Search results for: low-level laser therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2785

Search results for: low-level laser therapy

1225 A Biomechanical Model for the Idiopathic Scoliosis Using the Antalgic-Trak Technology

Authors: Joao Fialho

Abstract:

The mathematical modelling of idiopathic scoliosis has been studied throughout the years. The models presented on those papers are based on the orthotic stabilization of the idiopathic scoliosis, which are based on a transversal force being applied to the human spine on a continuous form. When considering the ATT (Antalgic-Trak Technology) device, the existent models cannot be used, as the type of forces applied are no longer transversal nor applied in a continuous manner. In this device, vertical traction is applied. In this study we propose to model the idiopathic scoliosis, using the ATT (Antalgic-Trak Technology) device, and with the parameters obtained from the mathematical modeling, set up a case-by-case individualized therapy plan, for each patient.

Keywords: idiopathic scoliosis, mathematical modelling, human spine, Antalgic-Trak technology

Procedia PDF Downloads 269
1224 The Influence of α-Defensin and Cytokine IL-1β, Molecular Factors of Innate Immune System, on Regulation of Inflammatory Periodontal Diseases in Orthodontic Patients

Authors: G. R. Khaliullina, S. L. Blashkova, I. G. Mustafin

Abstract:

The article presents the results of a study involving 97 patients with different types of orthodontic pathology. Immunological examination of patients included determination of the level of α-defensin and cytokine IL-1β in mixed saliva. The study showed that the level of α-defensin serves as a diagnostic marker for determining the therapeutic measures in the treatment of inflammatory processes in periodontal tissues. Α-defensins exhibit immunomodulating and antimicrobial activity during inflammatory processes and play an important role in the regulation of the pathology of periodontal disease. The obtained data allowed the development of an algorithm for diagnosis and the implementation of immunomodulating therapy in the treatment of periodontal diseases in orthodontic patients.

Keywords: α-difensin, cytokine, orthodontic treatment, periodontal disease, periodontal pathogens

Procedia PDF Downloads 180
1223 Use of Adjunctive Cannabinoids in Opioid Dosing for Patients with Chronic Pain

Authors: Kristina De Milt, Nicole Huang, Jihye Park

Abstract:

Opioids have been a mainstay of the treatment of chronic pain, but their overprescription and misuse have led to an opioid epidemic. Recently, as an attempt to decrease the number of opioids prescribed, the use of cannabinoid therapy has become an increasingly popular adjunctive chronic pain management choice among providers. This review of literature investigates the effects of adjunctive cannabinoids to opioids in the management of chronic pain. The nine articles are included in the literature review range from observational studies to meta-analyses published in the year 2016 and after. A majority of the studies showed a decrease in the need for opioids after adjunctive cannabinoids were introduced and, in some instances, the cessation of opioid consumption. More high-quality evidence is needed to further support this stance and providers should weigh the benefits and risks of adjunctive cannabinoids according to the clinical picture.

Keywords: cannabis, chronic pain, opioids, pain management

Procedia PDF Downloads 253
1222 Exploiting Kinetic and Kinematic Data to Plot Cyclograms for Managing the Rehabilitation Process of BKAs by Applying Neural Networks

Authors: L. Parisi

Abstract:

Kinematic data wisely correlate vector quantities in space to scalar parameters in time to assess the degree of symmetry between the intact limb and the amputated limb with respect to a normal model derived from the gait of control group participants. Furthermore, these particular data allow a doctor to preliminarily evaluate the usefulness of a certain rehabilitation therapy. Kinetic curves allow the analysis of ground reaction forces (GRFs) to assess the appropriateness of human motion. Electromyography (EMG) allows the analysis of the fundamental lower limb force contributions to quantify the level of gait asymmetry. However, the use of this technological tool is expensive and requires patient’s hospitalization. This research work suggests overcoming the above limitations by applying artificial neural networks.

Keywords: kinetics, kinematics, cyclograms, neural networks, transtibial amputation

Procedia PDF Downloads 443
1221 Space Debris Mitigation: Solutions from the Dark Skies of the Remote Australian Outback Using a Proposed Network of Mobile Astronomical Observatories

Authors: Muhammad Akbar Hussain, Muhammad Mehdi Hussain, Waqar Haider

Abstract:

There are tens of thousands of undetected and uncatalogued pieces of space debris in the Low Earth Orbit (LEO). They are not only difficult to be detected and tracked, their sheer number puts active satellites and humans in orbit around Earth into danger. With the entry of more governments and private companies into harnessing the Earth’s orbit for communication, research and military purposes, there is an ever-increasing need for not only the detection and cataloguing of these pieces of space debris, it is time to take measures to take them out and clean up the space around Earth. Current optical and radar-based Space Situational Awareness initiatives are useful mostly in detecting and cataloguing larger pieces of debris mainly for avoidance measures. Smaller than 10 cm pieces are in a relatively dark zone, yet these are deadly and capable of destroying satellites and human missions. A network of mobile observatories, connected to each other in real time and working in unison as a single instrument, may be able to detect small pieces of debris and achieve effective triangulation to help create a comprehensive database of their trajectories and parameters to the highest level of precision. This data may enable ground-based laser systems to help deorbit individual debris. Such a network of observatories can join current efforts in detection and removal of space debris in Earth’s orbit.

Keywords: space debris, low earth orbit, mobile observatories, triangulation, seamless operability

Procedia PDF Downloads 167
1220 The Synopsis of the AI-Powered Therapy Web Platform ‘Free AI Therapist'

Authors: Arwa Alnowaiser, Hala Shoukri

Abstract:

The ‘FreeAITherapist’ is an artificial intelligence application that uses the power of AI to offer advice and mental health counseling to its users through its chatbot services. The AI therapist is designed to understand users' issues, concerns, and problems and respond appropriately; it provides empathy and guidance and uses evidence-based therapeutic techniques. With its user-friendly platform, it ensures accessibility for individuals in need, regardless of their geographical location. This website was created in direct response to the growing demand for mental health support, aiming to provide a cost-effective and confidential solution. Through promising confidentiality, it considers user privacy and data security. The ‘FreeAITherapist’ strives to bridge the gap in mental health services, offering a reliable resource for individuals seeking guidance and counseling to improve their overall well-being.

Keywords: artificial intelligence, mental health, AI therapist, website, counseling

Procedia PDF Downloads 45
1219 Characterization on Molecular Weight of Polyamic Acids Using GPC Coupled with Multiple Detectors

Authors: Mei Hong, Wei Liu, Xuemin Dai, Yanxiong Pan, Xiangling Ji

Abstract:

Polyamic acid (PAA) is the precursor of polyimide (PI) prepared by a two-step method, its molecular weight and molecular weight distribution not only play an important role during the preparation and processing, but also influence the final performance of PI. However, precise characterization on molecular weight of PAA is still a challenge because of the existence of very complicated interactions in the solution system, including the electrostatic interaction, hydrogen bond interaction, dipole-dipole interaction, etc. Thus, it is necessary to establisha suitable strategy which can completely suppress these complex effects and get reasonable data on molecular weight. Herein, the gel permeation chromatography (GPC) coupled with differential refractive index (RI) and multi-angle laser light scattering (MALLS) detectors were applied to measure the molecular weight of (6FDA-DMB) PAA using different mobile phases, LiBr/DMF, LiBr/H3PO4/THF/DMF, LiBr/HAc/THF/DMF, and LiBr/HAc/DMF, respectively. It was found that combination of LiBr with HAc can shield the above-mentioned complex interactions and is more conducive to the separation of PAA than only addition of LiBr in DMF. LiBr/HAc/DMF was employed for the first time as a mild mobile phase to effectively separate PAA and determine its molecular weight. After a series of conditional experiments, 0.02M LiBr/0.2M HAc/DMF was fixed as an optimized mobile phase to measure the relative and absolute molecular weights of (6FDA-DMB) PAA prepared, and the obtained Mw from GPC-MALLS and GPC-RI were 35,300 g/mol and 125,000 g/mol, respectively. Particularly, such a mobile phase is also applicable to other PAA samples with different structures, and the final results on molecular weight are also reproducible.

Keywords: Polyamic acids, Polyelectrolyte effects, Gel permeation chromatography, Mobile phase, Molecular weight

Procedia PDF Downloads 55
1218 Experimental Parameters’ Effects on the Electrical Discharge Machining Performances

Authors: Asmae Tafraouti, Yasmina Layouni, Pascal Kleimann

Abstract:

The growing market for Microsystems (MST) and Micro-Electromechanical Systems (MEMS) is driving the research for alternative manufacturing techniques to microelectronics-based technologies, which are generally expensive and time-consuming. Hot-embossing and micro-injection modeling of thermoplastics appear to be industrially viable processes. However, both require the use of master models, usually made in hard materials such as steel. These master models cannot be fabricated using standard microelectronics processes. Thus, other micromachining processes are used, such as laser machining or micro-electrical discharge machining (µEDM). In this work, µEDM has been used. The principle of µEDM is based on the use of a thin cylindrical micro-tool that erodes the workpiece surface. The two electrodes are immersed in a dielectric with a distance of a few micrometers (gap). When an electrical voltage is applied between the two electrodes, electrical discharges are generated, which cause material machining. In order to produce master models with high resolution and smooth surfaces, it is necessary to well control the discharge mechanism. However, several problems are encountered, such as a random electrical discharge process, the fluctuation of the discharge energy, the electrodes' polarity inversion, and the wear of the micro-tool. The effect of different parameters, such as the applied voltage, the working capacitor, the micro-tool diameter, and the initial gap, has been studied. This analysis helps to improve the machining performances, such as the workpiece surface condition and the lateral crater's gap.

Keywords: craters, electrical discharges, micro-electrical discharge machining, microsystems

Procedia PDF Downloads 74
1217 Creating a Virtual Perception for Upper Limb Rehabilitation

Authors: Nina Robson, Kenneth John Faller II, Vishalkumar Ahir, Arthur Ricardo Deps Miguel Ferreira, John Buchanan, Amarnath Banerjee

Abstract:

This paper describes the development of a virtual-reality system ARWED, which will be used in physical rehabilitation of patients with reduced upper extremity mobility to increase limb Active Range of Motion (AROM). The ARWED system performs a symmetric reflection and real-time mapping of the patient’s healthy limb on to their most affected limb, tapping into the mirror neuron system and facilitating the initial learning phase. Using the ARWED, future experiments will test the extension of the action-observation priming effect linked to the mirror-neuron system on healthy subjects and then stroke patients.

Keywords: physical rehabilitation, mirror neuron, virtual reality, stroke therapy

Procedia PDF Downloads 432
1216 An Exploitation of Electrical Sensors in Monitoring Pool Chlorination

Authors: Fahad Alamoudi, Yaser Miaji

Abstract:

The growing popularity of swimming pools and other activities in the water for sport, fitness, therapy or just enjoyable relaxation have led to the increased use of swimming pools and the establishment of a variety of specific-use pools such as spa pools, water slides, and more recently, hydrotherapy and wave pools. In this research, a few simple equipment is used for test, detect and alert for detection of water cleanness and pollution. YSI Photometer Systems, TDSTestr High model, Rio 12HF and Electrode A1. The researchers used electrolysis as a method of separating bonded elements and compounds by passing an electric current through them. The results which use 41 experiments show the higher the salt concentration, the more efficient the electrode and the smaller the gap between the plates, the lower the electrode voltage. Furthermore, it is proved that the larger the surface area, the lower the cell voltage and the higher current used the more chlorine produced.

Keywords: photometer, electrode, electrolysis, swimming pool chlorination

Procedia PDF Downloads 363
1215 Dynamics of Mach Zehnder Modulator in Open and Closed Loop Bias Condition

Authors: Ramonika Sengupta, Stuti Kachhwaha, Asha Adhiya, K. Satya Raja Sekhar, Rajwinder Kaur

Abstract:

Numerous efforts have been done in the past decade to develop the methods of secure communication that are free from interception and eavesdropping. In fiber optic communication, chaotic optical carrier signals are used for data encryption in secure data transmission. Mach-Zehnder Modulators (MZM) are the key components for generating the chaotic signals to be used as optical carriers. This paper presents the dynamics of a lithium niobate MZM modulator under various biasing conditions. The chaotic fluctuations of the intensity of a laser diode have been generated using the electro-optic MZM modulator operating in a highly nonlinear regime. The modulator is driven in closed loop by its own output at an earlier time. When used as an electro-optic oscillator employing delayed feedback, the MZM displays a wide range of output waveforms of varying complexity. The dynamical behavior of the system ranges from periodic to nonlinear oscillations. The nonlinearity displayed by the system is reproducible and is easily controllable. In this paper, we demonstrate a wide variety of optical signals generated by MZM using easily controllable device parameters in both open and close loop bias conditions.

Keywords: chaotic carrier, fiber optic communication, Mach-Zehnder modulator, secure data transmission

Procedia PDF Downloads 272
1214 X-Glove: Case Study of Soft Robotic Hand Exoskeleton

Authors: Pim Terachinda, Witaya Wannasuphoprasit, Wasuwat Kitisomprayoonkul, Anan Srikiatkhachorn

Abstract:

Restoration of hand function and dexterity remain challenges in rehabilitation after stroke. We have developed soft exoskeleton hand robot in which using tendon-driven mechanism. Finger flexion and extension can be triggered by a foot switch and force can be adjusted manually depending on patient’s grip strength. The objective of this study is to investigate feasibility and safety of this device. The study was done in 2 stroke patients with the strength of the finger flexors/extensors grade 1/0 and 3/1 on Medical Research Council scale, respectively. Grasp and release training was performed for 30 minutes. No complication was observed. Results demonstrated that the device is safe, and therapy can be tailored to individual patient’s need. However, further study is required to determine recovery and rehabilitation outcomes after training in patients after nervous system injury.

Keywords: hand, rehabilitation, robot, stroke

Procedia PDF Downloads 290
1213 Study of the Effect of the Continuous Electric Field on the Rd Cancer Cell Line by Response Surface Methodology

Authors: Radia Chemlal, Salim Mehenni, Dahbia Leila Anes-boulahbal, Mohamed Kherat, Nabil Mameri

Abstract:

The application of the electric field is considered to be a very promising method in cancer therapy. Indeed, cancer cells are very sensitive to the electric field, although the cellular response is not entirely clear. The tests carried out consisted in subjecting the RD cell line under the effect of the continuous electric field while varying certain parameters (voltage, exposure time, and cell concentration). The response surface methodology (RSM) was used to assess the effect of the chosen parameters, as well as the existence of interactions between them. The results obtained showed that the voltage, the cell concentration as well as the interaction between voltage and exposure time have an influence on the mortality rate of the RD cell line.

Keywords: continuous electric field, RD cancer cell line, RSM, voltage

Procedia PDF Downloads 113
1212 Electrochemically Reduced Graphene Oxide Modified Boron-Doped Diamond Paste Electrode on Paper-Based Analytical Device for Simultaneous Determination of Norepinephrine and Serotonin

Authors: Siriwan Nantaphol, Robert B. Channon, Takeshi Kondo, Weena Siangproh, Orawon Chailapakul, Charles S. Henry

Abstract:

In this work, we demonstrate a novel electrochemically reduced graphene oxide (ERGO) modified boron-doped diamond paste (BDDP) electrode on paper-based analytical devices (PADs) for simultaneous determination of norepinephrine (NE) and serotonin (5-HT). The BDD paste electrode was easily constructed by filling BDD paste in small channels, which made in transparency film sheets using a CO₂ laser etching 
system. The counter and reference electrodes were fabricated on paper by in-house screen-printing and then combined with BDD paste microelectrode. The electrochemical characterization of the device was investigated by cyclic voltammetry (CV). Differential pulse voltammetry (DPV) was employed for the simultaneous determination of NE and 5-HT. The ERGO-modified BDDP electrode displayed excellent electrocatalytic activities toward the oxidation of NE and 5-HT and strong function for resolving the overlapping voltammetric responses of NE and 5-HT into two well-defined voltammetric peaks. This device was capable of simultaneously detecting NE and 5-HT in wide concentration ranges and with a low limit of detections. In addition, it has the advantages in terms of ease of use, low cost, and disposability.

Keywords: boron-doped diamond paste electrode, electrochemically reduced graphene oxide, norepinephrine, paper-based analytical device, serotonin

Procedia PDF Downloads 259
1211 Clinical Audit on the Introduction of Apremilast into Ireland

Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane

Abstract:

Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.

Keywords: Apremilast, introduction, Ireland, clinical audit

Procedia PDF Downloads 149
1210 Experimental Parameters’ Effects on the Electrical Discharge Machining Performances (µEDM)

Authors: Asmae Tafraouti, Yasmina Layouni, Pascal Kleimann

Abstract:

The growing market for Microsystems (MST) and Micro-Electromechanical Systems (MEMS) is driving the research for alternative manufacturing techniques to microelectronics-based technologies, which are generally expensive and time-consuming. Hot-embossing and micro-injection modeling of thermoplastics appear to be industrially viable processes. However, both require the use of master models, usually made in hard materials such as steel. These master models cannot be fabricated using standard microelectronics processes. Thus, other micromachining processes are used, as laser machining or micro-electrical discharge machining (µEDM). In this work, µEDM has been used. The principle of µEDM is based on the use of a thin cylindrical micro-tool that erodes the workpiece surface. The two electrodes are immersed in a dielectric with a distance of a few micrometers (gap). When an electrical voltage is applied between the two electrodes, electrical discharges are generated, which cause material machining. In order to produce master models with high resolution and smooth surfaces, it is necessary to well control the discharge mechanism. However, several problems are encountered, such as a random electrical discharge process, the fluctuation of the discharge energy, the electrodes' polarity inversion, and the wear of the micro-tool. The effect of different parameters, such as the applied voltage, the working capacitor, the micro-tool diameter, the initial gap, has been studied. This analysis helps to improve the machining performances, such: the workpiece surface condition and the lateral crater's gap.

Keywords: craters, electrical discharges, micro-electrical discharge machining (µEDM), microsystems

Procedia PDF Downloads 96
1209 Theoretical Analysis of Photoassisted Field Emission near the Metal Surface Using Transfer Hamiltonian Method

Authors: Rosangliana Chawngthu, Ramkumar K. Thapa

Abstract:

A model calculation of photoassisted field emission current (PFEC) by using transfer Hamiltonian method will be present here. When the photon energy is incident on the surface of the metals, such that the energy of a photon is usually less than the work function of the metal under investigation. The incident radiation photo excites the electrons to a final state which lies below the vacuum level; the electrons are confined within the metal surface. A strong static electric field is then applied to the surface of the metal which causes the photoexcited electrons to tunnel through the surface potential barrier into the vacuum region and constitutes the considerable current called photoassisted field emission current. The incident radiation is usually a laser beam, causes the transition of electrons from the initial state to the final state and the matrix element for this transition will be written. For the calculation of PFEC, transfer Hamiltonian method is used. The initial state wavefunction is calculated by using Kronig-Penney potential model. The effect of the matrix element will also be studied. An appropriate dielectric model for the surface region of the metal will be used for the evaluation of vector potential. FORTRAN programme is used for the calculation of PFEC. The results will be checked with experimental data and the theoretical results.

Keywords: photoassisted field emission, transfer Hamiltonian, vector potential, wavefunction

Procedia PDF Downloads 226
1208 Silver Grating for Strong and Reproducible SERS Response

Authors: Y. Kalachyova, O. Lyutakov, V. Svorcik

Abstract:

One of the most significant obstacles for the application of surface enhanced Raman spectroscopy (SERS) is the poor reproducibility of SERS active substrates: SERS intensity can be varied from one substrate to another and moreover along the one substrate surface. High enhancement of the near-field intensity is the key factor for ultrasensitive SERS realization. SERS substrate can be prepared through introduction of highly ordered metal array, where light focusing is achieved through excitation of surface plasmon-polaritons (SPPs). In this work, we report the preparation of silver nanostructures with plasmon absorption peaks tuned by the metal arrangement. Excimer laser modification of poly(methyl methacrylate) followed by silver evaporation is proposed as an effective way for the creation of reproducible and effective surface plasmon-polaritons (SPP)-based SERS substrate. Theoretical and experimental studies were performed to optimize structure parameter for effective SPP excitation. It was found that the narrow range of grating periodicity and metal thickness exist, where SPPs can be most efficiently excited. In spite of the fact, that SERS response was almost always achieved, the enhancement factor was found to vary more with the effectivity of SPP excitation. When the real structure parameters were set to optimal for SPP excitation, a SERS enhancement factor was achieved up to four times. Theoretical and experimental investigation of SPP excitation on the two-dimensional periodical silver array was performed with the aim to make SERS response as high as possible.

Keywords: grating, nanostructures, plasmon-polaritons, SERS

Procedia PDF Downloads 268
1207 Follicular Thyroid Carcinoma in a Developing Country: A Retrospective Study of 10 Years

Authors: Abdul Aziz, Muhammad Qamar Masood, Saadia Sattar, Saira Fatima, Najmul Islam

Abstract:

Introduction: The most common endocrine tumor is thyroid cancer. Follicular Thyroid Carcinoma (FTC) accounts for 5%–10% of all thyroid cancers. Patients with FTC frequently present with more advanced stage diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery, while radioactive iodine therapy is the main adjuvant therapy as per ATA guidelines. In many developing countries, surgical facilities and radioactive iodine are in short supply; therefore, understanding follicular thyroid cancer trends may help developing countries plan and use resources more effectively. Methodology: It was a retrospective observational study of FTC patients of age 18 years and above conducted at Aga Khan University Hospital, Karachi, from 1st January 2010 to 31st December 2019. Results: There were 404 patients with thyroid carcinoma, out of which forty (10.1%) were FTC. 50% of the patients were in the 41-60 years age group, and the female to male ratio was 1.5: 1. Twenty-four patients (60%) presented with complain of neck swelling followed by metastasis (20%) and compressive symptoms (20%). The most common site of metastasis was bone (87.5%), followed by lung (12.5%). The pre-operative thyroglobulin level was done in six out of eight metastatic patients (75%) in which it was elevated. This emphasizes the importance of checking thyroglobulin level in unusual presentation (bone pain, fractures) of a patient having neck swelling also to help in establishing the primary source of tumor. There was no complete documentation of ultrasound features of the thyroid gland in all the patients, which is an important investigation done in the initial evaluation of thyroid nodule. On FNAC, 50% (20 patients) had Bethesda category III-IV nodules, while 10% ( 4 patients ) had Bethesda category II. In sixteen patients, FNAC was not done as they presented with compressive symptoms or metastasis. Fifty percent had a total thyroidectomy and 50% had subtotal followed by completion thyroidectomy, plus ten patients had lymph node dissection, out of which seven had histopathological lymph node involvement. On histopathology, twenty-three patients (57.5%) had minimally invasive, while seventeen (42.5%) had widely invasive follicular thyroid carcinoma. The capsular invasion was present in thirty-three patients (82.5%); one patient had no capsular invasion, but there was a vascular invasion. Six patients' histopathology had no record of capsular invasion. In contrast, the lymphovascular invasion was present in twenty-six patients (65%). In this study, 65 % of the patients had clinical stage 1 disease, while 25% had stage 2 and 10% had clinical stage 4. Seventeen patients (42.5%) had received RAI 30-100 mCi, while ten patients (25%) received more than 100 mCi. Conclusion: FTC demographic and clinicopathological presentation are the same in Pakistan as compared to other countries. Surgery followed by RAI is the mainstay of treatment. Thus understanding the trend of FTC and proper planning and utilization of the resources will help the developing countries in effectively treating the FTC.

Keywords: thyroid carcinoma, follicular thyroid carcinoma, clinicopathological features, developing countries

Procedia PDF Downloads 192
1206 Evolution of Cord Absorbed Dose during Larynx Cancer Radiotherapy, with 3D Treatment Planning and Tissue Equivalent Phantom

Authors: Mohammad Hassan Heidari, Amir Hossein Goodarzi, Majid Azarniush

Abstract:

Radiation doses to tissues and organs were measured using the anthropomorphic phantom as an equivalent to the human body. When high-energy X-rays are externally applied to treat laryngeal cancer, the absorbed dose at the laryngeal lumen is lower than given dose because of air space which it should pass through before reaching the lesion. Specially in case of high-energy X-rays, the loss of dose is considerable. Three-dimensional absorbed dose distributions have been computed for high-energy photon radiation therapy of laryngeal and hypo pharyngeal cancers, using a coaxial pair of opposing lateral beams in fixed positions. Treatment plans obtained under various conditions of irradiation.

Keywords: 3D treatment planning, anthropomorphic phantom, larynx cancer, radiotherapy

Procedia PDF Downloads 547
1205 Thermal Conductivity and Optical Absorption of GaAsPN/GaP for Tandem Solar Cells: Effect of Rapid Thermal Annealing

Authors: S. Ilahi, S. Almosni, F. Chouchene, M. Perrin, K. Zelazna, N. Yacoubi, R. Kudraweic, P. Rale, L. Lombez, J. F. Guillemoles, O. Durand, C. Cornet

Abstract:

Great efforts have been dedicated to obtain high quality of GaAsPN. The properties of GaAsPN have played a great part on the development of solar cells devices based in Si substrate. The incorporation of N in GaAsPN that having a band gap around of 1.7 eV is of special interest in view of growing in Si substrate. In fact, post-growth and rapid thermal annealing (RTA) could be an effective way to improve the quality of the layer. Then, the influence of growth conditions and post-growth annealing on optical and thermal parameters is considered. We have used Photothermal deflection spectroscopy PDS to investigate the impact of rapid thermal annealing on thermal and optical properties of GaAsPN. In fact, the principle of the PDS consists to illuminate the sample by a modulated monochromatic light beam. Then, the absorbed energy is converted into heat through the nonradiative recombination process. The generated thermal wave propagates into the sample and surrounding media creating a refractive-index gradient giving rise to the deflection of a laser probe beam skimming the sample surface. The incident light is assumed to be uniform, and only the sample absorbs the light. In conclusion, the results are promising revealing an improvement in absorption coefficient and thermal conductivity.

Keywords: GaAsPN absorber, photothermal defelction technique PDS, photonics on silicon, thermal conductivity

Procedia PDF Downloads 354
1204 Increasing of Gain in Unstable Thin Disk Resonator

Authors: M. Asl. Dehghan, M. H. Daemi, S. Radmard, S. H. Nabavi

Abstract:

Thin disk lasers are engineered for efficient thermal cooling and exhibit superior performance for this task. However the disk thickness and large pumped area make the use of this gain format in a resonator difficult when constructing a single-mode laser. Choosing an unstable resonator design is beneficial for this purpose. On the other hand, the low gain medium restricts the application of unstable resonators to low magnifications and therefore to a poor beam quality. A promising idea to enable the application of unstable resonators to wide aperture, low gain lasers is to couple a fraction of the out coupled radiation back into the resonator. The output coupling gets dependent on the ratio of the back reflection and can be adjusted independently from the magnification. The excitation of the converging wave can be done by the use of an external reflector. The resonator performance is numerically predicted. First of all the threshold condition of linear, V and 2V shape resonator is investigated. Results show that the maximum magnification is 1.066 that is very low for high quality purposes. Inserting an additional reflector covers the low gain. The reflectivity and the related magnification of a 350 micron Yb:YAG disk are calculated. The theoretical model was based on the coupled Kirchhoff integrals and solved numerically by the Fox and Li algorithm. Results show that with back reflection mechanism in combination with increasing the number of beam incidents on disk, high gain and high magnification can occur.

Keywords: unstable resonators, thin disk lasers, gain, external reflector

Procedia PDF Downloads 413
1203 Women’s Experience of Managing Pre-Existing Lymphoedema during Pregnancy and the Early Postnatal Period

Authors: Kim Toyer, Belinda Thompson, Louise Koelmeyer

Abstract:

Lymphoedema is a chronic condition caused by dysfunction of the lymphatic system, which limits the drainage of fluid and tissue waste from the interstitial space of the affected body part. The normal physiological changes in pregnancy cause an increased load on a normal lymphatic system which can result in a transient lymphatic overload (oedema). The interaction between lymphoedema and pregnancy oedema is unclear. Women with pre-existing lymphoedema require accurate information and additional strategies to manage their lymphoedema during pregnancy. Currently, no resources are available to guide women or their healthcare providers with accurate advice and additional management strategies for coping with lymphoedema during pregnancy until they have recovered postnatally. This study explored the experiences of Australian women with pre-existing lymphoedema during recent pregnancy and the early postnatal period to determine how their usual lymphoedema management strategies were adapted and what were their additional or unmet needs. Interactions with their obstetric care providers, the hospital maternity services, and usual lymphoedema therapy services were detailed. Participants were sourced from several Australian lymphoedema community groups, including therapist networks. Opportunistic sampling is appropriate to explore this topic in a small target population as lymphoedema in women of childbearing age is uncommon, with prevalence data unavailable. Inclusion criteria were aged over 18 years, diagnosed with primary or secondary lymphoedema of the arm or leg, pregnant within the preceding ten years (since 2012), and had their pregnancy and postnatal care in Australia. Exclusion criteria were a diagnosis of lipedema and if unable to read or understand a reasonable level of English. A mixed-method qualitative design was used in two phases. This involved an online survey (REDCap platform) of the participants followed by online semi-structured interviews or focus groups to provide the transcript data for inductive thematic analysis to gain an in-depth understanding of issues raised. Women with well-managed pre-existing lymphoedema coped well with the additional oedema load of pregnancy; however, those with limited access to quality conservative care prior to pregnancy were found to be significantly impacted by pregnancy, including many reporting deterioration of their chronic lymphoedema. Misinformation and a lack of support increased fear and apprehension in planning and enjoying their pregnancy experience. Collaboration between maternity and lymphoedema therapy services did not happen despite study participants suggesting it. Helpful resources and unmet needs were identified in the recent Australian context to inform further research and the development of resources to assist women with lymphoedema who are considering or are pregnant and their supporters, including health care providers.

Keywords: lymphoedema, management strategies, pregnancy, qualitative

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1202 Pentosan Polysulfate Sodium: A Potential Treatment to Improve Bone and Joint Manifestations of Mucopolysaccharidosis I

Authors: Drago Bratkovic, Curtis Gravance, David Ketteridge, Ravi Krishnan, Michael Imperiale

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The mucopolysaccharidoses (MPSs) are a group of lysosomal storage diseases that have a common defect in the catabolism of glycosaminoglycans (GAGs). MPS I is the most common of the MPS diseases. Manifestations of MPS I include coarsening of facial features, corneal clouding, developmental delay, short stature, skeletal manifestations, hearing loss, cardiac valve disease, hepatosplenomegaly, and umbilical and inguinal hernias. Treatments for MPS I restore or activate the missing or deficient enzyme in the case of enzyme replacement therapy (ERT) and haematopoietic stem cell transplantation (HSCT). Pentosan polysulfate sodium (PPS) is a potential treatment to improve bone and joint manifestations of MPS I. The mechanisms of action of PPS that are relevant to the treatment of MPS I are the ability to: (i) Reduce systemic and accumulated GAG, (ii) Reduce inflammatory effects via the inhibition of NF-kB, resulting in the reduction in pro-inflammatory mediators. (iii) Reduce the expression of the pain mediator nerve growth factor in osteocytes from degenerating joints. (iv) Inhibit the cartilage degrading enzymes related to joint dysfunction in MPS I. PPS is being evaluated as an adjunctive therapy to ERT and/or HSCT in an open-label, single-centre, phase 2 study. Patients are ≥ 5 years of age with a diagnosis of MPS I and previously received HSCT and/or ERT. Three white, female, patients with MPS I-Hurler, ages 14, 15, and 19 years, and one, white male patient aged 15 years are enrolled. All were diagnosed at ≤2 years of age. All patients received HSCT ≤ 6 months after diagnosis. Two of the patients were treated with ERT prior to HSCT, and 1 patient received ERT commencing 3 months prior to HSCT. Two patients received 0.75mg/kg and 2 patients received 1.5mg/kg of PPS. PPS was well tolerated at doses of 0.75 and 1.5 mg/kg to 47 weeks of continuous dosing. Of the 19 adverse events (AEs), 2 were related to PPS. One AE was moderate (pre-syncope) and 1 was mild (injection site bruising), experienced in the same patient. All AEs were reported as mild or moderate. There have been no SAEs. One subject experienced a COVID-19 infection and PPS was interrupted. The MPS I signature GAG fragments, sulfated disaccharide and UA-HNAc S, tended to decrease in 3 patients from baseline through Week 25. Week 25 GAG data are pending for the 4th patient. Overall, most biomarkers (inflammatory, cartilage degeneration, and bone turnover) evaluated in the 3 patients with 25-week assessments have indicated either no change or a reduction in levels compared to baseline. In 3 patients, there was a trend toward improvement in the 2MWT from baseline to Week 48 with > 100% increase in 1 patient (01-201). In the 3 patients that had Week 48 assessments, patients and proxies reported improvement in PGIC, including “worthwhile difference” (n=1), or “made all the difference” (n=2).

Keywords: MPS I, pentosan polysulfate sodium, clinical study, 2MWT, QoL

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1201 Antimicrobial Value of Olax subscorpioidea and Bridelia ferruginea on Micro-Organism Isolates of Dental Infection

Authors: I. C. Orabueze, A. A. Amudalat, S. A. Adesegun, A. A. Usman

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Dental and associated oral diseases are increasingly affecting a considerable portion of the population and are considered some of the major causes of tooth loss, discomfort, mouth odor and loss of confidence. This study focused on the ethnobotanical survey of medicinal plants used in oral therapy and evaluation of the antimicrobial activities of methanolic extracts of two selected plants from the survey for their efficacy against dental microorganisms. The ethnobotanical survey was carried out in six herbal markets in Lagos State, Nigeria by oral interviewing and information obtained from an old family manually complied herbal medication book. Methanolic extracts of Olax subscorpioidea (stem bark) and Bridelia ferruginea (stem bark) were assayed for their antimicrobial activities against clinical oral isolates (Aspergillus fumigatus, Candida albicans, Streptococcus spp, Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa). In vitro microbial technique (agar well diffusion method and minimum inhibitory concentration (MIC) assay) were employed for the assay. Chlorhexidine gluconate was used as the reference drug for comparison with the extract results. And the preliminary phytochemical screening of the constituents of the plants were done. The ethnobotanical survey produced plants (28) of diverse family. Different parts of plants (seed, fruit, leaf, root, bark) were mentioned but 60% mentioned were either the stem or the bark. O. subscorpioidea showed considerable antifungal activity with zone of inhibition ranging from 2.650 – 2.000 cm against Aspergillus fumigatus but no such encouraging inhibitory activity was observed in the other assayed organisms. B. ferruginea showed antibacterial sensitivity against Streptococcus spp, Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa with zone of inhibitions ranging from 3.400 - 2.500, 2.250 - 1.600, 2.700 - 1.950, 2.225 – 1.525 cm respectively. The minimum inhibitory concentration of O. subscorpioidea against Aspergillus fumigatus was 51.2 mg ml-1 while that of B. ferruginea against Streptococcus spp was 0.1mg ml-1 and for Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa were 25.6 mg ml-1. A phytochemical analysis reveals the presence of alkaloids, saponins, cardiac glycoside, tannins, phenols and terpenoids in both plants, with steroids only in B. ferruginea. No toxicity was observed among mice given the two methanolic extracts (1000 mg Kg-1) after 21 days. The barks of both plants exhibited antimicrobial properties against periodontal diseases causing organisms assayed, thus up-holding their folkloric use in oral disorder management. Further research could be done viewing these extracts as combination therapy, checking for possible synergistic value in toothpaste and oral rinse formulations for reducing oral bacterial flora and fungi load.

Keywords: antimicrobial activities, Bridelia ferruginea, dental disinfection, methanolic extract, Olax subscorpioidea, ethnobotanical survey

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1200 Linac Quality Controls Using An Electronic Portal Imaging Device

Authors: Domingo Planes Meseguer, Raffaele Danilo Esposito, Maria Del Pilar Dorado Rodriguez

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Monthly quality control checks for a Radiation Therapy Linac may be performed is a simple and efficient way once they have been standardized and protocolized. On the other hand this checks, in spite of being imperatives, require a not negligible execution times in terms of machine time and operators time. Besides it must be taken into account the amount of disposable material which may be needed together with the use of commercial software for their performing. With the aim of optimizing and standardizing mechanical-geometric checks and multi leaves collimator checks, we decided to implement a protocol which makes use of the Electronic Portal Imaging Device (EPID) available on our Linacs. The user is step by step guided by the software during the whole procedure. Acquired images are automatically analyzed by our programs all of them written using only free software.

Keywords: quality control checks, linac, radiation oncology, medical physics, free software

Procedia PDF Downloads 199
1199 Optimization of Rehabilitation in Scapolohumeral Periarthrosis Using Botulinum Toxin

Authors: M. A. Akulov, V. O. Zaharov, A. A. Tomskij

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Introduction: Scapulohumeral periarthrosis, resulting as a reaction to mechanical injury of shoulder tendons and muscles, is associated with high incidence of temporal and permanent disability. There is a strong need for investigation of treatment of that patient group. Severe pain leads to limitation of movements range, which result in secondary alterations of joint capsule and ligamentous apparatus. Muscle tension and edema, swelling of fascial and fibrous structures result in nerve and vascular compression in intramuscular and osseo-muscular-fibrous spaces. Botulinum toxin injection leads to decrease of muscle tone, increase of movements range and associated pain alleviation. Study aim: Optimization of rehabilitation process in scapolohumeral periarthrosis using Xeomin. Patients and methods: 40 patients aged 37-56 years with scapulohumeral periarthrosis were evaluated. Patients were divided into two groups according to treatment regimen. The first (main) group included 21 patients, receiving intramuscular Xeomin 150-200 U in the area of brachio-scapular joint and trigger points (inducing motion range limitation and pain). Treatment procedures were combined with physical therapy and osteopathic procedures. The second (control) group included 19 patients, receiving conventional physical therapy and osteopathic procedures. The evaluation and efficacy comparison was carried out using McGill pain questionnaire, Clinical Global Impression scale (CGI), and patient-reported increase of brachio-scapular joint movement range and pain decrease at 1, 3 and 6 months of treatment. Results. The study demonstrated a significant improvement in the main group after one month of treatment, which persisted during months of treatment. At baseline, rank pain index on McGill pain questionnaire was 18,4±4,9 and 17,8±5,1 in the main and control group, respectively (p > 0,05). At 1 month of treatment we observed a significant decrease of pain syndrome (no pain or modest pain) and increase of movement range in angular degrees in the main group (р < 0,05). In the control group significant improvements were observed only on the 3 month of treatment (р < 0,05), but at 6 months of treatment the improvement in pain syndrome and motion range in brachio-scapular joint was significantly smaller, than in the main group. Rank pain index on McGill pain scale was 5,2±1,8 in the main group compared to 12,0±2,6 in the control group (р < 0,05). At 6 months of treatment patients in the first group reported a significant/highly significant improvement of general health on CGI, whereas in the second group most patients reported a minimal improvement. We observed a sustained and persistent improvement of motion range in brachio-scapular joint in the main group. Conclusion: Xeomin injections as a part of rehabilitation process in scapulohumeral periarthrosis lead to reduced time and increased quality of rehabilitation.

Keywords: botulinum toxin, rehabilitation, scapulohumeral periarthrosis

Procedia PDF Downloads 279
1198 Scale up of Isoniazid Preventive Therapy: A Quality Management Approach in Nairobi County, Kenya

Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

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HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

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1197 Socio-Cultural Factors Influencing Adherence to Anti-Retroviral Therapy among HIV Patients in a University Teaching Hospital in South-Western Nigeria

Authors: Okunola Oluseye Ademola

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The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

Procedia PDF Downloads 278
1196 Experiencing Negative Thoughts? Write It, Crumple It and Throw It

Authors: Yasmin Othman Mydin

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When one experiences problems, this may lead to negative thoughts. These thoughts may occur repetitively. The present study investigates the effectiveness of cognitive and behavioural techniques to reduce negative thoughts. 20 undergraduate university students participated as the sample in these experimental therapy sessions. Ten students received the intervention while the other ten students were in control group. 15 items Perseverative Thinking Questionnaire was administered before and after the intervention to test the effectiveness of the techniques. The behavioural techniques applied were such as, write down the negative thoughts, crumple it and throw it away. While the cognitive technique was to imagine that the thoughts are being taken out of the mind while throwing it away. Paired samples t-test analysis revealed that there were significant reductions (t=4.245,df=9, p .003) in the negative thoughts in the group that received the intervention compared to the control group. This indicates that these techniques are effective to reduce the repetitive negative thoughts.

Keywords: behaviour and cognitive intervention, negative thoughts, writing, psychology

Procedia PDF Downloads 375