Search results for: treatment based on acceptance and commitment

Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Farnaz Dehkhoda

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This study was conducted to compare the effectiveness of active and receptive music-therapy on anxiety in cancer patients undergoing chemotherapy or radiotherapy. 184 young adult patients, who were diagnosed with early stage cancer and were undergoing treatment, were divided into three groups. Two groups received music therapy as a parallel treatment and the third group was control group. In active music-therapy, a music specialist helped the patients to play guitar and sing. In the receptive music-therapy, patients preferred pre-recorded music played by MP3 player. The level of anxiety was measured by the Beck Anxiety Inventory as pre-test and post-test. ANCOVA revealed that both types of music-therapy reduced anxiety level of patients and the active music-therapy intervention found to be more effective. The results suggest that music-therapy can be applied as an intervention method contemporary with cancer medical treatment, for improving quality of life in cancer patients by reducing their anxiety.

Keywords: Anxiety, Cancer, Chemotherapy, Music-therapy

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Authors: Hye Kyung Kim, Myung-Gyou Kim, Kang-Hyun Leem

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The deer velvet antler is well known for its traditional medicinal value and is widely used in the clinic. It has been considered to possess bone-strengthening activity. The goal of this study was to investigate the anti-osteoporotic effect of deer antler velvet on ovariectomized rats (OVX), and their possible mechanism of the action. In the first step, the in vitro effects of DAE on bone loss were determined. The proliferation, collagen content and alkaline phosphatase (ALP) activity of human osteoblastic MG-63 cells and osteoclastogenesis from bone marrow-derived precursor cells were measured. The in vivo experiment confirmed the positive effect of DAE on bone tissue. 3-month old female Sparague-Dawley rats were either sham operated or OVX, and administered DAE (20 and 100 mg/kg) for 4 weeks. DAE increased MG-63 cell proliferation and ALP activity in a dose-dependent manner. Collagen content was also increased by DAE treatment. However, the effect of DAE on bone resorption was not observed. OVX rats supplemented with DAE showed osteoprotective effects as the bone ALP level was increased and c-terminal telopeptide level was decreased by 100 mg/kg DAE treatment compared with OVX controls. Moreover, the tartrate-resistant acid phosphatase-5b level was also decreased by DAE treatment. The present study suggests that DAE is effective in preventing bone loss in OVX rats, and may be potential therapeutic agents for the treatment of postmenopausal osteoporosis.

Keywords: bone ALP, c-terminal telopeptide, deer antler, osteoporosis, ovariectomy, tartrate-resistant acid phosphatase-5b

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Authors: Tigabu Dagne Akal

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Electronic health records (EHRs) can help to store, maintain, and make the appropriate handling of patient histories for proper treatment and decision. Merging the EHRs with big data analytics (BDA) capabilities enable healthcare stakeholders to provide effective and efficient treatments for chronic diseases. Though there are huge opportunities and efforts that exist in the deployment of EMRs and the development of BDA, there are challenges in addressing resources and organizational capabilities that are required to achieve the competitive advantage and sustainability of EHRs and BDA. The resource-based view (RBV), information system (IS), and non- IS theories should be extended to examine organizational capabilities and resources which are required for successful data analytics in the healthcare industries. The main purpose of this study is to develop a conceptual framework for the development of healthcare BDA capabilities based on past works so that researchers can extend. The research question was formulated for the search strategy as a research methodology. The study selection was made at the end. Based on the study selection, the conceptual framework for the development of BDA capabilities in the healthcare settings was formulated.

Keywords: EHR, EMR, Big data, Big data analytics, resource-based view

Procedia PDF Downloads 132

Authors: Suraj Amrutkar, R. Gowri, Asma Khan, Nazam Khan, Vikas Mahajan, Manpreet Kour And Bharti Deshmukh

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Herbal additives are rich in vitamin C, A and other biological active compounds and may act as surrogate source to subdue heat stress in chicken. Among various herbal additives such as rough lemon (Citrus Jambhiri Lush) juice, amla (Emblica officinalis) juice and aloe vera (Aloe barbadensis miller) gel are easily available during summer (stress period) and also cost less as comparison to synthetic feed additives in market. In order to analyze the performance by supplementation of rough lemon juice, amla juice and aloe vera gel in broiler under heat stress conditions. Study was carried out with a random distribution of day old straight run chicks (240 No.) in to four treatment group (n=60) was done. All the groups were given basal diet (Maize-Soya based; T0) was same for all the groups with supplementation of rough lemon juice (T1), amla juice (T2) and aloe vera (T3) @ 2% in drinking water. Experiment trial lasted for 42 days during heat stress period (June-July) with minimum THI (78.2) and Maximum THI (88.02). Feed and water were offered ad-libitum throughout the trial. Results revealed significantly higher (P<0.05) body weight in T3 and T2, followed by T1 and least in T0 at 42 days of age. The overall mean of Feed conversion ratio of various treatment T0, T1, T2 andT3 were 2.16, 1.98, 1.89 and 1.82, respectively. The mortality percentage in various treatment, T0, T1, T2 and T3, were 6.67, 3.33, 0.0 and 1.67, respectively. pH value, PCV (%), Sodium (mmol/L) and Potassium (mmol/L) was higher in T3 than rest of the groups. HL ratio is significantly lower (P<0.05) in T3, T2 followed by T1 than T0 at 42 days of age. It may be inferred that amongst these phyto-additives, aloe vera leads in alleviating heat stress in broiler in an economical way, followed by amla and rough lemon.

Keywords: rough lemon, amla, aloe vera, heat stress, broiler

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Authors: Chhaya Sharma, Dushyant Kumar

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The present work deals with the treatment of wastewater generated by paper industry by using aluminium as anode material. The quantitative and qualitative analyses of chloropenolics have been carried out by using primary clarifier effluent with the help of gas chromatography mass spectrometry. Sixteen chlorophenolics compounds have been identified and estimated. Results indicated that among 16 identified compounds, 7 are 100% removed and overall 66% reduction in chorophenolics compounds have been detected. Moreover, during the treatment, the biodegradability index of wastewater significantly increases, along with 70 % reduction in chemical oxygen demand and 99 % in color.

Keywords: aluminium anode, chlorophenolics, electrocoagulation, pollution load, wastewater

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Authors: Abdullah Alyoussef

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Folliculitis decalvans is a rare inflammatory scalp disorder. This paper gives an update to patient management and treatment modalities. Folliculitis decalvans is classified as primary neutrophilic cicatricial alopecia and predominantly occurs in middle-aged adults. The cause of folliculitis decalvans (FD) remains unknown. Staphylococcus aureus and a deficient host immune response seem to play an important role in the development of this disfiguring scalp disease. Lesions occur mainly in the vertex and occipital area. Clinically, the lesions present with follicular pustules, lack of ostia, diffuse and perifollicular erythema, follicular tufting, and, oftentimes, hemorrhagic crusts and erosions. Histology displays a mainly neutrophilic inflammatory infiltrate in early lesions and additionally lymphocytes and plasma cells in advanced lesions. Treatment is focused on the eradication of S. aureus and anti-inflammatory agents. Although the etiology of FD is unclear, S. aureus is almost always isolated from affected areas, and eradication is an important part of therapeutic management, in combination with systemic and ⁄ or topical anti-inflammatory treatment.

Keywords: cicatricial alopecia, folliculitis decalvans, tufted folliculitis, erosion

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Authors: N. F. Hamid, A. Kipar, J. Stewart, D. J. Antoine, B. K. Park, D. P. Williams

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Acetaminophen (APAP) is a widely used analgesic that is safe at therapeutic doses. The mouse model of APAP has been extensively used for studies on pathogenesis and intervention of drug induced liver injury based on the CytP450 mediated formation of N-acetyl-p-benzo-quinoneimine and, more recently, as model for mechanism based biomarkers. Delay of the fasted CD1 mice to rebound to the basal level of hepatic GSH compare to fed mice is reported in this study. Histologically, 15 hours fasted mice prior to APAP treatment leading to overall more intense cell loss with no evidence of apoptosis as compared to non-fasted mice, where the apoptotic cells were clearly seen on cleaved caspase-3 immunostaining. After 15 hours post APAP administration, hepatocytes underwent stage of recovery with evidence of mitotic figures in fed mice and return to completely no histological difference to control at 24 hours. On the contrary, the evidence of ongoing cells damage and inflammatory cells infiltration are still present on fasted mice until the end of the study. To further measure the regenerative capacity of the hepatocytes, the inflammatory mediators of cytokines that involved in the progression or regression of the toxicity like TNF-α and IL-6 in liver and spleen using RT-qPCR were also included. Yet, quantification of proliferating cell nuclear antigen (PCNA) has demonstrated the time for hepatic regenerative in fasted is longer than that to fed mice. Together, these data would probably confirm that fasting prior to APAP treatment does not only modulate liver injury, but could have further effects to delay subsequent regeneration of the hepatocytes.

Keywords: acetaminophen, liver, proliferating cell nuclear antigen, regeneration, apoptosis

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Authors: F. Pal-Fam, S. Keszthelyi

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Phytosanitary condition of sunflower (Helianthus annuus L.) was endangered by several phytopathogenic agents, mainly microfungi, such as Sclerotinia sclerotiorum, Diaporthe helianthi, Plasmopara halstedtii, Macrophomina phaseolina and so on. There are more agrotechnical and chemical technologies against them, for instance, tolerant hybrids, crop rotations and eventually several in-crop chemical treatments. There are different fungicide treatment methods in sunflower in Hungarian agricultural practice in the quest of obtaining healthy and economic plant products. Besides, there are many choices of useable active ingredients in Hungarian sunflower protection. This study carried out into the examination of the effect of five different fungicide active substances (found on the market) and three different application modes (early; late; and early and late treatments) in a total number of 9 sample plots, 0.1 ha each other. Five successive vegetation periods have been investigated in long term, between 2013 and 2017. The treatments were: 1)untreated control; 2) boscalid and dimoxystrobin late treatment (July); 3) boscalid and dimoxystrobin early treatment (June); 4) picoxystrobin and cyproconazole early treatment; 5) picoxystrobin and cymoxanil and famoxadone early treatment; 6) picoxystrobin and cyproconazole early; cymoxanil and famoxadone late treatments; 7) picoxystrobin and cyproconazole early; picoxystrobin and cymoxanil and famoxadone late treatments; 8) trifloxystrobin and cyproconazole early treatment; and 9) trifloxystrobin and cyproconazole both early and late treatments. Due to the very different yearly weather conditions different phytopathogenic fungi were dominant in the particular years: Diaporthe and Alternaria in 2013; Alternaria and Sclerotinia in 2014 and 2015; Alternaria, Sclerotinia and Diaporthe in 2016; and Alternaria in 2017. As a result of treatments ‘infection frequency’ and ‘infestation rate’ showed a significant decrease compared to the control plot. There were no significant differences between the efficacies of the different fungicide mixes; all were almost the same effective against the phytopathogenic fungi. The most dangerous Sclerotinia infection was practically eliminated in all of the treatments. Among the single treatments, the late treatment realised in July was the less efficient, followed by the early treatments effectuated in June. The most efficient was the double treatments realised in both June and July, resulting 70-80% decrease of the infection frequency, respectively 75-90% decrease of the infestation rate, comparing with the control plot in the particular years. The lowest yield quantity was observed in the control plot, followed by the late single treatment. The yield of the early single treatments was higher, while the double treatments showed the highest yield quantities (18.3-22.5% higher than the control plot in particular years). In total, according to our five years investigation, the most effective application mode is the double in-crop treatment per vegetation time, which is reflected by the yield surplus.

Keywords: fungicides, treatments, phytopathogens, sunflower

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Authors: David Tanujaya Kurniawan

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Background: Liver injury caused by paracetamol is marked by increased serum transaminase levels. Turmeric is a local herb that is available in large quantities and inexpensive in contradiction to its substantial benefits, including its potency to increase glutathione production and regenerate hepatocyte into normal condition. Aim: The aim of this study was to analyze the potencial treatment effect of turmeric rhizome extract to reduce serum transaminase level on paracetamol induced liver toxicity in rats. Methods: This study was a laboratory experimental research with post-test only controlled group design. A group of 24 Wistar white male rats was induced with paracetamol 360 mg/kg body weight for 10 days. The group was then separated into four groups: the first and the second was treated with 100 mg/kg body weight and 150 mg/kg body weight of turmeric rhizome extract, subsequently, the third as positive control was given 27 mg/kg body weight of lesichol, while the fourth as negative control was given CMC-Na 1%. Each of this treatment was given for seven days. At the end of the study, the blood samples were taken to measure SGOT and SGPT levels. The one-way Anova test revealed significant difference in mean of SGPT level (p=0,001). The LSD test showed significant differences of SGPT levels in both treatment groups and negative control group. However, there was no sgnificant difference between positive control and both treatment groups. Conclusion: Curcuma domestica Val. rhizome extract could not reduce SGOT level, but it reduced SGPT level significantly.

Keywords: Curcuma domestica val., SGOT, SGPT, paracetamol, liver toxicity

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Authors: Omaimah Algohary

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Kaolin is one of the principle intestinal adsorbents, has traditionally been used internally in the treatment of various enteric disorders, colitis, enteritis, dysentery, and diarrhea associated with food and alkaloidal poisoning and in traveler’s diarrhea. It binds to and traps bacteria and its toxins and gases in the gut. It also binds to water in the gut, which helps to make the stools firmer, hence giving symptomatic relief. Metronidazole is a synthetic antibacterial agent that is used primarily in the treatment of various anaerobic infections such as intra-abdominal infections, antiprotozoal, and as amebicidal. The need for safe, therapeutically effective antidiarrheal combination continuously lead to effective treatment. Metronidazol used for treatment of anaerobic bacteria and kaolin , when administered simultaneously, Metronidazole–Kaolin interactions have been reported by FDA but not studied. This project is the first to study the effect of Metronidazole–Kaolin interactions on the antimicrobial activity of metronidazole. Agar diffusion method performed to test the antimicrobial activity of metronidazole–kaolin antidiarrheal combination from aqueous solutions at an in-vivo simulated pHs conditions that obtained at 37+0.5 °C on Helicobacter pylori as anaerobic bacteria and E.coli as aerobic bacteria and used as a control for the technique. The antimicrobial activity of metronidazole combination as 1:1 and 1:2 with kaolin was abolished in acidic media as no zones of inhibition shown compared to only metronidazole that used as a control. In alkaline media metronidazole combination as 1:1 and 1:2 with kaolin showed diminutive activity compared to the control. These results proved that the kaolin adsorb metronidazole and abolish its antimicrobial activity and such combination should be avoided.

Keywords: kaolin, metronidazole, interaction, Helicobacter pylori. E. coli, antimicrobial activity

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Authors: Naheed Malik, Waheed Akhtar

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An introduction to the Islamic move towards the managing human resource is a preliminary attempt to provide managers with a useful way of managing and accepting employees. This knowledge would be helpful to even non-Muslim managers. Muslim managers are required not to know only the Islamic HR but also it is expected from them to apply the Islamic approach in managing the employees. Human resource is considered the most substantial asset of organizations. Studies have recommended that successful human resource management (HRM) leads to positive attitudes and behaviors at the workplace. On the contrary, unproductive use of human resources results in negative penalty in the form of lower job satisfaction, lower commitment, or even high employee turnover and even poor workforce quality.The study examined the Impact of Islamic HR practices on job satisfaction. Islamic HR variables encompass the aspects of performance appraisal, training and development, selection and recruitment. Data was obtained via self –administered questionnaires distributed among the employees of Banks in Pakistan which are practicing Islamic Banking. The sampling method employed was purposive sampling.Based on 240 responses obtained ,the study revealed that Islamic HRM deliberates the 40per cent of the variances in Job satisfaction .All variables excluding recruitment were found to be substantially pertinent to the dependent variable. The study also meditated the implications for future studies.

Keywords: islamic HRM, job satisfaction, islamic and conventional banks, Pakistan

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Authors: Kai-Shiang Chang, Shiao-Shing Chen, Saikat Sinha Ray, Hung-Te Hsu

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In recent years, membrane bioreactors (MBR) have been widely utilized as it can effectively replace conventional activated sludge process (CAS). Membrane bioreactor (MBR) is found to be more effective technology compared to other conventional activated sludge process and advanced membrane separation technique. Additionally, as far as the MBR is concerned, it is having excellent control of sludge retention time (SRT) and hydraulic retention time (HRT) and conducive to the retention of high concentration of sludge biomass. The membrane bioreactor (MBR) can effectively reduce footprint in terms of area and omit the secondary processing procedures in the conventional activated sludge process (CAS). Currently, as per the membrane technology, the ceramic membrane is found to have highly strong anti-acid-base properties, and it is more suitable than polymeric membrane while using for backwash and chemical cleaning. This study is based upon the treatment of Cutting Fluid wastewater, as the Cutting Fluid is widely used in the cutting equipment. However, the Cutting Fluid wastewater is very difficult to treat. In this study, the ceramic membrane was used and combine with of MBR system to treat the Cutting Fluid wastewater. In this present study, different kind of chemical coagulants have been utilized for pretreatment purpose in order to get the supernatant and simultaneously this wastewater (supernatant) was treated by MBR process. Nevertheless, ceramic membrane has three advantages such as high mechanical strength, drug resistance and reuse. During the experiment, the backwash technique was used for every interval of 10 minutes in order to avoid fouling of the membrane. In this study, during pretreatment the Chemical Oxygen Demand (COD) removal efficiency was found to be 71-86% and oil removal efficiency was analyzed to be 83-92%. This pretreatment study suggests that it is quiet effective methodology to reduce COD and oil concentration. Finally, In the MBR system when the HRT is more than 7.5 hour, the COD removal efficiency was found to be 87-93% and could achieve 100% oil removal efficiency. Coagulation test series were seen in Refs coagulants for the treatment of wastewater containing cutting oil with better oil and COD removal efficiency. The results also showed that the oil removal efficiency in the MBR system could reduce the oil content to less than 1 mg / L when the oil quality was 126 mg / L. Therefore, in this paper, the performance of membrane bioreactor by utilizing ceramic membrane has been demonstrated for treatment of Cutting Fluid wastewater.

Keywords: membrane bioreactor, cutting fluid, oil, chemical oxygen demand

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Authors: Ananya Pal, Neelakshi Sarkar, Debraj Saha, Dipanwita Das, Subhashish Kamal Guha, Bibhuti Saha, Runu Chakravarty

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Presently, tenofovir disoproxil fumurate (TDF) is the most effective anti-viral agent for the treatment of hepatitis B virus (HBV) in individuals co-infected with HIV and HBV as TDF has activity to suppress both wild-type and lamivudine (3TC)-resistant HBV. However, suboptimal response to TDF was reported in HIV-HBV co-infected individuals with prior 3TC therapy from different countries recently. The incidence of 3TC-resistant HBV strains is quite high in HIV-HBV co-infected patients experiencing long-term anti-retroviral therapy (ART) in eastern India. In spite of this risk, most of the patients with long-term 3TC treatment are continued with the same anti-viral agent in this country. Only a few have received TDF in addition to 3TC in the ART regimen since TDF has been available in India for the treatment of HIV-infected patients in 2012. In this preliminary study, we investigated the virologic and biochemical parameters among HIV-HBV co-infected patients who are non-responders to 3TC treatment during the continuation of 3TC or TDF add-on to 3TC in their ART regimen. Fifteen HIV-HBV co-infected patients who experienced long-term 3TC (mean duration months 36.87 ± 24.08 months) were identified with high HBV viremia ( > 20,000 IU/ml) or harbouring 3TC-resistant HBV. These patients receiving ART from School of Tropical Medicine Kolkata, the main ART centre in eastern India were followed-up semi-annually for next three visits. Different virologic parameters including quantification of plasma HBV load by real-time PCR, detection of hepatitis B e antigen (HBeAg) by commercial ELISA and anti-viral resistant mutations by sequencing were studied. During three follow-up among study subjects, 86%, 47%, and 43% had 3TC-mono-therapy (mean treatment-duration 41.54±18.84, 49.67±11.67, 54.17±12.37 months respectively) whereas 14%, 53%, and 57% experienced TDF in addition to 3TC (mean treatment duration 4.5±2.12, 16.56±11.06, and 23±4.07 months respectively). Mean CD4 cell-count in patients receiving 3TC was tended to be lower during third follow-up as compared to the first and the second [520.67±380.30 (1st), 454.8±196.90 (2nd), and 397.5±189.24 (3rd) cells/mm3) and similar trend was seen in patients experiencing TDF in addition to 3TC [334.5±330.218 (1st), 476.5±194.25 (2nd), and 461.17±269.89 (3rd) cells/mm3]. Serum HBV load was increased during successive follow-up of patients with 3TC-mono-therapy. Initiation of TDF lowered serum HBV-load among 3TC-non-responders at the time of second visit ( < 2,000 IU/ml), interestingly during third follow-up, mean HBV viremia increased >1 log IU/ml (mean 3.56±2.84 log IU/ml). Persistence of 3TC-resistant double and triple mutations was also observed in both the treatment regimens. Mean serum alanine aminotransferase remained elevated in these patients during this follow-up study. Persistence of high HBV viraemia and 3TC-resistant mutation in HBV during the continuation of 3TC might lead to major public health threat in India. The inclusion of TDF in the ART regimen of 3TC non-responder HIV-HBV co-infected patients showed adverse treatment response in terms of virologic and biochemical parameters. Therefore, serious attention is necessary for proper management of long-term 3TC experienced HIV-HBV co-infected patients with high HBV viraemia or 3TC-resistant HBV mutants in India.

Keywords: HBV, HIV, TDF, 3TC-resistant

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Authors: Jessica Maiuolo, Irene Bava, Micaela Gliozzi, Vincenzo Mollace

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Doxorubicin is an anthracycline that is commonly used as a chemotherapy drug due to its cytotoxic effects. The clinical use of doxorubicin is limited due to its known cardiotoxic effects. Polyphenols have a wide range of beneficial properties, and particular importance is given to Oleuropein, one of the main polyphenolic compounds of olive oil. The biological mechanisms involved and the role of the endoplasmic reticulum were examined. Olive oil extract and Oleuropein were able to decrease the damage induced by exposure to doxorubicin. In particular, this natural compound was found to reduce cell mortality and oxidative damage, increase lipid content, and decrease the concentration of calcium ions that escaped from the endoplasmic reticulum. In addition, the direct involvement of this cellular organelle was demonstrated by silencing the ATF6 arm of the Unfolded Protein Response, which was activated after treatment with doxorubicin. The protection afforded by pre-treatment with the natural compound of interest, following the early damage induced by DOXO, provided valuable information regarding the potential use of these substances along with chemotherapy treatment.

Keywords: Olea europea L., oleuropein, doxorubicin, endoplasmic reticulum, nutraceutical support

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Authors: Yongyu Duo, Xiaogang Liu, Qingrui Yue

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The anchor plays a critical role in the utilization of the tensile strength of carbon fiber-reinforced polymer (CFRP) plate when it is applied for the prestressed retrofitted and cable structures. In this paper, the anchor behavior of planar clamping anchor (PCA) under different interface treatment forms and normal pressures was investigated by the uniaxial static tensile test. Two interface treatment forms were adopted, including pure friction and the coupling action of friction and bonding. The results indicated that the load-bearing capacity of PCA could be obviously improved by the coupling action of friction and bonding compared with the action of pure friction. Under the normal pressure of 11 MPa, 22 MPa, and 33 MPa, the load-bearing capacity of PCA was enhanced by 164.61%, 68.40%, and 52.78%, respectively, and the tensile strength of the CFRP plate was fully exploited when the normal pressure reached 44 MPa. In addition, the experimental coefficient of static friction between the galling CFRP plate and a sandblasted steel plate was in the range of 0.28-0.30, corresponding to various normal pressure. Moreover, the failure mode was determined by the interface treatment form and normal pressure. The research in this paper has important guiding significance to optimize the design of the mechanical clamping anchor, contributing to promoting the application of CFRP plate in reinforcement and cable structure.

Keywords: PCA, CFRP plate, interface treatment form, normal pressure, friction, coupling action

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Authors: Varsha Gupta, Priya Datta, Gursimran Mohi, Jagdish Chander

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Fluoroquinolones form the mainstay of therapy for the treatment of infections due to Salmonella enterica subsp. enterica. There is a complex interplay between several resistance mechanisms for quinolones and various fluoroquinolones discs, giving varying results, making detection and interpretation of fluoroquinolone resistance difficult. For detection of fluoroquinolone resistance in Salmonella ssp., we compared the use of pefloxacin and nalidixic acid discs as surrogate marker. Using MIC for ciprofloxacin as the gold standard, 43.5% of strains showed MIC as ≥1 μg/ml and were thus resistant to fluoroquinoloes. Based on the performance of nalidixic acid and pefloxacin discs as surrogate marker for ciprofloxacin resistance, both the discs could correctly detect all the resistant phenotypes; however, use of nalidixic acid disc showed false resistance in the majority of the sensitive phenotypes. We have also tested newer antimicrobial agents like cefixime, imipenem, tigecycline and azithromycin against Salmonella spp. Moreover, there was a comeback of susceptibility to older antimicrobials like ampicillin, chloramphenicol, and cotrimoxazole. We can also use cefixime, imipenem, tigecycline and azithromycin in the treatment of multidrug resistant S. typhi due to their high susceptibility.

Keywords: salmonella, pefloxacin, surrogate marker, chloramphenicol

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Authors: Bashayer Alsana

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Emerging technologies present human interaction with new challenges. Individuals are required to interact and collaborate to achieve mutual gain. Accomplishing shared goals requires all parties involved to trust others commitment to fulfill their specified obligations. Trust is harder to establish when groups work virtually and members transcend time, space, and culture. This paper identifies the importance of trust in virtual groups of students at Cairo University by exposing them to electronic projects on which they collaborate.Students respond to a survey to assess their range of trust within their teams and how the outcome is affected. Gender differences and other demographic factors are analyzed to understand results and rates of trust. The paper concludes with summarizing factors influencing trust development and possible implications.

Keywords: students, teams, trust, virtual

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Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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Authors: Ramūnas Antanaitis, Robertas Stoškus, Mindaugas Televičius

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The objective is to identify changes in the quantity of milk and the pH and the temperature of rumen content after omentopexia. The research was performed in a dairy farm with 550 cows on December 2014 – January 2015. The sample consisted of 10 cows. Left-sided displacement of the abomasums was diagnosed in 5 of them, which was treated by lateral omentopexia according to Dirksen; the rest 5 were used for control. Additional treatment was not applied. A special bolus for measuring pH and temperature was administered to the rumen of healthy cows and cows after the operation. The quantity of milk was registered with the help of herd management program Westfalia DP C21. All data were recorded ones a week in the period of four weeks. Statistically reliable difference in the quantity of milk (p<0.05) between the research groups was observed during the entire research. The major difference was recorded on Week 1 after the treatment (29.18 kg/d); on Week 4, the difference was 13.97 kg/d. During the entire research, rumen pH of Test group was lower than that of the Control group. Statistically reliable difference between the groups was identified on Week 1 (p<0.05). On the period mentioned, the pH of the rumen content of Test group was lower by 0.42 than that of the Control group. On Week 3, the difference increased up to 0.84. On Weeks 1, 2, and 3, statistically reliable (p<0.05) higher temperature was observed in the Test group. Major difference of temperature, 1.81 °C, was recorded on Week 1. On Week 4, the temperature of rumen in the Test group became equal to that of the Control group. After omentopexia treatment, the first four weeks showed the following results: statistically reliable difference in the quantity of milk remains the most obvious in Week 1 after the treatment; cows with left-sided displacement of abomasums were exposed to greater risk of acidosis; they indicated lower pH of rumen content; the first two weeks after omentopexia, rumen content has increased temperature, especially obvious in Week 1.

Keywords: Displacement of the abomasum, omentopexia, acidosis

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Authors: Mohammed Moustafa, Khaled Ayad, Waleed Reda

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Shoulder impingement syndrome is the most common disorder of the shoulder, resulting in functional loss and disability. Objective: This study was designed to compare between the effects of scapular muscle training versus rhythmic stabilization exercises in treatment of shoulder impingement syndrome. Methods: Thirty patients participated in this study; they were assigned randomly into two experimental groups. The first experimental group (A) consisted of 15 patients with a mean age (21.87±2.72) years; they received graduated rhythmic stabilization exercises and stretching of the posterior capsule. The second experimental group (B) consisted of 15 patients with a mean age (22.27±2.94) years; they received scapular muscle training exercises in addition to stretching of the posterior capsule. Treatment was given three times per week, every other day, for four consecutive weeks. Patients have been evaluated pretreatment and post treatment for shoulder pain severity and functional disability. Results: Both groups showed highly statistical significant reduction in pain severity and functional disability measured post-treatment when compared with their corresponding values in pretreatment assessment. Conclusion: Both of rhythmic stabilization exercises and scapular muscle training are effective interventions to reduce shoulder pain severity and functional disability.

Keywords: impingement syndrome, scapular exercises, rhythmic stabilization exercises, posterior capsule stretch

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Authors: Emine Aydin, Duygu Gocmen

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Pumpkin flour (PF) has a long shelf life and can be used as a nutritive, functional (antioxidant properties, phenolic contents, etc.) and coloring agent in many food items, especially in bakery products, sausages, instant noodles, pasta and flour mixes. Pre-treatment before drying is one of the most important factors affecting the quality of a final powdered product. Pretreatment, such as soaking in a bisulfite solution, provides that total carotenoids in raw materials rich in carotenoids, especially pumpkins, are retained in the dried product. This is due to the beneficial effect of antioxidant additives in the protection of carotenoids in the dehydrated plant foods. The oxygen present in the medium is removed by the radical SO₂, and thus the carotene degradation caused by the molecular oxygen is inhibited by the presence of SO₂. In this study, pumpkin flours (PFs) produced by two different applications (with or without metabisulfite pre-treatment) and then dried in a freeze dryer. The phenolic contents and antioxidant activities of pumpkin flour were determined. In addition to this, the compound of bioavailable phenolic substances which is obtained by PF has also been investigated using in vitro methods. As a result of researches made in recent years, it has been determined that all nutrients taken with foodstuffs are not bioavailable. Bioavailability changes depending on physical properties, chemical compounds, and capacities of individual digestion of foods. Therefore in this study; bioaccessible phenolics and phenolic bioaccessibility were also determined. The phenolics of the samples with metabisulfite application were higher than those of the samples without metabisulfite pre-treatment. Soaking in metabisulfite solution might have a protective effect for phenolic compounds. Phenolics bioaccessibility of pumpkin flours was investigated in order to assess pumpkin flour as sources of accessible phenolics. The higher bioaccessible phenolics (384.19 mg of GAE 100g⁻¹ DW) and phenolic bioaccessibility values (33.65 mL 100 mL⁻¹) were observed in the pumpkin flour with metabisulfite pre-treatment. Metabisulfite application caused an increase in bioaccessible phenolics of pumpkin flour. According to all assay (ABTS, CUPRAC, DPPH, and FRAP) results, both free and bound phenolics of pumpkin flour with metabisulfite pre-treatment had higher antioxidant activity than those of the sample without metabisulfite pre-treatment. The samples subjected to MS pre-treatment exhibited higher antioxidant activities than those of the samples without MS pre-treatment, this possibly due to higher phenolic contents of the samples with metabisulfite applications. As a result, metabisulfite application caused an increase in phenolic contents, bioaccessible phenolics, phenolic bioaccessibility and antioxidant activities of pumpkin flour. It can be said that pumpkin flour can be used as an alternative functional and nutritional ingredient in bakery products, dairy products (yoghurt, ice-cream), soups, sauces, infant formulae, confectionery, etc.

Keywords: pumpkin flour, bioaccessible phenolics, phenolic bioaccessibility, antioxidant activity

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Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

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Authors: Javier De La Torre Costa, Belen Rubio Ballester, Martina Maier, Paul F. M. J. Verschure

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After a stroke, a great number of patients experience persistent motor impairments such as hemiparesis or weakness in one entire side of the body. As a result, the lack of use of the paretic limb might be one of the main contributors to functional loss after clinical discharge. We aim to reverse this cycle by promoting the use of the paretic limb during activities of daily living (ADLs). To do so, we describe the key components of a system that is composed of a wearable bracelet (i.e., a smartwatch) and a mobile phone, designed to bring a set of neurorehabilitation principles that promote acquisition, retention and generalization of skills to the home of the patient. A fundamental question is whether the loss in motor function derived from learned–non–use may emerge as a consequence of decision–making processes for motor optimization. Our system is based on well-established rehabilitation strategies that aim to reverse this behaviour by increasing the reward associated with action execution as well as implicitly reducing the expected cost associated with the use of the paretic limb, following the notion of the reinforcement–induced movement therapy (RIMT). Here we validate an accelerometer–based measure of arm use, and its capacity to discriminate different activities that require increasing movement of the arm. We also show how the system can act as a personalized assistant by providing specific goals and adjusting them depending on the performance of the patients. The usability and acceptance of the device as a rehabilitation tool is tested using a battery of self–reported and objective measurements obtained from acute/subacute patients and healthy controls. We believe that an extension of these technologies will allow for the deployment of unsupervised rehabilitation paradigms during and beyond the hospitalization time.

Keywords: stroke, wearables, learned non use, hemiparesis, ADLs

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Authors: Somaiya Mateen, Shagufta Moin, Abdul Qayyum, Atif Zafar

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Cytokines and reactive species play an important role in the pathophysiology of rheumatoid arthritis (RA). This study was done to determine the levels of reactive oxygen and nitrogen species (ROS and RNS), inflammatory cytokines and the markers of protein, DNA and lipid oxidation in the blood of RA patients, with the aim to study the antioxidant and anti-inflammatory role of moderate intensity exercises in the management of RA. RA patients were subdivided into two groups- first group (n=30) received treatment with conventional RA drugs while the second group (n=30) received moderate exercise therapy along with the conventional drugs for a period of 12 weeks. The levels of ROS, RNS, inflammatory cytokines and markers of biomolecule oxidation were monitored before and after 12 weeks of treatment. RA patients showed a marked increase in the levels of ROS, RNS, inflammatory cytokines, lipid, protein and DNA oxidation as compared to the healthy controls. These parameters were ameliorated after treatment with drugs alone and exercise combined with drugs, with the amelioration being more significant in patients given drugs along with the moderate intensity exercise treatment. In conclusion, the role of ROS, RNS and inflammatory cytokines in the pathogenesis of RA has been confirmed by this study. These may also serve as potential biomarker for assessing the disease severity. Finally, the addition of moderate intensity exercises in the management of RA may be of great value.

Keywords: rheumatoid arthritis, reactive oxygen species, inflammatory cytokines, moderate intensity exercises

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Authors: A. Khalina, K. Shaharuddin, M. S. Wahab, M. P. Saiman, H. A. Aisyah

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This paper investigates the effect of alkali treatment and mechanical properties of kenaf (Hibiscus cannabinus) fibre for the development of yarn. Two different fibre sources are used for the yarn production. Kenaf fibres were treated with sodium hydroxide (NaOH) in the concentration of 3, 6, 9, and 12% prior to fibre opening process and tested for their tensile strength and Young’s modulus. Then, the selected fibres were introduced to fibre opener at three different opening processing parameters; namely, speed of roller feeder, small drum, and big drum. The diameter size, surface morphology, and fibre durability towards machine of the fibres were characterized. The results show that concentrations of NaOH used have greater effects on fibre mechanical properties. From this study, the tensile and modulus properties of the treated fibres for both types have improved significantly as compared to untreated fibres, especially at the optimum level of 6% NaOH. It is also interesting to highlight that 6% NaOH is the optimum concentration for the alkaline treatment. The untreated and treated fibres at 6% NaOH were then introduced to fibre opener, and it was found that the treated fibre produced higher fibre diameter with better surface morphology compared to the untreated fibre. Higher speed parameter during opening was found to produce higher yield of opened-kenaf fibres.

Keywords: alkaline treatment, kenaf fibre, tensile strength, yarn production

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Authors: Mohamad Reza Khodabakhsh

Abstract:

The present study investigated the effectiveness of attachment-based family therapy on maladaptive schemas and depressive symptoms of adolescence. This study was a quasi-experimental study, and a pre-test and post-test design with a control group were used. In this study, the study population included all adolescence. The sample consisted of 30 adolescents who were selected by the available sampling method. Then they were randomly divided into experimental (n = 15) and control (n = 15) groups. Data were collected in this study using the Beck Depression Inventory (1974) and the short form of Young's early maladaptive schema questionnaire (1988). After taking the pre-test, group implementation of family therapy based on attachment style was presented for 11 sessions of two and a half hours for two months in the experimental group. At the end of the sessions, both groups were retested, and the data were analyzed using analysis of covariance in SPSS-22 software. The results showed that attachment-based family therapy led to a significant reduction in maladaptive schemas, including emotional deprivation, rejection/abandonment, mistrust/abuse, social isolation, disability/shame, dependence/inadequacy, vulnerability/trauma, and depressive symptoms were compared to the control group. It can be concluded that this treatment has an effect on maladaptive schemas and symptoms of depression.

Keywords: attachment-based family therapy, maladaptive schemas, depressive symptoms, adolescence

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Authors: Ibrahim Hakeem

Abstract:

Biosolids are stabilised sewage sludge produced from wastewater treatment processes. Biosolids contain valuable plant nutrient which facilitates their beneficial reuse in agricultural land. However, the increasing levels of legacy and emerging contaminants such as heavy metals (HMs), PFAS, microplastics, pharmaceuticals, microbial pathogens etc., are restraining the direct land application of biosolids. Pyrolysis of biosolids can effectively degrade microbial and organic contaminants; however, HMs remain a persistent problem with biosolids and their pyrolysis-derived biochar. In this work, we demonstrated the integrated processing of biosolids involving the acid pre-treatment for HMs removal and selective reduction of ash-forming elements followed by the bench-scale pyrolysis of the treated biosolids to produce quality biochar and bio-oil enriched with valuable platform chemicals. The pre-treatment of biosolids using 3% v/v H₂SO₄ at room conditions for 30 min reduced the ash content from 30 wt% in raw biosolids to 15 wt% in the treated sample while removing about 80% of limiting HMs without degrading the organic matter. The preservation of nutrients and reduction of HMs concentration and mobility via the developed hydrometallurgical process improved the grade of the treated biosolids for beneficial land reuse. The co-removal of ash-forming elements from biosolids positively enhanced the fluidised bed pyrolysis of the acid-treated biosolids at 700 ℃. Organic matter devolatilisation was improved by 40%, and the produced biochar had higher surface area (107 m²/g), heating value (15 MJ/kg), fixed carbon (35 wt%), organic carbon retention (66% dry-ash free) compared to the raw biosolids biochar with surface area (56 m²/g), heating value (9 MJ/kg), fixed carbon (20 wt%) and organic carbon retention (50%). Pre-treatment also improved microporous structure development of the biochar and substantially decreased the HMs concentration and bioavailability by at least 50% relative to the raw biosolids biochar. The integrated process is a viable approach to enhancing value recovery from biosolids.

Keywords: biosolids, pyrolysis, biochar, heavy metals

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Authors: Ibrahim M. I. Hamoda, Ahmed R. Z. Baghdadi, Mohammed K. Mohamed, Nawal A. Abu-Shady

Abstract:

Background: Most of patients with vestibular dysfunction suffering from balance disorders, Abnormality in balance increase effort and exertion which affect the independency, so this study might be a guide in managing balance problem and consequently improve walking with less exertion and maximum function. Purpose: to analyze and discuss the effect of transcranial magnetic therapy on balance in patients with vestibular dysfunction. Methods: forty subjects from both sexes were classified to divided randomly into two equal groups; Group I study group: this group received transcranial magnetic therapy, with a selected physical therapy program for improving balance and vestibular disorders (Balance training, Cawthorne-Cooksey Exercises) and group II (control group): this group received a selected physical therapy program as group I without transcranial magnetic therapy. This treatment procedure will be applied three times weekly for three months. The mean age was 54.53±3.44 and 55.33±2.32 years and BMI 35.7±3.03 and 35.73±1.03 kg/m2 for group I and II respectively. The Biodex Balance System, Berge balances scale (BBS) and brain MRI were used for assessment. Assessments were conducted before and after treatment. The treatment program for group I included balance training, Cawthorne-Cooksey Exercises and pulsed magnetic therapy (Parameters used in the program of 20 minutes, Intensity 2 gausses, Frequency 1 Hz). This selected program was done in approximately one hour every other day for three month. The treatment program group II Patients received the same program as group A without transcranial magnetic therapy. Results: The One-way ANOVA revealed that there were no significant differences in BBS scores, overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability between both groups. Moreover, the BBS scores increased and overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability decreased significantly after treatment in group I and II compared with before treatment. Interpretation/Conclusion: Adding pulsed magnetic therapy to balance training, Cawthorne-Cooksey Exercises has no effect on static and dynamic balance in patients with balance problems due to benign positional paroxysmal vertigo.

Keywords: balance, transcranial magnetic therapy, vestibular dysfunction, biomechanic

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Authors: Farzana Esmailkassam, Usakorn Kunanuvat, Zahraa Mohammed Ali

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Objective: The key barrier in Clozapine treatment of treatment-resistant schizophrenia (TRS) includes frequent bloods draws to monitor neutropenia, the main drug side effect. WBC and ANC monitoring must occur throughout treatment. Accurate WBC and ANC counts are necessary for clinical decisions to halt, modify or continue clozapine treatment. The CSAN Pronto point-of-care (POC) analyzer generates white blood cells (WBC) and absolute neutrophils (ANC) through image analysis of capillary blood. POC monitoring offers significant advantages over central laboratory testing. This study evaluated the performance of the CSAN Pronto against the Beckman DxH900 Hematology laboratory analyzer. Methods: Forty venous samples (EDTA whole blood) with varying concentrations of WBC and ANC as established on the DxH900 analyzer were tested in duplicates on three CSAN Pronto analyzers. Additionally, both venous and capillary samples were concomitantly collected from 20 volunteers and assessed on the CSAN Pronto and the DxH900 analyzer. The analytical performance including precision using liquid quality controls (QCs) as well as patient samples near the medical decision points, and linearity using a mix of high and low patient samples to create five concentrations was also evaluated. Results: In the precision study for QCs and whole blood, WBC and ANC showed CV inside the limits established according to manufacturer and laboratory acceptability standards. WBC and ANC were found to be linear across the measurement range with a correlation of 0.99. WBC and ANC from all analyzers correlated well in venous samples on the DxH900 across the tested sample ranges with a correlation of > 0.95. Mean bias in ANC obtained on the CSAN pronto versus the DxH900 was 0.07× 109 cells/L (95% L.O.A -0.25 to 0.49) for concentrations <4.0 × 109 cells/L, which includes decision-making cut-offs for continuing clozapine treatment. Mean bias in WBC obtained on the CSAN pronto versus the DxH900 was 0.34× 109 cells/L (95% L.O.A -0.13 to 0.72) for concentrations <5.0 × 109 cells/L. The mean bias was higher (-11% for ANC, 5% for WBC) at higher concentrations. The correlations between capillary and venous samples showed more variability with mean bias of 0.20 × 109 cells/L for the ANC. Conclusions: The CSAN pronto showed acceptable performance in WBC and ANC measurements from venous and capillary samples and was approved for clinical use. This testing will facilitate treatment decisions and improve clozapine uptake and compliance.

Keywords: absolute neutrophil counts, clozapine, point of care, white blood cells

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