 pg/ml for the ACEIs users. There was no statistical difference between the two groups when estimated by the Kaplan-Meier curve, though more deaths were observed in those who were neither on ACEIs nor ARBs, with a calculated P value of 0.01. Conclusion: This study demonstrates that ACEIs have more efficacy and overall better clinical outcome than ARBs, but this should be taken under the patient-based case, considering the side effects of ACEIs and patients’ adherence.

Keywords: angiotensin converting enzymes inhibitors, angiotensin receptor blockers, guideline direct medical therapy, N-terminal pro-brain natriuretic peptide

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1440 Effect of Nicorandil, Bone Marrow-Derived Mesenchymal Stem Cells and Their Combination in Isoproterenol-Induced Heart Failure in Rats

Authors: Sarah Elsayed Mohammed, Lamiaa Ahmed Ahmed, Mahmoud Mohammed Khattab

Abstract:

Aim: The aim of the present study was to investigate whether combined nicorandil and bone marrow-derived mesenchymal stem cells (BMDMSC) treatment could offer an additional benefit in ameliorating isoproterenol (ISO)-induced heart failure in rats. Methods: ISO (85 and 170 mg/kg/day) was injected subcutaneously for 2 successive days, respectively. By day 3, electrocardiographic changes were recorded and serum was separated for determination of CK-MB level for confirmation of myocardial damage. Nicorandil (3 mg/kg/day) was then given orally with or without a single i.v. BMDMSC administration. Electrocardiography and echocardiography were recorded 2 weeks after beginning of treatment. Rats were then sacrificed and ventricles were isolated for estimation of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) contents, caspase-3 activity as well as inducible nitric oxide synthase (iNOS) and connexin-43 protein expressions. Moreover, histological analysis of myocardial fibrosis was performed and cryosections were done for estimation of homing of BMDMSC. Results: ISO induced a significant increase in ventricles/body weight ratio, left ventricular end diastolic (LVEDD) and systolic dimensions (LVESD), ST segment and QRS duration. Moreover, myocardial fibrosis as well as VEGF, TNF-α and TGF-β contents were significantly increased. On the other hand, connexin-43 protein expression was significantly decreased, while caspase-3 and iNOS protein expressions were significantly increased. Combined therapy provided additional improvement compared to cell treatment alone towards reducing cardiac hypertrophy, fibrosis and inflammation. Furthermore, combined therapy induced significant increase in angiogenesis and BMDMSC homing and prevented ISO induced changes in iNOS, connexin-43 and caspase-3 protein expressions. Conclusion: Combined nicorandil/BMDMSC treatment was superior to BMDMSC alone towards preventing ISO-induced heart failure in rats.

Keywords: fibrosis, isoproterenol, mesenchymal stem cells, nicorandil

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1439 Heat Pipe Production and Life Performance Tests in Geosynchronous Telecom Satellites

Authors: Erkam Arslantas

Abstract:

Heat pipes one of the thermal control elements are used in communication satellites. A selection of the heat pipes of satellite thermal design will be emphasized how important and effective it is. In this article, manufacturing and performance control tests of heat pipes are reviewed from the current literature. The heat pipe is expected to function efficiently during all missions of the spacecraft from Beginning of Life (BOL) to End of Life (EOL). There are many parameters that are evaluated in manufacturing and performance control tests of the heat pipes which are used in satellites. These parameters are pressure design, leakage, noncondensable gas level (N.C.G), sine vibration, shock and static load capabilities, aging, bending, proof, final test etc. These parameters will be explained separately for the heat pipes in this review article and young researches working on the thermal control system of Geosynchronous Satellites systems can find easily related information in this article.

Keywords: communication satellite, heat pipe, performance test, thermal control

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1438 Optimization of a Cone Loudspeaker Parameter of Design Parameters by Analysis of a Narrow Acoustic Sound Pathway

Authors: Yue Hu, Xilu Zhao, Takao Yamaguchi, Manabu Sasajima, Yoshio Koike, Akira Hara

Abstract:

This study tried optimization of design parameter of a cone loudspeaker unit as an example of the high flexibility of the products design. We developed an acoustic analysis software program that considers the impact of damping caused by air viscosity. In sound reproduction, it is difficult to each design the parameter of the loudspeaker. To overcome the limitation of the design problem in practice, this paper proposes a new an acoustic analysis algorithm to optimize design the parameter of the loudspeaker. The material character of cone paper and the loudspeaker edge was the design parameter, and the vibration displacement of the cone paper was the objective function. The results of the analysis were compared with the predicted value. They had high accuracy to the predicted value. These results suggest that, though the parameter design is difficult by experience and intuition, it can be performed comparatively easily using the optimization design by the developed acoustic analysis software.

Keywords: air viscosity, loudspeaker, cone paper, edge, optimization

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1437 Readout Development of a LGAD-based Hybrid Detector for Microdosimetry (HDM)

Authors: Pierobon Enrico, Missiaggia Marta, Castelluzzo Michele, Tommasino Francesco, Ricci Leonardo, Scifoni Emanuele, Vincezo Monaco, Boscardin Maurizio, La Tessa Chiara

Abstract:

Clinical outcomes collected over the past three decades have suggested that ion therapy has the potential to be a treatment modality superior to conventional radiation for several types of cancer, including recurrences, as well as for other diseases. Although the results have been encouraging, numerous treatment uncertainties remain a major obstacle to the full exploitation of particle radiotherapy. To overcome therapy uncertainties optimizing treatment outcome, the best possible radiation quality description is of paramount importance linking radiation physical dose to biological effects. Microdosimetry was developed as a tool to improve the description of radiation quality. By recording the energy deposition at the micrometric scale (the typical size of a cell nucleus), this approach takes into account the non-deterministic nature of atomic and nuclear processes and creates a direct link between the dose deposited by radiation and the biological effect induced. Microdosimeters measure the spectrum of lineal energy y, defined as the energy deposition in the detector divided by most probable track length travelled by radiation. The latter is provided by the so-called “Mean Chord Length” (MCL) approximation, and it is related to the detector geometry. To improve the characterization of the radiation field quality, we define a new quantity replacing the MCL with the actual particle track length inside the microdosimeter. In order to measure this new quantity, we propose a two-stage detector consisting of a commercial Tissue Equivalent Proportional Counter (TEPC) and 4 layers of Low Gain Avalanche Detectors (LGADs) strips. The TEPC detector records the energy deposition in a region equivalent to 2 um of tissue, while the LGADs are very suitable for particle tracking because of the thickness thinnable down to tens of micrometers and fast response to ionizing radiation. The concept of HDM has been investigated and validated with Monte Carlo simulations. Currently, a dedicated readout is under development. This two stages detector will require two different systems to join complementary information for each event: energy deposition in the TEPC and respective track length recorded by LGADs tracker. This challenge is being addressed by implementing SoC (System on Chip) technology, relying on Field Programmable Gated Arrays (FPGAs) based on the Zynq architecture. TEPC readout consists of three different signal amplification legs and is carried out thanks to 3 ADCs mounted on a FPGA board. LGADs activated strip signal is processed thanks to dedicated chips, and finally, the activated strip is stored relying again on FPGA-based solutions. In this work, we will provide a detailed description of HDM geometry and the SoC solutions that we are implementing for the readout.

Keywords: particle tracking, ion therapy, low gain avalanche diode, tissue equivalent proportional counter, microdosimetry

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1436 Tablet Computer Based Cognitive Rehabilitation Program, Injini, for Children with Cognitive Impairment

Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

Abstract:

Cognitive impairment is commonly encountered problem in children with various clinical diseases, including Down syndrome, autism spectrum disorder, brain injury, and others. Cognitive impairment limits participation in education and society, and this further hinders development in cognition. However, young children with cognitive impairment tend not to respond well to traditional cognitive treatments, therefore alternative treatment choices are need. As a cognitive training program, touch screen technology can easily be applied to very young children by involving visual and auditory support. Injini was developed as tablet computer based cognitive rehabilitation program for young children or individuals with severe cognitive impairment, which targeted on cognitive ages of 18 to 36 months. The aim of this study was to evaluate the efficacy of a tablet computer based cognitive rehabilitation program (Injini) for children with cognitive impairment. 38 children between cognitive ages of 18 to 36 months confirmed by cognitive evaluations were recruited and randomly assigned to the intervention group (n=20) and the control group (n=18). The intervention group received tablet computer based cognitive rehabilitation program (Injini) for 30 minutes per session, twice a week, over a period of 12 weeks, in addition to the traditional rehabilitation program. The control group received traditional rehabilitation program only. Mental score of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), Laboratory Temperament Assessment Battery (Lab-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. When comparing the baseline characteristics, there was no significant difference between the two groups in the measurements of cognitive function. After 12 weeks of treatment, both group showed improvements in all measurements. However, in comparison of improvements after treatment, the intervention group showed more improvements in the mental score of BSID II, social function domain of PEDI, observation domain of Lab-TAB, and GAS, as compared to the control group. Application of the tablet computer based cognitive rehabilitation program (Injini) would be beneficial for improvement of cognitive function in young children with cognitive impairment.

Keywords: cognitive therapy, computer-assisted therapy, early intervention, tablets

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1435 Mistuning in Radial Inflow Turbines

Authors: Valentina Futoryanova, Hugh Hunt

Abstract:

One of the common failure modes of the diesel engine turbochargers is high cycle fatigue of the turbine wheel blades. Mistuning of the blades due to the casting process is believed to contribute to the failure mode. Laser vibrometer is used to characterize mistuning for a population of turbine wheels through the analysis of the blade response to piezo speaker induced noise. The turbine wheel design under investigation is radial and is typically used in 6-12 L diesel engine applications. Amplitudes and resonance frequencies are reviewed and summarized. The study also includes test results for a paddle wheel that represents a perfectly tuned system and acts as a reference. Mass spring model is developed for the paddle wheel and the model suitability is tested against the actual data. Randomization is applied to the stiffness matrix to model the mistuning effect in the turbine wheels. Experimental data is shown to have good agreement with the model.

Keywords: vibration, radial turbines, mistuning, turbine blades, modal analysis, periodic structures, finite element

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1434 An Investigation of Water Atomizer in Ejected Gas of a Vehicle Engine

Authors: Chun-Wei Liu, Feng-Tsai Weng

Abstract:

People faced pollution threaten in modern age although the standard of exhaust gas of vehicles has been established. The goal of this study is to investigate the effect of water atomizer in a vehicle emission system. Diluted 20% ammonia water was used in spraying system. Micro particles produced by exhausted gas from engine of vehicle which were cumulated through atomized spray in a self-development collector. In experiments, a self-designed atomization model plate and a gas tank controlled by the micro-processor using Pulse Width Modulation (PWM) logic was prepared for exhaust test. The gas from gasoline-engine of vehicle was purified with the model panel collector. A soft well named ANSYS was utilized for analyzing the distribution condition of rejected gas. Micro substance and percentage of CO, HC, CO2, NOx in exhausted gas were investigated at different engine speed, and atomizer vibration frequency. Exceptional results in the vehicle engine emissions measurement were obtained. The temperature of exhausted gas can be decreased 3oC. Micro substances PM10 can be decreased and the percentage of CO can be decreased more than 55% at 2500RPM by proposed system. Value of CO, HC, CO2 and NOX was all decreased when atomizers were used with water.

Keywords: atomizer, CO, HC, NOx, PM2.5

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1433 Concanavaline a Conjugated Bacterial Polyester Based PHBHHx Nanoparticles Loaded with Curcumin for the Ovarian Cancer Therapy

Authors: E. Kilicay, Z. Karahaliloglu, B. Hazer, E. B. Denkbas

Abstract:

In this study, we have prepared concanavaline A (ConA) functionalized curcumin (CUR) loaded PHBHHx (poly(3-hydroxybutyrate-co-3-hydroxyhexanoate)) nanoparticles as a novel and efficient drug delivery system. CUR is a promising anticancer agent for various cancer types. The aim of this study was to evaluate therapeutic potential of curcumin loaded PHBHHx nanoparticles (CUR-NPs) and concanavaline A conjugated curcumin loaded NPs (ConA-CUR NPs) for ovarian cancer treatment. ConA was covalently connected to the carboxylic group of nanoparticles by EDC/NHS activation method. In the ligand attachment experiment, the binding capacity of ConA on the surface of NPs was found about 90%. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) analysis showed that the prepared nanoparticles were smooth and spherical in shape. The size and zeta potential of prepared NPs were about 228±5 nm and −21.3 mV respectively. ConA-CUR NPs were characterized by FT-IR spectroscopy which confirmed the existence of CUR and ConA in the nanoparticles. The entrapment and loading efficiencies of different polymer/drug weight ratios, 1/0.125 PHBHHx/CUR= 1.25CUR-NPs; 1/0.25 PHBHHx/CUR= 2.5CUR-NPs; 1/0.5 PHBHHx/CUR= 5CUR-NPs, ConA-1.25CUR NPs, ConA-2.5CUR NPs and ConA-5CUR NPs were found to be ≈ 68%-16.8%; 55%-17.7 %; 45%-33.6%; 70%-15.7%; 60%-17%; 51%-30.2% respectively. In vitro drug release showed that the sustained release of curcumin was observed from CUR-NPs and ConA-CUR NPs over a period of 19 days. After binding of ConA, the release rate was slightly increased due to the migration of curcumin to the surface of the nanoparticles and the matrix integrities was decreased because of the conjugation reaction. This functionalized nanoparticles demonstrated high drug loading capacity, sustained drug release profile, and high and long term anticancer efficacy in human cancer cell lines. Anticancer activity of ConA-CUR NPs was proved by MTT assay and reconfirmed by apoptosis and necrosis assay. The anticancer activity of ConA-CUR NPs was measured in ovarian cancer cells (SKOV-3) and the results revealed that the ConA-CUR NPs had better tumor cells decline activity than free curcumin. The nacked nanoparticles have no cytotoxicity against human ovarian carcinoma cells. Thus the developed functionalized nanoformulation could be a promising candidate in cancer therapy.

Keywords: curcumin, curcumin-PHBHHx nanoparticles, concanavalin A, concanavalin A-curcumin PHBHHx nanoparticles, PHBHHx nanoparticles, ovarian cancer cell

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1432 Treating Complex Pain and Addictions with Bioelectrode Therapy: An Acupuncture Point Stimulus Method for Relieving Human Suffering

Authors: Les Moncrieff

Abstract:

In a world awash with potent opioids flaming an international crisis, the need to explore safe alternatives has never been more urgent. Bio-electrode Therapy is a novel adjunctive treatment method for relieving acute opioid withdrawal symptoms and many types of complex acute and chronic pain (often the underlying cause of opioid dependence). By combining the science of developmental bioelectricity with Traditional Chinese Medicine’s theory of meridians, rapid relief from pain is routinely being achieved in the clinical setting. Human body functions are dependent on electrical factors, and acupuncture points on the body are known to have higher electrical conductivity than surrounding skin tissue. When tiny gold- and silver-plated electrodes are secured to the skin at specific acupuncture points using established Chinese Medicine principles and protocols, an enhanced microcurrent and electrical field are created between the electrodes, influencing the entire meridian and connecting meridians. No external power source or electrical devices are required. Endogenous DC electric fields are an essential fundamental component for development, regeneration, and wound healing. Disruptions in the normal ion-charge in the meridians and circulation of blood will manifest as pain and development of disease. With the application of these simple electrodes (gold acting as cathode and silver as anode) according to protocols, the resulting microcurrent is directed along the selected meridians to target injured or diseased organs and tissues. When injured or diseased cells have been stimulated by the microcurrent and electrical fields, the permeability of the cell membrane is affected, resulting in an immediate relief of pain, a rapid balancing of positive and negative ions (sodium, potassium, etc.) in the cells, the restoration of intracellular fluid levels, replenishment of electrolyte levels, pH balance, removal of toxins, and a re-establishment of homeostasis.

Keywords: bioelectricity, electrodes, electrical fields, acupuncture meridians, complex pain, opioid withdrawal management

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1431 Improving Depression, Anxiety and Distress Symptoms in Type 2 Diabetes Patients

Authors: Seyed Reza Alvani, Norzarina Mohd Zaharim

Abstract:

Diabetes mellitus is one of the chronic, progressive illnesses that has reached a widespread level all over the world and considered an extreme life-threatening condition in South East Asian countries region include Malaysia. Co-morbid psychological factors like diabetes-related distress and low level of psychological well-being are related to high levels of blood sugar and hypo/hyperglycemia complications. As a result, the implementation of any effective psychological interventions among diabetes patients is necessary. One such intervention is cognitive behavioural therapy (CBT) that is approved and suggested by many professionals as an empirically-supported technique of treatment for people how are suffering from diabetes around the world where there is no clear evidence of using this technique in Malaysia. The target of this study was to see whether or not participation in group CBT would end in an improvement of psychological well-being (by decreasing the levels of depression and anxiety) and diabetes-related distress followed by lower level of blood sugar level. The sample of the present study was 60 type 2 diabetes adults (ages 20-65) with HbA1c ≥ 7 from Universiti Sains Malaysia (USM) clinic. All participants were selected by the convenience sampling technique. Participants completed Well-Being Questionaire (W-BQ) and Distress Scale (DDS-17) after signing written consent form. Those participants who were interested to join CBT groups were placed to the experimental groups, and people who were not interested were assigned to the control group. The experimental groups (n = 30) received group CBT, whereas participants in the control group (n = 30) did not receive any kind of psychological intervention. For testing the effect of intervention, mixed between-within ANOVA used. The entire intervention program took three months, and a significant improvement in the level of psychological well-being and decline in the level of diabetes distress observed among participants from experimental group, but not for those in the control group. Additionally, the result of the study suggested that group CBT could help participants in experimental group achieve more acceptable HbA1c levels in comparison with those in the control group. Malaysian Ministry of Health, researcher and governors should give due interest and commitment to psychological care as a pathway to diabetes mitigation among Malaysian adults.

Keywords: cognitive behavioral therapy, diabetes related distress, diabetes type 2, Malaysia, well-being

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1430 Combined Treatment with Microneedling and Chemical Peels Improves Periorbital Wrinkles and Skin Laxity

Authors: G. Kontochristopoulos, T. Spiliopoulos, V. Markantoni, E. Platsidaki, A. Kouris, E. Balamoti, C. Bokotas, G. Haidemenos

Abstract:

Introduction: There is a high patient demand for periorbital rejuvenation since the facial area is often the first to show visible signs of aging. With advancing age, there are sometimes marked changes that occur in the skin, fat, muscle and bone of the periorbital region, resulting to wrinkles and skin laxity. These changes are among the easiest areas to correct using several minimally invasive techniques, which have become increasingly popular over the last decade. Lasers, radiofrequency, botulinum toxin, fat grafting and fillers are available treatments sometimes in combination to traditional blepharoplasty. This study attempts to show the benefits of a minimally invasive approach to periorbital wrinkles and skin laxity that combine microneedling and 10% trichloroacetic acid (TCA) peels. Method: Eleven female patients aged 34-72 enrolled in the study. They all gave informed consent after receiving detailed information regarding the treatment procedure. Exclusion criteria in the study were previous treatment for the same condition in the past six months, pregnancy, allergy or hypersensitivity to the components, infection, inflammation and photosensitivity on the affected region. All patients had diffuse periorbital wrinkles and mild to moderate upper or lower eyelid skin laxity. They were treated with Automatic Microneedle Therapy System-Handhold and topical application of 10% trichloroacetic acid solution to each periorbital area for five minutes. Needling at a 0,25 mm depth was performed in both latelar (x-y) directions. Subsequently, the peeling agent was applied to each periorbital area for five minutes. Patients were subjected to the above combination every two weeks for a series of four treatments. Subsequently they were followed up regularly every month for two months. The effect was photo-documented. A Physician's and a Patient's Global Assessment Scale was used to evaluate the efficacy of the treatment (0-25% indicated poor response, 25%-50% fair, 50%-75% good and 75%-100% excellent response). Safety was assessed by monitoring early and delayed adverse events. Results: At the end of the study, almost all patients demonstrated significant aesthetic improvement. Physicians assessed a fair and a good improvement in 9(81.8% of patients) and 2(18.1% of patients) participants respectively. Patients Global Assessment rated a fair and a good response in 6 (54.5%) and 5 (45.4%) participants respectively. The procedure was well tolerated and all patients were satisfied. Mild discomfort and transient erythema were quite common during or immediately after the procedure, however only temporary. During the monthly follow up, no complications or scars were observed. Conclusions: Microneedling is known as a simple, office–based collagen induction therapy. Low concentration TCA solution applied to the epidermis that has been more permeable by microneedling, can reach the dermis more effectively. In the present study, chemical peels with 10% TCA acted as an adjuvant to microneedling, as it causes controlled skin damage, promoting regeneration and rejuvenation of tissues. This combined therapy improved periorbital fine lines, wrinkles, and overall appearance of the skin. Thus it constitutes an alternative treatment of periorbital skin aging, with encouraging results and minor side-effects.

Keywords: chemical peels, microneedling, periorbital wrinkles, skin laxity

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1429 Analysis of Building Response from Vertical Ground Motions

Authors: George C. Yao, Chao-Yu Tu, Wei-Chung Chen, Fung-Wen Kuo, Yu-Shan Chang

Abstract:

Building structures are subjected to both horizontal and vertical ground motions during earthquakes, but only the horizontal ground motion has been extensively studied and considered in design. Most of the prevailing seismic codes assume the vertical component to be 1/2 to 2/3 of the horizontal one. In order to understand the building responses from vertical ground motions, many earthquakes records are studied in this paper. System identification methods (ARX Model) are used to analyze the strong motions and to find out the characteristics of the vertical amplification factors and the natural frequencies of buildings. Analysis results show that the vertical amplification factors for high-rise buildings and low-rise building are 1.78 and 2.52 respectively, and the average vertical amplification factor of all buildings is about 2. The relationship between the vertical natural frequency and building height was regressed to a suggested formula in this study. The result points out an important message; the taller the building is, the greater chance of resonance of vertical vibration on the building will be.

Keywords: vertical ground motion, vertical amplification factor, natural frequency, component

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1428 Isolation and Molecular Characterization of Lytic Bacteriophage against Carbapenem Resistant Klebsiella pneumoniae

Authors: Guna Raj Dhungana, Roshan Nepal, Apshara Parajuli, , Archana Maharjan, Shyam K. Mishra, Pramod Aryal, Rajani Malla

Abstract:

Introduction: Klebsiella pneumoniae is a well-known opportunistic human pathogen, primarily causing healthcare-associated infections. The global emergence of carbapenemase-producing K. pneumoniaeis a major public health burden, which is often extensively multidrug resistant.Thus, because of the difficulty to treat these ‘superbug’ and menace and some term as ‘apocalypse’ of post antibiotics era, an alternative approach to controlling this pathogen is prudent and one of the approaches is phage mediated control and/or treatment. Objective: In this study, we aimed to isolate novel bacteriophage against carbapenemase-producing K. pneumoniaeand characterize for potential use inphage therapy. Material and Methods: Twenty lytic phages were isolated from river water using double layer agar assay and purified. Biological features, physiochemical characters, burst size, host specificity and activity spectrum of phages were determined. One most potent phage: Phage TU_Kle10O was selected and characterized by electron microscopy. Whole genome sequences of the phage were analyzed for presence/absence of virulent factors, and other lysin genes. Results: Novel phage TU_Kle10O showed multiple host range within own genus and did not induce any BIM up to 5th generation of host’s life cycle. Electron microscopy confirmed that the phage was tailed and belonged to Caudovirales family. Next generation sequencing revealed its genome to be 166.2 Kb. bioinformatical analysis further confirmed that the phage genome ‘did not’ contain any ‘bacterial genes’ within phage genome, which ruled out the concern for transfer of virulent genes. Specific 'lysin’ enzyme was identified phages which could be used as 'antibiotics'. Conclusion: Extensively multidrug resistant bacteria like carbapenemase-producing K. pneumoniaecould be treated efficiently by phages.Absence of ‘virulent’ genes of bacterial origin and presence of lysin proteins within phage genome makes phages an excellent candidate for therapeutics.

Keywords: bacteriophage, Klebsiella pneumoniae, MDR, phage therapy, carbapenemase,

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1427 Revising the Student Experiment Materials and Practices at the National University of Laos

Authors: Syhalath Xaphakdy, Toshio Nagata, Saykham Phommathat, Pavy Souwannavong, Vilayvanh Srithilat, Phoxay Sengdala, Bounaom Phetarnousone, Boualay Siharath, Xaya Chemcheng

Abstract:

The National University of Laos (NUOL) invited a group of volunteers from the Japan International Cooperation Agency (JICA) to revise the physics experiments to utilize the materials that were already available to students. The intension was to review and revise the materials regularly utilized in physics class. The project had access to limited materials and a small budget for the class in the unit; however, by developing experimental textbooks related to mechanics, electricity, and wave and vibration, the group found a way to apply them in the classroom and enhance the students teaching activities. The aim was to introduce a way to incorporate the materials and practices in the classroom to enhance the students learning and teaching skills, particularly when they graduate and begin working as high school teachers.

Keywords: NUOL, JICA, physics experiment materials, small budget, mechanics, electricity

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1426 Effect of Pulmonary Rehabilitation towards Length of Stay and IL-6 Level on Community-Acquired Pneumonia Patients

Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

Abstract:

Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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1425 Study of Effect of Steering Column Orientation and Operator Platform Position on the Hand Vibration in Compactors

Authors: Sunil Bandaru, Suresh Yv, Srinivas Vanapalli

Abstract:

Heavy machinery especially compactors has more vibrations induced from the compactor mechanism than the engines. Since the operator’s comfort is most important in any of the machines, this paper shows interest in studying the vibrations on the steering wheel for a double drum compactor. As there are no standard procedures available for testing vibrations on the steering wheel of double drum compactors, this paper tries to evaluate the vibrations on the steering wheel by considering most of the possibilities. In addition to the feasibility for the operator to adjust the steering wheel tilt as in the case of automotive, there is an option for the operator to change the orientation of the operator platform for the complete view of the road’s edge on both the ends of the front and rear drums. When the orientation is either +/-180°, the operator will be closer to the compactor mechanism; also there is a possibility for the shuffle in the modes with respect to the operator. Hence it is mandatory to evaluate the vibrations levels in both cases. This paper attempts to evaluate the vibrations on the steering wheel by considering the two operator platform positions and three steering wheel tilting angles.

Keywords: FEA, CAE, steering column, steering column orientation position

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1424 Thermomechanical Processing of a CuZnAl Shape-Memory Alloy

Authors: Pedro Henrique Alves Martins, Paulo Guilherme Ferreira De Siqueira, Franco De Castro Bubani, Maria Teresa Paulino Aguilar, Paulo Roberto Cetlin

Abstract:

Cu-base shape-memory alloys (CuZnAl, CuAlNi, CuAlBe, etc.) are promising engineering materials for several unconventional devices, such as sensors, actuators, and mechanical vibration dampers. Brittleness is one of the factors that limit the commercial use of these alloys, as it makes thermomechanical processing difficult. In this work, a method for the hot extrusion of a 75.50% Cu, 16,74% Zn, 7,76% Al (weight %) alloy is presented. The effects of the thermomechanical processing in the microstructure and the pseudoelastic behavior of the alloy are assessed by optical metallography, compression and hardness tests. Results show that hot extrusion is a suitable method to obtain severe cross-section reductions in the CuZnAl shape-memory alloy studied. The alloy maintained its pseudoelastic effect after the extrusion and the modifications in the mechanical behavior caused by precipitation during hot extrusion can be minimized by a suitable precipitate dissolution heat treatment.

Keywords: hot extrusion, pseudoelastic, shape-memory alloy, thermomechanical processing

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1423 Comparison of the Dose Reached to the Rectum and Bladder in Two Treatment Methods by Tandem and Ovoid and Tandem and Ring in the High Dose Rate Brachytherapy of Cervical Cancer

Authors: Akbar Haghzadeh Saraskanroud, Amir Hossein Yahyavi Zanjani, Niloofar Kargar, Hanieh Ahrabi

Abstract:

Cervical cancer refers to an unusual growth of cells in the cervix. The cervix is the lower part of the uterus, which connects to the vagina. Various risk factors such as human papillomavirus (HPV), having a weakened immune system, smoking or breathing in secondhand smoke, reproductive factors, and obesity play important roles in causing most cervical cancers. When cervical cancer happens, surgery is often the first treatment option to remove it. Other treatments might include chemotherapy and targeted therapy medicines. Radiation therapy with high-energy photon beams also may be used. Sometimes combined treatment, including radiation with low-dose chemotherapy, was applied. Intracavitary brachytherapy is an integral part of radiotherapy for locally advanced gynecologic malignancies such as cervical cancer. In the treatment of cervical cancer, there are different tools for doing brachytherapy. Two combinations of different applicators for this purpose are Tandem and Ovoid and Tandem and Ring. This study evaluated the dose differences between these two methods in the organs at risk of the rectum, sigmoid, and bladder. In this study, the treatment planswere simulated by the Oncentra treatment planning system and Tandem, Ovid, and Rings of different sizes. CT scan images of 23 patients were treated with HDR_BT Elekta Flexitron system were used for this study. Contouring of HR-CTV, rectum and bladder was performed for all patients. Then, the received dose of 0.1 and 0.2cc volumes of organs at risk were obtained and compared for these two methods: T-Ovoid and T-Ring. By doing investigations and dose measurements of points A and B and the volumes specified by ICRU, it seems that when comparing ring and ovoid to tandem and ovoid, the total dose to the rectum was lower by about 11%, and the bladder was 7%. In the case of HR CTV, this comparison showed that this ratio is about 7% better. Figure 1 shows the amount of decrease in rectum dose in the T-Ring method compared to T-Ovoid. Figure 2 indicates the amount of decrease in bladder dose in the T-Ring method compared to T-Ovoid. Finally, figure 3 illustrates the amount of HR-CTV coverage in the T-Ring method compared to the T-Ovoid.

Keywords: cervical cancer, brachytherapy, rectum, tandem and ovoid, tandem and ring.

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1422 Wave State of Self: Findings of Synchronistic Patterns in the Collective Unconscious

Authors: R. Dimitri Halley

Abstract:

The research within Jungian Psychology presented here is on the wave state of Self. What has been discovered via shared dreaming, independently correlating dreams across dreamers, is beyond the Self stage into the deepest layer or the wave state Self: the very quantum ocean, the Self archetype is embedded in. A quantum wave or rhyming of meaning constituting synergy across several dreamers was discovered in dreams and in extensively shared dream work with small groups at a post therapy stage. Within the format of shared dreaming, we find synergy patterns beyond what Jung called the Self archetype. Jung led us up to the phase of Individuation and delivered the baton to Von Franz to work out the next synchronistic stage, here proposed as the finding of the quantum patterns making up the wave state of Self. These enfolded synchronistic patterns have been found in group format of shared dreaming of individuals approximating individuation, and the unfolding of it is carried by belief and faith. The reason for this format and operating system is because beyond therapy and of living reality, we find no science – no thinking or even awareness in the therapeutic sense – but rather a state of mental processing resembling more like that of spiritual attitude. Thinking as such is linear and cannot contain the deepest layer of Self, the quantum core of the human being. It is self reflection which is the container for the process at the wave state of Self. Observation locks us in an outside-in reactive flow from a first-person perspective and hence toward the surface we see to believe, whereas here, the direction of focus shifts to inside out/intrinsic. The operating system or language at the wave level of Self is thus belief and synchronicity. Belief has up to now been almost the sole province of organized religions but was viewed by Jung as an inherent property in the process of Individuation. The shared dreaming stage of the synchronistic patterns forms a larger story constituting a deep connectivity unfolding around individual Selves. Dreams of independent dreamers form larger patterns that come together as puzzles forming a larger story, and in this sense, this group work level builds on Jung as a post individuation collective stage. Shared dream correlations will be presented, illustrating a larger story in terms of trails of shared synchronicity.

Keywords: belief, shared dreaming, synchronistic patterns, wave state of self

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1421 Effectiveness of Medication and Non-Medication Therapy on Working Memory of Children with Attention Deficit and Hyperactivity Disorder

Authors: Mohaammad Ahmadpanah, Amineh Akhondi, Mohammad Haghighi, Ali Ghaleiha, Leila Jahangard, Elham Salari

Abstract:

Background: Working memory includes the capability to keep and manipulate information in a short period of time. This capability is the basis of complicated judgments and has been attended to as the specific and constant character of individuals. Children with attention deficit and hyperactivity are among the people suffering from deficiency in the active memory, and this deficiency has been attributed to the problem of frontal lobe. This study utilizes a new approach with suitable tasks and methods for training active memory and assessment of the effects of the trainings. Participants: The children participating in this study were of 7-15 year age, who were diagnosed by the psychiatrist and psychologist as hyperactive and attention deficit based on DSM-IV criteria. The intervention group was consisted of 8 boys and 6 girls with the average age of 11 years and standard deviation of 2, and the control group was consisted of 2 girls and 5 boys with an average age of 11.4 and standard deviation of 3. Three children in the test group and two in the control group were under medicinal therapy. Results: Working memory training meaningfully improved the performance in not-trained areas as visual-spatial working memory as well as the performance in Raven progressive tests which are a perfect example of non-verbal, complicated reasoning tasks. In addition, motional activities – measured based on the number of head movements during computerized measuring program – was meaningfully reduced in the medication group. The results of the second test showed that training similar exercise to teenagers and adults results in the improvement of cognition functions, as in hyperactive people. Discussion: The results of this study showed that the performance of working memory is improved through training, and these trainings are extended and generalized in other areas of cognition functions not receiving any training. Trainings resulted in the improvement of performance in the tasks related to prefrontal. They had also a positive and meaningful impact on the moving activities of hyperactive children.

Keywords: attention deficit hyperactivity disorder, working memory, non-medical treatment, children

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1420 Conceptual Design of a Customer Friendly Variable Volume and Variable Spinning Speed Washing Machine

Authors: C. A. Akaash Emmanuel Raj, V. R. Sanal Kumar

Abstract:

In this paper using smart materials we have proposed a specially manufactured variable volume spin tub for loading clothes for negating the vibration to a certain extent for getting better operating performance. Additionally, we have recommended a variable spinning speed rotor for handling varieties of garments for an efficient washing, aiming for increasing the life span of both the garments and the machine. As a part of the conflicting dynamic constraints and demands of the customer friendly design optimization of a lucrative and cosmetic washing machine we have proposed a drier and a desalination system capable to supply desirable heat and a pleasing fragrance to the garments. We thus concluded that while incorporating variable volume and variable spinning speed tub integrated with a drier and desalination system, the washing machine could meet the varieties of domestic requirements of the customers cost-effectively.

Keywords: customer friendly washing machine, drier design, quick cloth cleaning, variable tub volume washing machine, variable spinning speed washing machine

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1419 Acute Myeloid Leukemia Relapse in an a Rare form After Treating his Tuberculosis TB

Authors: Sheikha Turki Alketbi

Abstract:

Objectives: 1. Documenting the spontaneous resolution of AML following the initiation of anti-TB therapy. 2. Presenting an uncommon type of relapse in Acute Myeloid Leukemia. 3. Highlighting the role of immune markers in the diagnosis of Leukemia cutis. 4. Exploring and highlighting the possibility of skin relapse as the exclusive manifestation, even when skin involvement is known secondary manifestation in AML. Background: Spontaneous remission of Acute Myeloid Leukemia (AML) is a rare phenomenon that has only been reported in some case reports, usually following severe infections. Some studies have described the occurrence of tuberculosis (TB) infection with AML, usually after starting chemotherapy. Spontaneous resolution of AML after starting anti TB therapy (ATT), without starting chemotherapy has never been described in the literature. Moreover, Leukemia cutis is another rare skin manifestation of Acute Myeloid Leukemia as a result of infiltration of the skin or subcutaneous tissue by leukemic cells, in which can present during, precedes, after or independently of systemic leukemia. Methods: Here, we present a case of a 13-year-old male who presented with fever, weight loss, lethargy, epistaxis, bruising and dry cough and was later diagnosed with AML. Before initiating leukemia treatment, the patient was tested for TB and was found to have active TB infection. His leukemia treatment was postponed to clear the TB infection and he was commenced on ATT. Two months later, repeat blood film and bone marrow biopsy showed resolution of his AML. The patient remained in remission for 1 month, after which he presented with symmetrical blue purple well-defined round indurated plaques on the chest and thighs. Our differentials were leukemia cutis and Kaposi sarcoma. Results: Skin Biopsy with immune markers done, showed a picture of Acute Myeloid Leukemia. Immunohistochemistry (IHC) showed neoplastic cells diffusely and strongly positive for LCA, CD2, CD31, MPO, CD117, Lysozymes and TDT, and moderately positive for CD34, CD99, CD43 and CD6 And patchy for CD68. Ki67 showed 60% proliferation index. They were negative for the remaining markers. This suggested acute myeloid leukemia (AML). Conclusion: In summary, we present a rare case of TB with AML that resolved after treatment of TB with ATT but relapsed later as leukemia cutis. While skin involvement might occur as a secondary manifestation of AML, Skin relapse could be the only one.

Keywords: Leukemia cutis, Leukemia relapse, Acute Myeloid Leukemia, spontaneous resolution of AML

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1418 Study of the Buckling of Sandwich Beams Consider Stretching Effect

Authors: R. Bennai, H. Ait Atmane, H. Fourne, B. Ayache

Abstract:

In this work, an analytical approach using a refined theory of hyperbolic shear deformation of a beam was developed to study the buckling of graduated sandwiches beams under different boundary conditions. The effects of transverse shear strains and the transverse normal deformation are considered. The constituent materials of the beam are supposed gradually variable depending on the height direction based on a simple power distribution law in terms of the volume fractions of the constituents; the two materials with which we worked are metals and ceramics. The core layer is taken homogeneous and made of an isotropic material; while the banks layers consist of functionally graded materials with a homogeneous fraction compared to the middle layer. In the end, illustrative examples are presented to show the effects of changes in different parameters such as (material graduation, the stretching effect of the thickness, boundary conditions and thickness ratio-length) on the vibration free of an FGM sandwich beams.

Keywords: FGM materials, refined shear deformation theory, stretching effect, buckling

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