Search results for: shock waves therapy

Authors: G. V. Siva Krishna Rao, B. Srinivasa Rao

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Electrical energy is vital in every aspect of day-to-day life. Keen interest is taken on all possible sources of energy from which it can be generated and this led to the encouragement of generating electrical power using renewable energy resources such as solar, tidal waves and wind energy. Due to the increasing interest on renewable sources in recent times, the studies on integration of distributed generation to the power grid have rapidly increased. Distributed Generation (DG) is a promising solution to many power system problems such as voltage regulation, power loss and reduction in operational cost, etc. To reduce production cost, it is important to minimize the losses by determining the location and size of local generators to be placed in the radial distribution systems. In this paper, reduction of production cost by optimal size of DG unit operated at optimal power factor is dealt. The optimal size of the DG unit is calculated analytically using approximate reasoning suitable nodes and DG placement to minimize production cost with minimum loss is determined by fuzzy technique. Total Cost of Power generation is compared with and without DG unit for 1 year duration. The suggested method is programmed under MATLAB software and is tested on IEEE 33 bus system and the results are presented.

Keywords: distributed generation, operational cost, exact loss formula, optimum size, optimum location

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Authors: H. Yousefnia, A. Golabi Dezfuli, S. Zolghadri, M. Hosntalab

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Peptide receptor radionuclide therapy is nowadays used for the treatment of various abnormalities with somatostatin receptors. In this study, 166Ho-DOTATOC was prepared and the best conditions for its radiolabeling was obtained. For this purpose, a certain of DOTATOC was added to a vial containing 166Ho. various experiments by varying ligand concentration, pH, temperature and time were performed to determine the best conditions. Radiochemical purity of the complex was assessed by instant thin layer chromatography method utilizing 0.9% NaCl as the mobile phase. 166Ho-DOTATOC was prepared with radiochemical purity of higher than 95% at the optimized condition (pH=4, temperature: 95° C, time:30 min). In 0.9% NaCl, free Ho cation was developed at Rf of 0.8 while the complex was remained at the front of the paper.

Keywords: Ho-166, neuroendocrine, octreotide, quality control

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Authors: Ming-Tzu Tsai, Jui-Ting Hsu, Chia-Chieh Lin, Feng-Tsai Chiang, Cheng-Chin Huang

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Far infrared (FIR), an invisible and short electromagnetic waves ranges from 6-14 μm also defines as the “growth ray.” Although the mechanism of FIR is still unknown, most data have suggested that FIR could accelerate the skin microcirculation by elevating the blood flow and nitric-oxide (NO) synthesis. In this present work, the effect of FIR irradiation and endothelial cell growth supplement (ECGS) on human umbilical vascular endothelial cells (HUVECs) was evaluated. To understand whether the cell viability and NO production of HUVECs affected by NO, cells with/without ECGS were treated in the presence or absence of L-NAME, an eNOS inhibitor. For FIR exposure, FIR-emitted ceramic powders consisted of a variety of well-mixed metal oxides were developed. The results showed that L-NAME did had a strong effect on the inhibition of NO production, especially in the ECGS-treated group. However, the cell viability of each group was rarely affected in the presence of L-NAME. Cells with the incubation of ECGS showed much higher cell viability compared to the control. Moreover, NO production of HUVECs exposed to FIR irradiation was significantly inhibited in the presence of L-NAME. It suggested that NO could play a role modulating the downstream signals of HUVECs during FIR exposure.

Keywords: far-infrared irradiation (FIR), nitric oxide (NO), endothelial nitric oxide synthase (eNOS), endothelial cell growth supplement (ECGS)

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Authors: Nouzha Yasmina Soulimane-Benhabib

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Language is a medium of communication and a means of expression that is why today the learning of foreign languages especially the English language has become a basic necessity for every student who is ambitious. It is known that culture and language are inseparable and complementary, however, in the process of teaching a foreign language, teachers used to focus mainly on preparing adequate syllabi for ESP students, yet, some parameters should be considered. For instance; the culture of the target language may play an important role since students attitudes towards a foreign language enhance their learning or vice versa. The aim of this study is to analyse how culture could influence the teaching of a foreign language, we have taken the example of the English language as it is considered as the second foreign language in Algeria after French. The study is conducted at the Preparatory School of Sciences and Techniques, Tlemcen where twenty-five students participated in this research. The reasons behind learning the English language are various, and since English is the most widely-spoken language in the world, it is the language of research and education and it is used in many other fields, we have to take into consideration one important factor which is the social distance between the culture of the Algerian learner and the culture of the target language, this gap may lead to a culture shock. Two steps are followed in this research: The first one is to collect data from those students who are studying at the Preparatory School under the form of questionnaire and an interview is submitted to six of them in order to reinforce our research and get effective and precise results, and the second step is to analyse these data taking into consideration the diversity of the learners within this institution. The results obtained show that learners’ attitudes towards the English community and culture are mixed and it may influence their curiosity and attention to learn. Despite of big variance between Algerian and European cultures, some of the students focused mainly on the benefits of the English language since they need it in their studies, research and a future carrier, however, the others manifest their reluctance towards this language and this is mainly due to the profound impact of the English culture which is different from the Algerian one.

Keywords: Algeria, culture, English, impact

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Authors: Majid Samiee Zonoozian

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For such important constructions as jacket type platforms, scrupulous attention in analysis, design and calculation processes is needed. The reliability assessment method has been established into an extensively used method to behavior safety calculation of jacket platforms. In the present study, a methodology for the reliability calculation of an offshore jacket platform in contradiction of the extreme wave loading state is available. Therefore, sensitivity analyses are applied to acquire the nonlinear response of jacket-type platforms against extreme waves. The jacket structure is modeled by applying a nonlinear finite-element model with regards to the tubular members' behave. The probability of a member’s failure under extreme wave loading is figured by a finite-element reliability code. The FORM and SORM approaches are applied for the calculation of safety directories and reliability indexes have been detected. A case study for a fixed jacket-type structure positioned in the Persian Gulf is studied by means of the planned method. Furthermore, to define the failure standards, equations suggested by the 21st version of the API RP 2A-WSD for The jacket-type structures’ tubular members designing by applying the mixed axial bending and axial pressure. Consequently, the effect of wave Loades in the reliability index was considered.

Keywords: Jacket-Type structure, reliability, failure probability, tubular members

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: advanced palliative aquatics care, magnetic field therapy, medical device, research design

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Authors: Maha Hamoud Alatawi

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Drawing on the work of John McLeod and Ariel Watson, this paper explains the relationship between narrative and psychotherapy in two plays by the Irish playwright Conor McPherson. Dublin Carol presents John’s chequered past through his reminiscences of alcohol addiction and Shining City tells the story of John who is haunted by the ghost of his wife, recently died in a car accident, and who seeks the help of Ian, a therapist. At first, the significance of storytelling as an integral part of Irish culture is highlighted. Such a tradition features prominently in contemporary Irish drama. The paper concludes that it is the power of narrative and its therapeutic impact and not the act of psychotherapy and treatment which brings signs of change to characters’ lives.

Keywords: Conor McPherson, drama, psychotherapy, storytelling

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Authors: Mmbulaheni Ramulondi, Sandy Van Vuuren, Helene De Wet

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The use of plant combinations to treat various medical conditions is not a new concept, and it is known that traditional people do not only rely on a single plant extract for efficacy but often combine various plant species for treatment. The knowledge of plant combinations is transferred from one generation to the other in the belief that combination therapy may enhance efficacy, reduce toxicity, decreases adverse effects, increase bioavailability and result in lower dosages. However, combination therapy may also be harmful when the interaction is antagonistic, since it may result in increasing toxicity. Although a fair amount of research has been done on the toxicity of medicinal plants, there is very little done on the toxicity of medicinal plants in combination. The aim of the study was to assess the toxicity potential of 19 plant combinations which have been documented as treatments of hypertension in northern KwaZulu-Natal by lay people. The aqueous extracts were assessed using two assays; the Brine shrimp assay (Artemia franciscana) and the Ames test (Mutagenicity). Only one plant combination (Aloe marlothii with Hypoxis hemerocallidea) in the current study has been previously assessed for toxicity. With the Brine shrimp assay, the plant combinations were tested in two concentrations (2 and 4 mg/ml), while for mutagenicity tests, they were tested at 5 mg/ml. The results showed that in the Brine shrimp assay, six combinations were toxic at 4 mg/ml. The combinations were Albertisia delagoensis with Senecio serratuloides (57%), Aloe marlothii with Catharanthus roseus (98%), Catharanthus roseus with Hypoxis hemerocallidea (66%), Catharanthus roseus with Musa acuminata (89%), Catharanthus roseus with Momordica balsamina (99%) and Aloe marlothii with Trichilia emetica and Hyphaene coriacea (50%). However when the concentration was reduced to 2 mg/ml, only three combinations were toxic which were Aloe marlothii with Catharanthus roseus (76%), Catharanthus roseus with Musa acuminata (66%) and Catharanthus roseus with Momordica balsamina (73%). For the mutagenicity assay, only the combinations between Catharanthus roseus with Hypoxis hemerocallidea and Catharanthus roseus with Momordica balsamina were mutagenic towards the Salmonella typhimurium strains TA98 and TA100. Most of the combinations which were toxic involve C. roseus which was also toxic when tested singularly. It is worth noting that C. roseus was one of the most frequently used plant species both to treat hypertension singularly and in combination and some of the individuals have been using this for the last 20 years. The mortality percentage of the Brine shrimp showed a significant correlation between dosage and toxicity thus toxicity was dosage dependant. A combination which is worth noting is the combination between A. delagoensis and S. serratuloides. Singularly these plants were non-toxic towards Brine shrimp, however their combination resulted in antagonism with the mortality rate of 57% at the total concentration of 4 mg/ml. Low toxicity was mostly observed, giving some validity to combined use, however the few combinations showing increased toxicity demonstrate the importance of analysing plant combinations.

Keywords: dosage, hypertension, plant combinations, toxicity

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Head and neck cancer (HNC) is a big global health problem in the world. Despite the development of diagnosis and treatment, the overall survival of HNC is still low. The well recognition of the interaction of the host immune system and cancer cells has led to realizing the processes of tumor initiation, progression and metastasis. Many systemic inflammatory responses have been shown to play a crucial role in cancer progression. The pre and post-treatment nutritional and immunological status of HNC patients is a reliable prognostic indicator of tumor outcomes and survivors. Methods: Between July 2020 to June 2022, We have enrolled 60 HNC patients, including 59 males and 1 female, in Chi Mei Medical Center, Liouying, Taiwan. The age distribution was from 37 to 81 years old (y/o), with a mean age of 57.6 y/o. We evaluated the pre-and post-treatment nutritional and immunological status of these HNC patients with body weight, body weight loss, body mass index (BMI), whole blood count including hemoglobin (Hb), lymphocyte, neutrophil and platelet counts, biochemistry including prealbumin, albumin, c-reactive protein (CRP), with the time period of before treatment, post-treatment 3 and 6 months. We calculated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to assess how these biomarkers influence the outcomes of HNC patients. Results: We have carcinoma of the hypopharynx in 21 cases with 35％, carcinoma of the larynx in 9 cases, carcinoma of the tonsil and tongue every 6 cases, carcinoma soft palate and tongue base every 5 cases, carcinoma of buccal mucosa, retromolar trigone and mouth floor every 2 cases, carcinoma of the hard palate and low lip each 1 case. There were stage I 15 cases, stage II 13 cases, stage III 6 cases, stage IVA 10 cases, and stage IVB 16 cases. All patients have received surgery, chemoradiation therapy or combined therapy. We have wound infection in 6 cases, 2 cases of pharyngocutaneous fistula, flap necrosis in 2 cases, and mortality in 6 cases. In the wound infection group, the average BMI is 20.4 kg/m2; the average Hb is 12.9 g/dL, the average albumin is 3.5 g/dL, the average NLR is 6.78, and the average PLR is 243.5. In the PC fistula and flap necrosis group, the average BMI is 21.65 kg/m2; the average Hb is 11.7 g/dL, the average albumin is 3.15 g/dL, average NLR is 13.28, average PLR is 418.84. In the mortality group, the average BMI is 22.3 kg/m2; the average Hb is 13.58 g/dL, the average albumin is 3.77 g/dL, the average NLR is 6.06, and the average PLR is 275.5. Conclusion: HNC is a big challenging public health problem worldwide, especially in the high prevalence of betel nut consumption area Taiwan. Besides the definite risk factors of smoking, drinking and betel nut related, the other biomarkers may play significant prognosticators in the HNC outcomes. We concluded that the average BMI is less than 22 kg/m2, the average Hb is low than 12.0 g/dL, the average albumin is low than 3.3 g/dL, the average NLR is low than 3, and the average PLR is more than 170, the surgical complications and mortality will be increased, and the prognosis is poor in HNC patients.

Keywords: nutritional, immunological, neutrophil-to-lymphocyte ratio, paltelet-to-lymphocyte ratio.

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Authors: Mathias Ebot, Päivi Harinen

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This article focuses on challenges of parenthood for Sub-Saharan African fathers in Finland. In this analysis Finland represents a Nordic welfare society where family relationships are strongly guided by national family policies and discourses. These policies are based on both traditional ideas of a proper Finnish family, as well as on the contemporary waves of female liberation and emphasis on children’s rights. We analyze how especially Cameroonian fathers perceive their parenthood positions and how they characterize and frame their fathering experiences in relation to the mainstream sociopolitical, cultural and national representations of fatherhood in Finland. The analysis is based on interviews and narrative reports collected among Cameroonian fathers living in Finland with their African spouses. The scrutiny shows that in the context where the mainstream cultural and national family representation is created by equality between parents and also between parents and their children, and where “good fatherhood” is created by embodied presence and warm relationships with children these fathers have difficulties: They have to fulfill another fatherhood duty – bread-winning – and thus ensure their labor possibilities all the time, from very marginalized positions of the labor market. When comparing their fatherhood position with the one in Cameroon they also feel embarrassed as the Finnish educational system teaches and encourages their children to challenge their authority as up-raising adults, which in Cameroon could not be possible.

Keywords: Cameroonian fathers, perception, fathering experiences, Finland

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Authors: Nancy N. Sharmila, Aparna Mishra

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Hemiparesis affects almost 80% of stroke patients each year. It is marked by paralysis or weakness on one half of the body. Our model provides both assistance and physical therapy for hemiparesis patients for swift recovery. In order to accomplish our goal a force is provided that pulls the forearm up (as in flexing the arm), and pushes the forearm down (as in extending the arm), which will also assist the user during ADL (Activities of Daily Living). The model consists of a mechanical component which is placed around the patient’s bicep and an EMG control circuit to assist patients in daily activities, which makes it affordable and easy to use. In order to enhance the neuromuscular system’s effectiveness in synchronize the movement, proprioceptive neuromuscular facilitation (PNF) concept is used. The EMG signals are acquired from the unaffected arm as an input to drive the orthosis. This way the patient is invigorated to use the orthosis for regular exercise.

Keywords: EMG, hemiparesis, orthosis, rehabilitation

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Authors: Husham Bayazed, Fatimah Yousif

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Purpose of Presentation: The infant immune system has a reputation for being weak and underdeveloped when compared to the adult immune system, but the comparison isn’t quite fair. At the start, as the COVID-19 pandemic drags on and evolves, many Pediatricians and kids' parents have been left with renewed questions about the consequences and sequel of infection on children and the steps to be taken if their child has the symptoms of COVID-19 or tests positive. Recent Findings Literature reviews and recent studies revealed that children are better than adults at controlling SARS-CoV-2. There was conflicting evidence on age-related differences in ACE2 expression in the nose and lungs. But scientists who measured the ‘viral load’ in children's upper airways have seen no clear difference between children and adults. Moreover, the hypothesis is that kids might be more exposed to other coronaviruses common cold, with a production of ready protective antibodies to lock on to the pandemic coronavirus. But the evidence suggests that adults also have this immunity too. Strikingly, these ‘cross-reactive’ antibodies don’t offer any special protection. Summary One of the few silver linings of the Covid-19 pandemic is that children are relatively spared. The kid's Innate Immunity is hardly the whole story, the innate immune response against SARS-CoV-2 infection is early initiative calm with low immunological tone to prevent an overactive immunity and with rapidly repair damage to the lungs in contrast to stormy waves in adults. Therefore, Kids are at much lower risk of Covid-19 infection, and they are still winning the battle against Covid-19 with their innate immunity.

Keywords: Covid-19, kids, ACE2 receptors, immunity

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Authors: S. Mohd Afzal, R. O'Connell

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Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.

Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus

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Authors: Seokbeen Lim, Gilwon Yoon

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The readiness potential in brain waves is a brain activity related with an intention whose potential arises even before its conscious intention. This study was carried out in order to understand the generation and mechanism of the readiness potential more. The experiment with two subjects was conducted in two ways following the Oddball task protocol. Firstly, auditory stimuli were randomly presented to the subjects. The subject was allowed to press the keyboard with the right index finger only when the subject heard the target stimulus but not the standard stimulus. Secondly, unlike the first one, the auditory stimuli were randomly presented, and the subjects pressed the keyboard in the same manner, but at the same time with grasping action of the left hand. The readiness potential showed up for both of these experiments. In the first Oddball experiment, the readiness potential was detected only when the target stimulus was presented. However, in the second Oddball experiment with the left hand action of grasping something, the readiness potential was detected at the presentation of for both standard and target stimuli. However, detected readiness potentials with the target stimuli were larger than those of the standard stimuli. We found an interesting phenomenon that the readiness potential was able to be detected even the standard stimulus. This indicates that motor-related readiness potentials can be generated only by the intention to move. These results present a new perspective in psychology and brain engineering since subconscious brain action may be prior to conscious recognition of the intention.

Keywords: readiness potential, auditory stimuli, event-related potential, electroencephalography, oddball task

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Authors: Wilai Masanga, Chirapha Tannanonta, Sangutid Thongsawad, Sasikarn Chamchod, Todsaporn Fuangrod

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The major factors of radiotherapy for head and neck (HN) cancers include patient’s anatomical changes and tumour shrinkage. These changes can significantly affect the planned dose distribution that causes the treatment plan deterioration. A measured transit EPID images compared to a predicted EPID images using gamma analysis has been clinically implemented to verify the dose accuracy as part of adaptive radiotherapy protocol. However, a global gamma analysis dose not sensitive to some critical organ changes as the entire treatment field is compared. The objective of this feasibility study is to evaluate the dosimetric response to patient anatomical changes during the treatment course in HN IMRT (Head and Neck Intensity-Modulated Radiation Therapy) using a novel comparison method; organ-of-interest gamma analysis. This method provides more sensitive to specific organ change detection. Random replanned 5 HN IMRT patients with causes of tumour shrinkage and patient weight loss that critically affect to the parotid size changes were selected and evaluated its transit dosimetry. A comprehensive physics-based model was used to generate a series of predicted transit EPID images for each gantry angle from original computed tomography (CT) and replan CT datasets. The patient structures; including left and right parotid, spinal cord, and planning target volume (PTV56) were projected to EPID level. The agreement between the transit images generated from original CT and replanned CT was quantified using gamma analysis with 3%, 3mm criteria. Moreover, only gamma pass-rate is calculated within each projected structure. The gamma pass-rate in right parotid and PTV56 between predicted transit of original CT and replan CT were 42.8%( ± 17.2%) and 54.7%( ± 21.5%). The gamma pass-rate for other projected organs were greater than 80%. Additionally, the results of organ-of-interest gamma analysis were compared with 3-dimensional cone-beam computed tomography (3D-CBCT) and the rational of replan by radiation oncologists. It showed that using only registration of 3D-CBCT to original CT does not provide the dosimetric impact of anatomical changes. Using transit EPID images with organ-of-interest gamma analysis can provide additional information for treatment plan suitability assessment.

Keywords: re-plan, anatomical change, transit electronic portal imaging device, EPID, head, and neck

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Authors: Wen Luo, Phil J. Vardon, Anne-Catherine Dieudonne

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One key process that partly controls the success of geothermal projects is fluid reinjection, which benefits in dealing with waste water, maintaining reservoir pressure, and supplying heat-exchange media, etc. Thus, sustaining the injectivity is of great importance for the efficiency and sustainability of geothermal production. However, the injectivity is sensitive to the reinjection process. Field experiences have illustrated that the injectivity can be damaged or improved. In this paper, the focus is on how the injectivity is improved. Since the injection pressure is far below the formation fracture pressure, hydraulic fracturing cannot be the mechanism contributing to the increase in injectivity. Instead, thermal stimulation has been identified as the main contributor to improving the injectivity. For low-enthalpy geothermal reservoirs, which are not fracture-controlled, thermal fracturing, instead of thermal shearing, is expected to be the mechanism for increasing injectivity. In this paper, field data from the sedimentary low-enthalpy geothermal reservoirs in the Netherlands were analysed to show the occurrence of thermal fracturing due to the cooling shock during reinjection. Injection data were collected and compared to show the effects of the thermal fractures on injectivity. Then, a thermo-hydro-mechanical (THM) model for the near field formation was developed and solved by finite element method to simulate the observed thermal fractures. It was then compared with the HM model, decomposed from the THM model, to illustrate the thermal effects on thermal fracturing. Finally, the effects of operational parameters, i.e. injection temperature and pressure, on the changes in injectivity were studied on the basis of the THM model. The field data analysis and simulation results illustrate that the thermal fracturing occurred during reinjection and contributed to the increase in injectivity. The injection temperature was identified as a key parameter that contributes to thermal fracturing.

Keywords: injectivity, reinjection, thermal fracturing, thermo-hydro-mechanical model

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Authors: May Zaw, Amber Latif, William Lim

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Postpartum dyspnea can be due to many causes, such as pulmonary embolism, amniotic fluid embolism, and peripartum cardiomyopathy, but less frequently due to acute pulmonary edema. The incidence of acute pulmonary edema during pregnancy and in the postpartum period has been estimated to be around 0.08%. About half of the cases are attributed to tocolytic therapy. Herein, we present a case of a young woman presenting with acute hypoxia after induction of labor with oxytocin and found to have acute pulmonary edema. This case aims to illustrate and add to a growing body of literature regarding oxytocin-induced acute pulmonary edema and highlights the importance of recognizing the rare complication of oxytocin and necessary interventions to avoid complications. Oxytocin-induced pulmonary edema is a relatively uncommon condition, but physicians should have a high index of suspicion to initiate timely intervention and avoid fetal complications.

Keywords: pulmonary, pregnancy, oxytocin, postpartum

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Authors: Surekha Tony, Roshan Mevada

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Wiskott-Aldrich syndrome (WAS) is a primary immunodeficiency disease resulting in recurrent infections, eczema, and microthrombocytopenia. In its classical form, significant combined immune deficiency, autoimmune complications, and risk of hematological malignancy necessitate early correction, preferably before 2 years of age, with hematopoietic stem cell transplant (HSCT) or gene therapy. Clinical features and severity are varied, making the diagnosis difficult in milder cases. We report an Omani boy diagnosed in early infancy with WAS based on clinical presentation and confirmed by genetic diagnosis with cure by HSCT from an HLA-identical sibling donor.

Keywords: genetic diagnosis, hematopoietic stem cell transplant, infant, Wiskott-Aldrich syndrome

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Authors: Aemro Tazeze Terefe, Mengistu K. Aredo, Abule M. Workagegnehu, Wondimagegn M. Tesfaye

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Climate-induced shocks have been shown to reduce agricultural production and cause fluctuation in output in developing countries. When livelihoods depend on rain-fed agriculture, climate-induced shocks translate into consumption shocks. Despite the substantial improvements in household consumption, climate-induced shocks, and other factors adversely affect consumption dynamics at the household level in Ethiopia. Therefore, household consumption dynamics in the context of climate-induced shocks help to guide resilience capacity and establish appropriate interventions and programs. The research employed three-round panel data based on the Ethiopian Socioeconomic Survey with spatial rainfall data to define unique measures of rainfall variability. The linear dynamic panel model results show that the lagged value of consumption, market shocks, and rainfall variability positively affected consumption dynamics. In contrast, production shocks, temperature, and amount of rainfall had a negative relationship. Coping strategies mitigate adverse climate-induced shocks on consumption aftershocks that smooth consumption over time. Support to increase the resilience capacity of households can involve efforts to make existing livelihoods and forms of production or reductions in the vulnerability of households. Therefore, government interventions are mandatory for asset accumulation agendas that support household coping strategies and respond to shocks. In addition, the dynamic linkage between consumption and significant socioeconomic and institutional factors should be taken into account to minimize the effect of climate-induced shocks on consumption dynamics.

Keywords: climate shock, Ethiopia, fixed-effect model, food security

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Authors: Govind Ji Pandey

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The divergent opinions in the society are important for its development but with reasonable restrictions. The world recently witnessed one of the most violent protests by a group against the editor and publisher of the magazine ‘Charlie Hebdo’ for publishing cartoon of their religious leader. The supporter of freedom of speech and expression around the world were in shock and termed it the strongest attack against the free speech. People all around the world condemned the killing of the journalists but many soft voices from several corners were also coming for reasonable restrictions on the freedom of speech and expression. Of late, Indian society has witnessed many protests and supports of films with controversial content. It is the beauty of the Indian democracy which gives an opportunity to all for discussion and debate on any issue that challenges established social norms. However, many organizations as well as individuals misuse it for their personal benefits. There have been many film directors who faced protest from several quarters for their controversial themes. This research aims at analyzing the controversial contents published in print media and shown in films. To understand the nature and frequency of such media reports, content analysis technique is used. The research also highlights the perception of the public regarding the controversies. For getting the popular opinion on the coverage of controversial content in cinema and print media, five hundred people from Lucknow, UP, India were randomly selected. The findings of this research are important to understand the response of media and society towards the controversial content presented in cinema and print media. The research highlights that how a handful of people curb free speech in a democratic country like India.

Keywords: cinema, censor board, free speech, liberty, social-religious beliefs

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Authors: P. Sam Vimal Rajkumar, K. Priyanga

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Acoustics is the scientific study of sound which includes the effect of reflection, refraction, absorption, diffraction and interference. Sound can be considered as a wave phenomenon. A sound wave is a longitudinal wave where particles of the medium are temporarily displaced in a direction parallel to energy transport and then return to their original position. The vibration in a medium produces alternating waves of relatively dense and sparse particles –compression and rarefaction respectively. The resultant variation to normal ambient pressure is translated by the ear and perceived as sound. Today much importance is given to the acoustical environment. The noise sources are increased day by day and annoying level is strongly violated in different locations by traffic, sound systems, and industries. There is simple evidence showing that the high noise levels cause sleep disturbance, hearing loss, decrease in productivity, learning disability, lower scholastic performance and increase in stress related hormones and blood pressure. Therefore, achieving a pleasing and noise free environment is one of the endeavours of many a research groups. This can be obtained by using various techniques. One such technique is by using suitable materials with good sound absorbing properties. The conventionally used materials that possess sound absorbing properties are rock wool or glass wool. In this work, an attempt is made to use synthetic material in both fibrous and sheet form and use it for manufacturing of non-woven for sound absorption.

Keywords: acoustics, fibre, non-woven, noise, sound absorption properties, sound absorption coefficient

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Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

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We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance

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Authors: Jeongyeon Park, Yeo Jun Yoon, Jiyoung Seo, In Seok Moon, Hae Jun Lee, Kiwon Song

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Cold Atmospheric Pressure Plasma (CAPP) is defined as a partially ionized gas with electrically charged particles at room temperature and atmospheric pressure. CAPP generates reactive oxygen species (ROS) and reactive nitrogen species (RNS), and has potential as a new apoptosis-promoting cancer therapy. With an annular type dielectric barrier discharge (DBD) CAPP-generating device combined with a helium (He) gas feeding system, we showed that CAPP selectively induced apoptosis in various cancer cells while it promoted proliferation of the adipose tissue-derived stem cell (ASC). The apoptotic effect of CAPP was highly selective toward p53-mutated cancer cells. The intracellular ROS was mainly responsible for apoptotic cell death in CAPP-treated cancer cells. CAPP induced apoptosis even in doxorubicin-resistant cancer cell lines, demonstrating the feasibility of CAPP as a potent cancer therapy. With the same device and exposure conditions to cancer cells, CAPP stimulated proliferation of the ASC, a kind of mesenchymal stem cell that is capable of self-renewing and differentiating into adipocytes, chondrocytes, osteoblasts and neurons. CAPP-treated ASCs expressed the stem cell markers and differentiated into adipocytes as untreated ASCs. The increase of proliferation by CAPP in ASCs was offset by a NO scavenger but was not affected by ROS scavengers, suggesting that NO generated by CAPP is responsible for the activated proliferation in ASCs. Usually, cancer stem cells are reported to be resistant to known cancer therapies. When we applied CAPP of the same device and exposure conditions to cancer cells to liver cancer stem cells (CSCs) that express CD133 and epithelial cell adhesion molecule (EpCAM) cancer stem cell markers, apoptotic cell death was not examined. Apoptotic cell death of liver CSCs was induced by the CAPP generated from a device with an air-based flatten type DBD. An exposure of liver CSCs to CAPP decreased the viability of liver CSCs to a great extent, suggesting plasma be used as a promising anti-cancer treatment. To validate whether CAPP can be a promising anti-cancer treatment or an adjuvant modality to eliminate remnant tumor in cancer surgery of vestibular schwannoma, we applied CAPP to mouse schwannoma cell line SC4 Nf2 ‑/‑ and human schwannoma cell line HEI-193. A CAPP treatment leads to anti-proliferative effect in both cell lines. We are currently studying the molecular mechanisms of differential physiological effect of CAPP; the proliferation of ASCs and apoptosis of various cancer cells and CSCs.

Keywords: cold atmospheric pressure plasma, apoptosis, proliferation, cancer cells, adult stem cells

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Authors: Adria Kajenski, Guinevere Strack, Edward Kingsley, Shahriar Khushrushahi, Alkim Akyurtlu

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Radio Frequency (RF) metasurfaces are arrangements of subwavelength elements interacting with electromagnetic radiation. These arrangements affect polarization state, amplitude, and phase of impinged radio waves; for example, metasurface designs are used to produce functional passband and stopband filters. Recent advances in additive manufacturing techniques have enabled the low-cost, rapid fabrication of ultra-thin metasurface elements on flexible substrates such as plastic films, paper, and textiles. Furthermore, scalable manufacturing processes promote the integration of fabric-based RF metasurfaces into the market of sensors and devices within the Internet of Things (IoT). The design and fabrication of metasurfaces on textiles require a multidisciplinary team with expertise in i) textile and materials science, ii) metasurface design and simulation, and iii) metasurface fabrication and testing. In this presentation, we will discuss RF metasurfaces on fabric with an emphasis on how the materials, including fabric and inks, along with fabrication techniques, affect the RF performance. We printed metasurfaces using a direct-write approach onto various woven and non-woven fabrics, as well as on fabrics coated with either thermoplastic or thermoset coatings. Our team also performed a range of tests on the printed structures, including different inks and their curing parameters, wash durability, abrasion resistance, and RF performance over time.

Keywords: electronic textiles, metasurface, printed electronics, flexible

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Authors: Van-Thanh Ho, Jaiyoung Ryu

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In soft robotics, the optimization of fluid dynamics through pneumatic methods plays a pivotal role in enhancing operational efficiency and reducing energy loss. This is particularly crucial when replacing conventional techniques such as cable-driven electromechanical systems. The pneumatic model employed in this study represents a sophisticated framework designed to efficiently channel pressure from a high-pressure reservoir to various muscle locations on the robot's body. This intricate network involves a branching system of tubes. The study introduces a comprehensive pneumatic model, encompassing the components of a reservoir, tubes, and Pneumatically Actuated Muscles (PAM). The development of this model is rooted in the principles of shock tube theory. Notably, the study leverages experimental data to enhance the understanding of the interplay between the PAM structure and the surrounding fluid. This improved interactive approach involves the use of morphing motion, guided by a contraction function. The study's findings demonstrate a high degree of accuracy in predicting pressure distribution within the PAM. The model's predictive capabilities ensure that the error in comparison to experimental data remains below a threshold of 10%. Additionally, the research employs a machine learning model, specifically a surrogate model based on the Kriging method, to assess and quantify uncertainty factors related to the initial reservoir pressure and tube diameter. This comprehensive approach enhances our understanding of pneumatic soft robotics and its potential for improved operational efficiency.

Keywords: pneumatic artificial muscles, pressure drop, morhing motion, branched network, surrogate model

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Authors: Michael Nolte, Iwona Kasior, Kala Flagg, Spiro Karavatas

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Background: Cryotherapy has been used as a post-exercise recovery modality for decades. Whole-body cryotherapy (WBC) is an intervention which involves brief exposures to extremely cold air in order to induce therapeutic effects. It is currently being investigated for its effectiveness in treating certain exercise-induced impairments. Purpose: The purpose of this systematic review was to determine whether WBC as a recovery intervention is more, less, or equally as effective as other interventions at reducing perceived levels of muscle soreness and promoting recovery of muscle function after exercise-induced muscle damage (EIMD) from running. Methods: A systematic review of the current literature was performed utilizing the following MeSH terms: cryotherapy, whole-body cryotherapy, exercise-induced muscle damage, muscle soreness, muscle recovery, and running. The databases utilized were PubMed, CINAHL, EBSCO Host, and Google Scholar. Articles were included if they were published within the last ten years, had a CEBM level of evidence of IIb or higher, had a PEDro scale score of 5 or higher, studied runners as primary subjects, and utilized both perceived levels of muscle soreness and recovery of muscle function as dependent variables. Articles were excluded if subjects did not include runners, if the interventions included PBC instead of WBC, and if both muscle performance and perceived muscle soreness were not assessed within the study. Results: Two of the four articles revealed that WBC was significantly more effective than treatment interventions such as far-infrared radiation and passive recovery at reducing perceived levels of muscle soreness and restoring muscle power and endurance following simulated trail runs and high-intensity interval running, respectively. One of the four articles revealed no significant difference between WBC and passive recovery in terms of reducing perceived muscle soreness and restoring muscle power following sprint intervals. One of the four articles revealed that WBC had a harmful effect compared to CWI and passive recovery on both perceived muscle soreness and recovery of muscle strength and power following a marathon. Discussion/Conclusion: Though there was no consensus in terms of WBC’s effectiveness at treating exercise-induced muscle damage following running compared to other interventions, it seems as though WBC may at least have a time-dependent positive effect on muscle soreness and recovery following high-intensity interval runs and endurance running, marathons excluded. More research needs to be conducted in order to determine the most effective way to implement WBC as a recovery method for exercise-induced muscle damage, including the optimal temperature, timing, duration, and frequency of treatment.

Keywords: cryotherapy, physical therapy intervention, physical therapy, whole body cryotherapy

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Authors: F. A. Thomas, M. Schrafl-Altermatt, R. Treier, S. Kaufmann

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Stroke is the main cause of adult disability. Especially upper limb function is affected in most patients. Recently, cooperative hand movements have been shown to be a promising type of upper limb training in stroke rehabilitation. In these movements, which are frequently found in activities of daily living (e.g. opening a bottle, winding up a blind), the force of one upper limb has to be equally counteracted by the other limb to successfully accomplish a task. The use of standardized and reliable clinical assessments is essential to evaluate the efficacy of therapy and the functional outcome of a patient. Many assessments for upper limb function or impairment are available. However, the evaluation of cooperative hand movement tasks are rarely included in those. Thus, the aim of this study was (i) to develop a novel clinical assessment (CASA - Cooperative Activity Stroke Assessment) for the evaluation of patients’ capacity to perform cooperative hand movements and (ii) to test its inter- and interrater reliability. Furthermore, CASA scores were compared to current gold standard assessments for upper extremity in stroke patients (i.e. Fugl-Meyer Assessment, Box & Blocks Test). The CASA consists of five cooperative activities of daily living including (1) opening a jar, (2) opening a bottle, (3) open and closing of a zip, (4) unscrew a nut and (5) opening a clipbox. Here, the goal is to accomplish the tasks as fast as possible. In addition to the quantitative rating (i.e. time) which is converted to a 7-point scale, also the quality of the movement is rated in a 4-point scale. To test the reliability of CASA, fifteen stroke subjects were tested within a week twice by the same two raters. Intra-and interrater reliability was calculated using the intraclass correlation coefficient (ICC) for total CASA score and single items. Furthermore, Pearson-correlation was used to compare the CASA scores to the scores of Fugl-Meyer upper limb assessment and the box and blocks test, which were assessed in every patient additionally to the CASA. ICC scores of the total CASA score indicated an excellent- and single items established a good to excellent inter- and interrater reliability. Furthermore, the CASA score was significantly correlated to the Fugl-Meyer and Box & Blocks score. The CASA provides a reliable assessment for cooperative hand movements which are crucial for many activities of daily living. Due to its non-costly setup, easy and fast implementation, we suggest it to be well suitable for clinical application. In conclusion, the CASA is a useful tool in assessing the functional status and therapy related recovery in cooperative hand movement capacity in stroke patients.

Keywords: activitites of daily living, clinical assessment, cooperative hand movements, reliability, stroke

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Authors: Babarina Maria, Andropova Margarita

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Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

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Authors: Patcharaporn Sakulpong, Wiriya Phokhwang

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Background: Banpunrug (Love Sharing House) established in 2013 provides a community-based palliative care for patients with cancer from 7 provinces in southern Thailand. These patients come to receive outpatient chemotherapy and radiotherapy at Suratthani Cancer Hospital. They are poor and uneducated; they need an accommodation during their 30-45 day course of therapy. Methods: A community-participatory action research (PAR) was employed to establish a model of palliative care for patients with cancer. The participants included health care providers, community, and patients and families. The PAR process includes problem identification and need assessment, community and team establishment, field survey, organization founding, model of care planning, action and inquiry (PDCA), outcome evaluation, and model distribution. Results: The model of care at Banpunrug involves the concepts of HHHS model, in that Banpunrug is a Home for patients; patients live in a house comfortable like in a Hotel resource; the patients are given care and living facilities similarly to those in a Hospital; the house is a School for patients to learn how to take care themselves, how to live well with cancer, and most importantly how to prepare themselves for a good death. The house is also a humanized care school for health care providers. Banpunrug’s philosophy of care is based on friendship therapy, social and spiritual support, community partnership, patient-family centeredness, Live & Love sharing house, and holistic and humanized care. With this philosophy, the house is managed as a home of the patients and everyone involved; everything is costless for all eligible patients and their family members; all facilities and living expense are donated from benevolent people, friends, and community. Everyone, including patients and family, has a sense of belonging to the house and there is no authority between health care providers and the patients in the house. The house is situated in a temple and a community and supported by many local nonprofit organizations and healthcare facilities such as a health promotion hospital at sub-disctrict level and Suratthani Cancer Hospital. Village health volunteers and multi-professional health care volunteers have contributed not only appropriate care, but also knowledge and experience to develop a distinguishing HHHS community-based palliative care model for patients with cancer. Since its opening the house has been a home for more than 400 patients and 300 family members. It is also a model for many national and international healthcare organizations and providers, who come to visit and learn about palliative care in and by community. Conclusions: The success of this palliative care model comes from community involvement, multi-professional volunteers and distributions, and concepts of HHHS model. Banpunrug promotes a consistent care across the cancer trajectory independent of prognosis in order to strengthen a full integration of palliative

Keywords: community-based palliative care, model, participatory action research, patients with cancer

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