Search results for: dialectical behaviour therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3846

Search results for: dialectical behaviour therapy

2136 Novel EGFR Ectodomain Mutations and Resistance to Anti-EGFR and Radiation Therapy in H&N Cancer

Authors: Markus Bredel, Sindhu Nair, Hoa Q. Trummell, Rajani Rajbhandari, Christopher D. Willey, Lewis Z. Shi, Zhuo Zhang, William J. Placzek, James A. Bonner

Abstract:

Purpose: EGFR-targeted monoclonal antibodies (mAbs) provide clinical benefit in some patients with H&N squamous cell carcinoma (HNSCC), but others progress with minimal response. Missense mutations in the EGFR ectodomain (ECD) can be acquired under mAb therapy by mimicking the effect of large deletions on receptor untethering and activation. Little is known about the contribution of EGFR ECD mutations to EGFR activation and anti-EGFR response in HNSCC. Methods: We selected patient-derived HNSCC cells (UM-SCC-1) for resistance to mAb Cetuximab (CTX) by repeated, stepwise exposure to mimic what may occur clinically and identified two concurrent EGFR ECD mutations (UM-SCC-1R). We examined the competence of the mutants to bind EGF ligand or CTX. We assessed the potential impact of the mutations through visual analysis of space-filling models of the native sidechains in the original structures vs. their respective side-chain mutations. We performed CRISPR in combination with site-directed mutagenesis to test for the effect of the mutants on ligand-independent EGFR activation and sorting. We determined the effects on receptor internalization, endocytosis, downstream signaling, and radiation sensitivity. Results: UM-SCC-1R cells carried two non-synonymous missense mutations (G33S and N56K) mapping to domain I in or near the EGF binding pocket of the EGFR ECD. Structural modeling predicted that these mutants restrict the adoption of a tethered, inactive EGFR conformation while not permitting association of EGFR with the EGF ligand or CTX. Binding studies confirmed that the mutant, untethered receptor displayed a reduced affinity for both EGF and CTX but demonstrated sustained activation and presence at the cell surface with diminished internalization and sorting for endosomal degradation. Single and double-mutant models demonstrated that the G33S mutant is dominant over the N56K mutant in its effect on EGFR activation and EGF binding. CTX-resistant UM-SCC-1R cells demonstrated cross-resistance to mAb Panitumuab but, paradoxically, remained sensitive to the reversible receptor tyrosine kinase inhibitor Erlotinib. Conclusions: HNSCC cells can select for EGFR ECD mutations under EGFR mAb exposure that converge to trap the receptor in an open, constitutively activated state. These mutants impede the receptor’s competence to bind mAbs and EGF ligand and alter its endosomal trafficking, possibly explaining certain cases of clinical mAb and radiation resistance.

Keywords: head and neck cancer, EGFR mutation, resistance, cetuximab

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2135 Effects of Alkaline Pretreatment Parameters on the Corrosion Resistance and ‎Wettability of Magnesium Implant

Authors: Mahtab Assadian, Mohd Hasbullah Idris, Mostafa Rezazadeh Shirdar, Mohammad Mahdi Taheri, ‎S. Izman

Abstract:

Corrosion behaviour and surface roughness of magnesium substrate were investigated after NaOH pretreatment in different concentrations (1, 5, and 10 molar) and duration of (10 min, 30 min, 1 h, 3 h, 6 h and 24 h). Creation of Mg(OH)2 barrier layer after pretreatment enhanced corrostion resistance as well as wettability of substrate surface. Characterization including Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) was conducted to detect the existence of this barrier layer. Surface roughness and wettability of substrate was evaluated using atomic force microscopy (AFM) and contact angle measurement respectively. It is found that magnesium treated by 1M NaOH for 30 min reveals higher corrosion resistance and lower water contact angle of substrate surface. In addition, this investigation indicates that pH value of SBF solution is strongly influenced by different time and concentration of alkaline pretreatment.

Keywords: magnesium, NaOH pretreatment, corrosion resistance, wettability

Procedia PDF Downloads 959
2134 Modeling and Control of a 4DoF Robotic Assistive Device for Hand Rehabilitation

Authors: Christopher Spiewak, M. R. Islam, Mohammad Arifur Rahaman, Mohammad H. Rahman, Roger Smith, Maarouf Saad

Abstract:

For those who have lost the ability to move their hand, going through repetitious motions with the assistance of a therapist is the main method of recovery. We have been developed a robotic assistive device to rehabilitate the hand motions in place of the traditional therapy. The developed assistive device (RAD-HR) is comprised of four degrees of freedom enabling basic movements, hand function, and assists in supporting the hand during rehabilitation. We used a nonlinear computed torque control technique to control the RAD-HR. The accuracy of the controller was evaluated in simulations (MATLAB/Simulink environment). To see the robustness of the controller external disturbance as modelling uncertainty (±10% of joint torques) were added in each joints.

Keywords: biorobotics, rehabilitation, robotic assistive device, exoskeleton, nonlinear control

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2133 Experimental Simulation of Soil Boundary Condition for Dynamic Studies

Authors: Omar S. Qaftan, T. T. Sabbagh

Abstract:

This paper studies the free-field response by adopting a flexible membrane container as soil boundary for experimental shaking table tests. The influence of the soil container boundary on the soil behaviour and the dynamic soil properties under seismic effect were examined. A flexible container with 1/50 scale factor was adopted in the experimental tests, including construction, instrumentation, and determination of the results of dynamic tests on a shaking table. Horizontal face displacements and accelerations were analysed to determine the influence of the container boundary on the performance of the soil. The outputs results show that the flexible boundary container allows more displacement and larger accelerations. The soil in a rigid wall container cannot deform as similar as the soil in the real field does. Therefore, the response of flexible container tested is believed to be more reliable for soil boundary than that in the rigid container.

Keywords: soil, seismic, earthquake, interaction

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2132 Erythema Multiforme Exudativum Major Caused by Isoniazid Hypersensitivity in a Child

Authors: Azwin Lubis, Rika Hapsari, Zahrah Hikmah, Anang Endaryanto, Ariyanto Harsono

Abstract:

Erythema Multiforme Exudativum Major (EMEM) is one of the drug allergy diseases. Drug allergies caused by isoniazid rarely causes EMEM. Cutaneous reactions caused by isoniazid were obtained in 0.98% of patients, but the precise occurrence of Steven Johnson’s Syndrome (SJS) and Toxic Epidermolisis Necrolisis (TEN) due to isoniazid is not known for certain. We present this case to show hypersensitivity of isoniazid in a child. Based on the history of drug intake, physical diagnostic tests, drug elimination and provocation; we established the diagnosis of isoniazid hypersensitivity. The child showed improvement on skin manifestation after stopped isoniazid therapy.

Keywords: erythema multiforme exudativum major, hypersensitivity, elimination test, provocation test

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2131 Slurry Erosion Behaviour of Cryotreated SS316L Impeller Steel Used for Irrigation Pumps

Authors: Jagtar Singh, Kulwinder Singh

Abstract:

Slurry erosion is a type of erosion wherein material is removed from the target surface due to impingement of solid particles entrained in liquid medium. Slurry erosion performance of deep cryogenic treatment on impeller steel SS 316 L has been investigated. Slurry collected from an actual irrigation pump used as the abrasive media in an erosion test rig. An attempt has been made to study the effect of velocity of fluid and impingement angle by constant concentration (ppm) on the slurry erosion behavior of these cryotreated steels under different experimental conditions. The slurry erosion wear analysis of cryotreated and untreated steels was done. The slurry erosion performance of cryotreated SS 316L impeller steel has been found to superior to that of untreated steel. Metallurgical investigation, hardness as well as %age of carbide in both types of steel was also investigated.

Keywords: deep cryogenic treatment, impeller, Irrigation pumps SS316L, slurry erosion

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2130 Low Density Lipoprotein: The Culprit in the Development of Obesity

Authors: Ojiegbe Ikenna Nathan

Abstract:

Obesity is a medical condition in which excess body fat has accumulated to the extent that it leads to reduced life expectancy and or increased health problems. Obesity as a worldwide problem is seen clustered in the families and it moves from generation to generation. It causes some disabilities, mortality and morbidity if left unattended to. The predisposing factors to obesity are either genetic or environment in origin. Nevertheless, the main predisposing factor to obesity is the excessive consumption of food rich in low-density lipoprotein (LDL) such as organ meats, saturated fats etc. This low-density lipoprotein causes an increase in adipose tissue and complicates to obesity. There are varieties of obesity which one needs to take appropriate measures to avoid; such as android, gynoid and morbid obesity. Nonetheless, studies have shown that there is hope for the obese individuals, despite the cause, type and degree of their obesity. This is through the use of the different available treatment measures which increase in physical activities, caloric restrictions, drug therapy and surgical intervention.

Keywords: low-density, lipoprotein, culprit, obesity

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2129 Antecedents of Online Trust Towards E-Retailers for Repeat Buyers: An Empirical Study in Indian Context

Authors: Prageet Aeron, Shilpi Jain

Abstract:

The present work explores the trust building mechanisms in the context of e-commerce vendors and reconciles trust as a cognitive as well as a knowledge-based mechanism in the framework which is developed. The paper conducts an empirical examination of the variables integrity, benevolence, and ability with trust as the dependent variable and propensity to trust as the mediating variable. Authors establish ability and integrity as primary antecedents as well as establish the central role of trust propensity in the online context for Indian buyers. Authors further identify that benevolence in the context of Indian buyers online behaviour seems insignificant, and this seems counter-intutive given the role of discounts in the Indian market. Lastly, authors conclude that the role of media and social influencers in building a perception of trust seems of little consequence.

Keywords: e-commerce, trust, e-retailers, propensity to trust

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2128 Alwadei Syndrome - A Genetic Cause Of Intellectual Disability

Authors: Mafalda Moreira, Diana Alba, Inês Paiva Ferreira, Rita Calejo, Ana Rita Soares, Leonilde Machado

Abstract:

Intellectual disability (ID) is characterized by deficits in intellectualfunctioningassociatedwithalterations in the adaptive behaviour, whose onset is inthedevelopmentalperiod. Itaffects 3% of the population, ofwhich 10% have a geneticaetiology. One of those causes isAlwadeiSyndrome, with 3 cases describedworldwide. It results from a homozygous nonsense mutation in theRUSC2 gene andisassociatedwithintellectualdisabilityanddysmorphic facialfeatures. Theauthorsreportthe case of a 5-year-old-boy, born to a healthymotherafter a full-termuneventfulpregnancy, thatwasreferred to Neurodevelopmentalconsultationdue toglobal developmentaldelay. Familyhistoryrevealedlearningdifficulties in the paternal brotherhood. Milddismorphicfeatureswereevidentsuch as darkinfraorbitalregion, low-set ears, beakednose, retrognathism, high-archedpalateandjointhyperlaxity. WechslerIntelligenceScale for Children III fullscaleIQ quoted 61. Karyotypeandchromosomalmicroarrayanalysiswerenormal, as well as the fragile X molecular study. DNA sequencingwasthenperformedandallowedtheidentificationof amutation in the RUSC2 gene. Theetiologicaldiagnosisof ID remains unknown in up to 80% of cases, creatinguncertainty in children’sfamilies. Theadvances in DNA sequencingtechnologieshaveincreasedourknowledgeofthegeneticdiseasesinvolved, as theAlwadeisyndromewasonlydescribedsince 2016. Thegeneticdiagnosisof ID allowsfamilygeneticcounselingandenablesthedevelopmentof target therapeutic approaches.

Keywords: intellectual disability, genetic aetiology, alwadei syndrome, RUSC2

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2127 Sourcing and Compiling a Maltese Traffic Dataset MalTra

Authors: Gabriele Borg, Alexei De Bono, Charlie Abela

Abstract:

There on a constant rise in the availability of high volumes of data gathered from multiple sources, resulting in an abundance of unprocessed information that can be used to monitor patterns and trends in user behaviour. Similarly, year after year, Malta is also constantly experiencing ongoing population growth and an increase in mobilization demand. This research takes advantage of data which is continuously being sourced and converting it into useful information related to the traffic problem on the Maltese roads. The scope of this paper is to provide a methodology to create a custom dataset (MalTra - Malta Traffic) compiled from multiple participants from various locations across the island to identify the most common routes taken to expose the main areas of activity. This use of big data is seen being used in various technologies and is referred to as ITSs (Intelligent Transportation Systems), which has been concluded that there is significant potential in utilising such sources of data on a nationwide scale.

Keywords: Big Data, vehicular traffic, traffic management, mobile data patterns

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2126 An Elbow Biomechanical Model and Its Coefficients Adjustment

Authors: Jie Bai, Yongsheng Gao, Shengxin Wang, Jie Zhao

Abstract:

Through the establishment of the elbow biomechanical model, it can provide theoretical guide for rehabilitation therapy on the upper limb of the human body. A biomechanical model of the elbow joint can be built by the connection of muscle force model and elbow dynamics. But there are many undetermined coefficients in the model like the optimal joint angle and optimal muscle force which are usually specified as the experimental parameters of other workers. Because of the individual differences, there is a certain deviation of the final result. To this end, the RMS value of the deviation between the actual angle and calculated angle is considered. A set of coefficients which lead to the minimum RMS value will be chosen to be the optimal parameters. The direct search method and the conjugacy search method are used to get the optimal parameters, thus the model can be more accurate and mode adaptability.

Keywords: elbow biomechanical model, RMS, direct search, conjugacy search

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2125 A Measurement Instrument to Determine Curricula Competency of Licensure Track Graduate Psychotherapy Programs in the United States

Authors: Laith F. Gulli, Nicole M. Mallory

Abstract:

We developed a novel measurement instrument to assess Knowledge of Educational Programs in Professional Psychotherapy Programs (KEP-PPP or KEP-Triple P) within the United States. The instrument was designed by a Panel of Experts (PoE) that consisted of Licensed Psychotherapists and Medical Care Providers. Licensure track psychotherapy programs are listed in the databases of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE); American Psychological Association (APA); Council on Social Work Education (CSWE); and the Council for Accreditation of Counseling & Related Educational Programs (CACREP). A complete list of psychotherapy programs can be obtained from these professional databases, selecting search fields of (All Programs) in (All States). Each program has a Web link that electronically and directly connects to the institutional program, which can be researched using the KEP-Triple P. The 29-item KEP Triple P was designed to consist of six categorical fields; Institutional Type: Degree: Educational Delivery: Accreditation: Coursework Competency: and Special Program Considerations. The KEP-Triple P was designed to determine whether a specific course(s) is offered in licensure track psychotherapy programs. The KEP-Triple P is designed to be modified to assess any part or the entire curriculum of licensure graduate programs. We utilized the KEP-Triple P instrument to study whether a graduate course in Addictions was offered in Marriage and Family Therapy (MFT) programs. Marriage and Family Therapists are likely to commonly encounter patients with Addiction(s) due to the broad treatment scope providing psychotherapy services to individuals, couples and families of all age groups. Our study of 124 MFT programs which concluded at the end of 2016 found that we were able to assess 61 % of programs (N = 76) since 27 % (N = 34) of programs were inaccessible due to broken Web links. From the total of all MFT programs 11 % (N = 14) did not have a published curriculum on their Institutional Web site. From the sample study, we found that 66 % (N = 50) of curricula did not offer a course in Addiction Treatment and that 34 % (N =26) of curricula did require a mandatory course in Addiction Treatment. From our study sample, we determined that 15 % (N = 11) of MFT doctorate programs did not require an Addictions Treatment course and that 1 % (N = 1) did require such a course. We found that 99 % of our study sample offered a Campus based program and 1 % offered a hybrid program with both online and residential components. From the total sample studied, we determined that 84 % of programs would be able to obtain reaccreditation within a five-year period. We recommend that MFT programs initiate procedures to revise curricula to include a required course in Addiction Treatment prior to their next accreditation cycle, to improve the escalating addiction crisis in the United States. This disparity in MFT curricula raises serious ethical and legal consideration for national and Federal stakeholders as well as for patients seeking a competently trained psychotherapist.

Keywords: addiction, competency, curriculum, psychotherapy

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2124 Bending Behaviour of Fiber Reinforced Polymer Composite Stiffened Panel Subjected to Transverse Loading

Authors: S. Kumar, Rajesh Kumar, S. Mandal

Abstract:

Fiber Reinforced Polymer (FRP) is gaining popularity in many branch of engineering and various applications due to their light weight, specific strength per unit weight and high stiffness in particular direction. As the strength of material is high it can be used in thin walled structure as industrial roof sheds satisfying the strength constraint with comparatively lesser thickness. Analysis of bending behavior of FRP panel has been done here with variation in oriented angle of stiffener panels, fiber orientation, aspect ratio and boundary conditions subjected to transverse loading by using Finite Element Method. The effect of fiber orientation and thickness of ply has also been studied to determine the minimum thickness of ply for optimized section of stiffened FRP panel.

Keywords: bending behavior, fiber reinforced polymer, finite element method, orientation of stiffeners

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2123 Effect of Drop Impact Behavior on Spray Retention

Authors: Hassina Hafida Boukhalfa, Mathieu Massinon, Fréderic Lebeau, Mohamed Belhamra

Abstract:

Drop behaviour during impact affects retention. The increase of adhesion is usually seen as the objective when applying crop protection products, while bouncing and shattering are seen as detrimental to spray retention. However, observation of drop impacts using high speed shadow graphy shows that fragmentation can occur in Wenzel wetting regime. In this case, a part of the drop sticks on the surface, what contributes to retention. Using simultaneous measurements of drop impacts with high speed imaging and of retention with fluorometry for 3 spray mixtures on excised barley leaves allowed us to observe that about 50% of the drops fragmented in Wenzel state remain on the leaf. Depending on spray mixture, these impact outcomes accounted for 25 to 50% of retention, the higher contribution being correlated with bigger VMD (Volume Median Diameter). This contribution is non-negligible and should be considered when a modelling of spray retention process is performed.

Keywords: drop impact, retention, fluorometry, high speed imaging

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2122 Hydro-Mechanical Behavior of a Tuff and Calcareous Sand Mixture for Use in Pavement in Arid Region

Authors: I. Goual, M. S. Goual, M. K. Gueddouda, Taïbi Saïd, Abou-Bekr Nabil, A. Ferhat

Abstract:

The aim of the paper is to study the hydro-mechanical behavior of a tuff and calcareous sand mixture. A first experimental phase was carried out in order to find the optimal mixture. This showed that the material composed of 80% tuff and 20% calcareous sand provides the maximum mechanical strength. The second experimental phase concerns the study of the drying-wetting behavior of the optimal mixture was carried out on slurry samples and compacted samples at the MPO. Experimental results let to deduce the parameters necessary for the prediction of the hydro-mechanical behavior of pavement formulated from tuff and calcareous sand mixtures, related to moisture. This optimal mixture satisfies the regulation rules and hence constitutes a good local eco-material, abundantly available, for the conception of pavements.

Keywords: tuff, sandy calcareous, road engineering, hydro mechanical behaviour, suction

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2121 Examining the Potential of Linear Parks as Sustainable Development Components

Authors: Andreas Savvides, Chloe Kadi

Abstract:

The objective of this study is to investigate how the planning and design of open parks within neighborhoods and communities can promote physical activity in order to enhance the health of the local population. An extensive literature review was conducted for studies regarding the relationship between health and physical activity and the park characteristics that can promote physical activity among people. The findings of the literature review were then compared and analysed, in order to identify the main characteristics of urban parks that can promote physical activity and enhance public health. In order to find out how the characteristics identified in the literature were applied in real life, an analysis of three existing parks in three different countries was conducted. The parks, apart from their geographical location, also vary in size and layout. The parks were chosen because they are urban open parks and they include facilities for physical activity.

Keywords: urban planning, active living behaviour, open parks, sustainable mobility

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2120 The Role of Genetic Markers in Prostate Cancer Diagnosis and Treatment

Authors: Farman Ali, Asif Mahmood

Abstract:

The utilization of genetic markers in prostate cancer management represents a significant advance in personalized medicine, offering the potential for more precise diagnosis and tailored treatment strategies. This paper explores the pivotal role of genetic markers in the diagnosis and treatment of prostate cancer, emphasizing their contribution to the identification of individual risk profiles, tumor aggressiveness, and response to therapy. By integrating current research findings, we discuss the application of genetic markers in developing targeted therapies and the implications for patient outcomes. Despite the promising advancements, challenges such as accessibility, cost, and the need for further validation in diverse populations remain. The paper concludes with an outlook on future directions, underscoring the importance of genetic markers in revolutionizing prostate cancer care.

Keywords: prostate cancer, genetic markers, personalized medicine, BRCA1 and BRCA2

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2119 The Writing Eight Exercise and Its Impact on Kindergartners

Authors: Karima Merchant

Abstract:

The aim of this study was to analyze the impact of the Writing Eight Exercise, an exercise from the Brain Integration Therapy, with Kindergartners who are struggling with writing tasks in school. With the help of this exercise, children were able to cross the midline, an invisible line running from our brain to our feet, which separates the body’s right from left. Crossing the midline integrates the brain hemispheres, thus encouraging bilateral movement. The study was spread over 15 weeks where the children were required to do the Writing Eight Exercise 4 times a week. The data collection methods included observations, student work samples and feedback from teachers and parents. Based on the results of this study, it can be concluded that the Writing Eight Exercise had a positive impact on students’ approach towards writing tasks, letter formation, and fine motor skills.

Keywords: crossing the midline, fine motor skills, letter formation, writing

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2118 Prediction of Outcome after Endovascular Thrombectomy for Anterior and Posterior Ischemic Stroke: ASPECTS on CT

Authors: Angela T. H. Kwan, Wenjun Liang, Jack Wellington, Mohammad Mofatteh, Thanh N. Nguyen, Pingzhong Fu, Juanmei Chen, Zile Yan, Weijuan Wu, Yongting Zhou, Shuiquan Yang, Sijie Zhou, Yimin Chen

Abstract:

Background: Endovascular Therapy (EVT)—in the form of mechanical thrombectomy—following intravenous thrombolysis is the standard gold treatment for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It is well established that an ASPECTS ≥ 7 is associated with an increased likelihood of positive post-EVT outcomes, as compared to an ASPECTS < 7. There is also prognostic utility in coupling posterior circulation ASPECTS (pc-ASPECTS) with magnetic resonance imaging for evaluating the post-EVT functional outcome. However, the value of pc-ASPECTS applied to CT must be explored further to determine its usefulness in predicting functional outcomes following EVT. Objective: In this study, we aimed to determine whether pc-ASPECTS on CT can predict post-EVT functional outcomes among patients with AIS due to LVO. Methods: A total of 247 consecutive patients aged 18 and over receiving EVT for LVO-related AIS were recruited into a prospective database. The data were retrospectively analyzed between March 2019 to February 2022 from two comprehensive tertiary care stroke centers: Foshan Sanshui District People’s Hospital and First People's Hospital of Foshan in China. Patient parameters included EVT within 24hrs of symptom onset, premorbid modified Rankin Scale (mRS) ≤ 2, presence of distal and terminal cerebral blood vessel occlusion, and subsequent 24–72-hour post-stroke onset CT scan. Univariate comparisons were performed using the Fisher exact test or χ2 test for categorical variables and the Mann–Whitney U test for continuous variables. A p-value of ≤ 0.05 was statistically significant. Results: A total of 247 patients met the inclusion criteria; however, 3 were excluded due to the absence of post-CTs and 8 for pre-EVT ASPECTS < 7. Overall, 236 individuals were examined: 196 anterior circulation ischemic strokes and 40 posterior strokes of basilar artery occlusion. We found that both baseline post- and pc-ASPECTS ≥ 7 serve as strong positive markers of favorable outcomes at 90 days post-EVT. Moreover, lower rates of inpatient mortality/hospice discharge, 90-day mortality, and 90-day poor outcome were observed. Moreover, patients in the post-ASPECTS ≥ 7 anterior circulation group had shorter door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), and last known normal-to-puncture-time (LKNPT). Conclusion: Patients of anterior and posterior circulation ischemic strokes with baseline post- and pc-ASPECTS ≥ 7 may benefit from EVT.

Keywords: endovascular therapy, thrombectomy, large vessel occlusion, cerebral ischemic stroke, ASPECTS

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2117 Care Experience of a Female Breast Cancer Patient Undergoing Modified Radical Mastectomy

Authors: Ting-I Lin

Abstract:

Purpose: This article explores the care experience of a 34-year-old female breast cancer patient who was admitted to the intensive care unit after undergoing a modified radical mastectomy. The patient discovered a lump in her right breast during a self-examination and, after mammography and ultrasound-guided biopsy, was diagnosed with a malignant tumor in the right breast. The tumor measured 1.5 x 1.4 x 2 cm, and the patient underwent a modified radical mastectomy. Postoperatively, she exhibited feelings of inferiority due to changes in her appearance. Method: During the care period, we engaged in conversations, observations, and active listening, using Gordon's Eleven Functional Health Patterns for a comprehensive assessment. In collaboration with the critical care team, a psychologist, and an oncology case manager, we conducted an interdisciplinary discussion and reached a consensus on key nursing issues. These included pain related to postoperative tumor excision and disturbed body image due to changes in appearance after surgery. Result: During the care period, a private space was provided to encourage the patient to express her feelings about her altered body image. Communication was conducted through active listening and a non-judgmental approach. The patient's anxiety level, as measured by the depression and anxiety scale, decreased from moderate to mild, and she was able to sleep for 6-8 hours at night. The oncology case manager was invited to provide education on breast reconstruction using breast models and videos to both the patient and her husband. This helped rebuild the patient's confidence. With the patient's consent, a support group was arranged where a peer with a similar experience shared her journey, offering emotional support and encouragement. This helped alleviate the psychological stress and shock caused by the cancer diagnosis. Additionally, pain management was achieved through adjusting the dosage of analgesics, administering Ultracet 37.5 mg/325 mg 1# Q6H PO, along with distraction techniques and acupressure therapy. These interventions helped the patient relax and alleviate discomfort, maintaining her pain score at a manageable level of 3, indicating mild pain. Conclusion: Disturbance in body image can cause significant psychological stress for patients. Through support group discussions, encouraging patients to express their feelings, and providing appropriate education on breast reconstruction and dressing techniques, the patient's self-concept was positively reinforced, and her emotions were stabilized. This led to renewed self-worth and confidence.

Keywords: breast cancer, modified radical mastectomy, acupressure therapy, Gordon's 11 functional health patterns

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2116 How Geant4 Hadronic Models Handle Tracking of Pion Particles Resulting from Antiproton Annihilation

Authors: M. B. Tavakoli, R. Reiazi, M. M. Mohammadi, K. Jabbari

Abstract:

From 2003, AD4/ACE experiment in CERN tried to investigate different aspects of antiproton as a new modality in particle therapy. Because of lack of reliable absolute dose measurements attempts to find out the radiobiological characteristics of antiproton have not reached to a reasonable result yet. From the other side, application of Geant4 in medical approaches is increased followed by Geant4-DNA project which focuses on using this code to predict radiation effects in the cellular scale. This way we can exploit Geant4-DNA results for antiproton. Unfortunately, previous studies showed there are serious problem in simulating an antiproton beam using Geant4. Since most of the problem was in the Bragg peak region which antiproton annihilates there, in this work we tried to understand if the problem came from the way in which Geant4 handles annihilation products especially pion particles. This way, we can predict the source of the dose discrepancies between Geant4 simulations and dose measurements done in CERN.

Keywords: Geant4, antiproton, annihilation, pion plus, pion minus

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2115 The Study of Information Uses Behaviour of Tourists in Songkhla Province, Thailand

Authors: Patraporn Kaewkhanitarak, Suchada Srichuar, Narawat Kanjanapan

Abstract:

This research is the survey research. The purpose of this research is to study information uses behavior and problem of tourists in Songkhla Province. The tool used in this study include structure questioner standardize in 5 levels rating scale. The 400 participants selected by convenience sampling (allowable error 5%) by Taro Yamane method. The collecting data period is 6 months from January-June 2014. The result of this study found that the type of information that the tourists often use to plan their trip is internet (x̅ = 3.81) and the most popular text is restaurant (x̅ = 3.77). The tourists found that booking or buying service from internet provided more affordable price and they could select appropriate plan by themselves. The most convenience source of information that the tourists often use is internet and website (x̅ = 3.69). Nevertheless, they explained that most of tourist information source in Songkhla province are lack and insufficient of tourist organization that provide information and service related to tourism.

Keywords: information, behavior, tourists, Thailand

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2114 Study of Tribological Behaviour of Al6061/Silicon Carbide/Graphite Hybrid Metal Matrix Composite Using Taguchi's Techniques

Authors: Mohamed Zakaulla, A. R. Anwar Khan

Abstract:

Al6061 alloy base matrix, reinforced with particles of silicon carbide (10 wt %) and Graphite powder (1wt%), known as hybrid composites have been fabricated by liquid metallurgy route (stir casting technique) and optimized at different parameters like applied load, sliding speed and sliding distance by taguchi method. A plan of experiment generated through taguchi technique was used to perform experiments based on L27 orthogonal array. The developed ANOVA and regression equations are used to find the optimum coefficient of friction and wear under the influence of applied load, sliding speed and sliding distance. On the basis of “smaller the best” the dry sliding wear resistance was analysed and finally confirmation tests were carried out to verify the experimental results.

Keywords: analysis of variance, dry sliding wear, hybrid composite, orthogonal array, Taguchi technique

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2113 Combined Treatment of Estrogen-Receptor Positive Breast Microtumors with 4-Hydroxytamoxifen and Novel Non-Steroidal Diethyl Stilbestrol-Like Analog Produces Enhanced Preclinical Treatment Response and Decreased Drug Resistance

Authors: Sarah Crawford, Gerry Lesley

Abstract:

This research is a pre-clinical assessment of anti-cancer effects of novel non-steroidal diethyl stilbestrol-like estrogen analogs in estrogen-receptor positive/ progesterone-receptor positive human breast cancer microtumors of MCF 7 cell line. Tamoxifen analog formulation (Tam A1) was used as a single agent or in combination with therapeutic concentrations of 4-hydroxytamoxifen, currently used as a long-term treatment for the prevention of breast cancer recurrence in women with estrogen receptor positive/ progesterone receptor positive malignancies. At concentrations ranging from 30-50 microM, Tam A1 induced microtumor disaggregation and cell death. Incremental cytotoxic effects correlated with increasing concentrations of Tam A1. Live tumor microscopy showed that microtumos displayed diffuse borders and substrate-attached cells were rounded-up and poorly adherent. A complete cytotoxic effect was observed using 40-50 microM Tam A1 with time course kinetics similar to 4-hydroxytamoxifen. Combined treatment with TamA1 (30-50 microM) and 4-hydroxytamoxifen (10-15 microM) induced a highly cytotoxic, synergistic combined treatment response that was more rapid and complete than using 4-hydroxytamoxifen as a single agent therapeutic. Microtumors completely dispersed or formed necrotic foci indicating a highly cytotoxic combined treatment response. Moreover, breast cancer microtumors treated with both 4-hydroxytamoxifen and Tam A1 displayed lower levels of long-term post-treatment regrowth, a critical parameter of primary drug resistance, than observed for 4-hydroxytamoxifen when used as a single agent therapeutic. Tumor regrowth at 6 weeks post-treatment with either single agent 4-hydroxy tamoxifen, Tam A1 or a combined treatment was assessed for the development of drug resistance. Breast cancer cells treated with both 4-hydroxytamoxifen and Tam A1 displayed significantly lower levels of post-treatment regrowth, indicative of decreased drug resistance, than observed for either single treatment modality. The preclinical data suggest that combined treatment involving the use of tamoxifen analogs may be a novel clinical approach for long-term maintenance therapy in patients with estrogen-receptor positive/progesterone-receptor positive breast cancer receiving hormonal therapy to prevent disease recurrence. Detailed data on time-course, IC50 and tumor regrowth assays post- treatment as well as a proposed mechanism of action to account for observed synergistic drug effects will be presented.

Keywords: 4-hydroxytamoxifen, tamoxifen analog, drug-resistance, microtumors

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2112 Mechanical and Tribological Characterization of Squeeze Cast Al 6061 Alloy Reinforced with SiC and Al₂O₃ Particulates

Authors: Gurcan A. B., Baker T. N.

Abstract:

Due to economic and environmental requirements, it is becoming increasingly important to reduce vehicle weight. The first approach consisted in using light materials with high thermal conductivity, such as aluminium alloys. This choice allowed significant mass reduction and lower temperature but required recourse to ventilated discs. Among aluminium alloys, Al 6xxx series alloys enjoy the highest strength-to-weight ratio and, therefore, have found wide applications in the automobile and aerospace industries. However, these alloys lose their high strength rapidly when they are exposed to elevated temperatures. This rapid decline in the strength is directly related to the coarsening of very fine precipitates which are then not as effective in obstructing the dislocations. The incorporation of micro-scale and nano-scale particulates in aluminium systems can greatly enhance their mechanical characteristics.

Keywords: mechanical and tribological behaviour, scanning electron microscope, optical test, mechanical properties test, experimental test

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2111 A Forearm-Wrist Rehabilitation Module for Stroke and Spinal Cord Injuries

Authors: Vahid Mehrabi, Iman Sharifi, H. A. Talebi

Abstract:

The automation of rehabilitation procedure by the implementation of robotic devices can overcome the limitation in conventional physiotherapy methods by increasing training sessions and duration of process. In this paper, the design of a simple rehabilitation robot for forearm-wrist therapy in stroke and spinal cord injuries is presented. Wrist’s biological joint motion is modeled by a gimbal-like mechanism which resembles the human arm anatomy. Presented device is an exoskeleton robot with rotation axes corresponding to human skeleton anatomy. The mechanical structure, actuator and sensor selection, system kinematics and comparison between our device range of motion and required active daily life values is illustrated.

Keywords: rehabilitation, robotic devices, physiotherapy, forearm-wrist

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2110 Estimating Current Suicide Rates Using Google Trends

Authors: Ladislav Kristoufek, Helen Susannah Moat, Tobias Preis

Abstract:

Data on the number of people who have committed suicide tends to be reported with a substantial time lag of around two years. We examine whether online activity measured by Google searches can help us improve estimates of the number of suicide occurrences in England before official figures are released. Specifically, we analyse how data on the number of Google searches for the terms “depression” and “suicide” relate to the number of suicides between 2004 and 2013. We find that estimates drawing on Google data are significantly better than estimates using previous suicide data alone. We show that a greater number of searches for the term “depression” is related to fewer suicides, whereas a greater number of searches for the term “suicide” is related to more suicides. Data on suicide related search behaviour can be used to improve current estimates of the number of suicide occurrences.

Keywords: nowcasting, search data, Google Trends, official statistics

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2109 The Next Frontier for Mobile Based Augmented Reality: An Evaluation of AR Uptake in India

Authors: K. Krishna Milan Rao, Nelvin Joseph, Praveen Dwarakanath

Abstract:

Augmented and Virtual Realties is quickly becoming a hotbed of activity with millions of dollars being spent on R & D and companies such as Google and Microsoft rushing to stake their claim. Augmented reality (AR) is however marching ahead due to the spread of the ideal AR device – the smartphone. Despite its potential, there remains a deep digital divide between the Developed and Developing Countries. The Technological Acceptance Model (TAM) and Hofstede cultural dimensions also predict the behaviour intention to uptake AR in India will be large. This paper takes a quantified approach by collecting 340 survey responses to AR scenarios and analyzing them through statistics. The Survey responses show that the Intention to Use, Perceived Usefulness and Perceived Enjoyment dimensions are high among the urban population in India. This along with the exponential smartphone indicates that India is on the cusp of a boom in the AR sector.

Keywords: mobile augmented reality, technology acceptance model, Hofstede, cultural dimensions, India

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2108 A Case of Prosthetic Vascular-Graft Infection Due to Mycobacterium fortuitum

Authors: Takaaki Nemoto

Abstract:

Case presentation: A 69-year-old Japanese man presented with a low-grade fever and fatigue that had persisted for one month. The patient had an aortic dissection on the aortic arch 13 years prior, an abdominal aortic aneurysm seven years prior, and an aortic dissection on the distal aortic arch one year prior, which were all treated with artificial blood-vessel replacement surgery. Laboratory tests revealed an inflammatory response (CRP 7.61 mg/dl), high serum creatinine (Cr 1.4 mg/dL), and elevated transaminase (AST 47 IU/L, ALT 45 IU/L). The patient was admitted to our hospital on suspicion of prosthetic vascular graft infection. Following further workups on the inflammatory response, an enhanced chest computed tomography (CT) and a non-enhanced chest DWI (MRI) were performed. The patient was diagnosed with a pulmonary fistula and a prosthetic vascular graft infection on the distal aortic arch. After admission, the patient was administered Ceftriaxion and Vancomycine for 10 days, but his fever and inflammatory response did not improve. On day 13 of hospitalization, a lung fistula repair surgery and an omental filling operation were performed, and Meropenem and Vancomycine were administered. The fever and inflammatory response continued, and therefore we took repeated blood cultures. M. fortuitum was detected in a blood culture on day 16 of hospitalization. As a result, we changed the treatment regimen to Amikacin (400 mg/day), Meropenem (2 g/day), and Cefmetazole (4 g/day), and the fever and inflammatory response began to decrease gradually. We performed a test of sensitivity for Mycobacterium fortuitum, and found that the MIC was low for fluoroquinolone antibacterial agent. The clinical course was good, and the patient was discharged after a total of 8 weeks of intravenous drug administration. At discharge, we changed the treatment regimen to Levofloxacin (500 mg/day) and Clarithromycin (800 mg/day), and prescribed these two drugs as a long life suppressive therapy. Discussion: There are few cases of prosthetic vascular graft infection caused by mycobacteria, and a standard therapy remains to be established. For prosthetic vascular graft infections, it is ideal to provide surgical and medical treatment in parallel, but in this case, surgical treatment was difficult and, therefore, a conservative treatment was chosen. We attempted to increase the treatment success rate of this refractory disease by conducting a susceptibility test for mycobacteria and treating with different combinations of antimicrobial agents, which was ultimately effective. With our treatment approach, a good clinical course was obtained and continues at the present stage. Conclusion: Although prosthetic vascular graft infection resulting from mycobacteria is a refractory infectious disease, it may be curative to administer appropriate antibiotics based on the susceptibility test in addition to surgical treatment.

Keywords: prosthetic vascular graft infection, lung fistula, Mycobacterium fortuitum, conservative treatment

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2107 Nutritional Education in Health Resort Institutions in the Face of Demographic and Epidemiological Changes in Poland

Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga

Abstract:

Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.

Keywords: health care system, nutritional education, public health, spa and treatment

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