Search results for: block farm program
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5358

Search results for: block farm program

3558 The Need for a More Defined Role for Psychologists in Adult Consultation Liaison Services in Hospital Settings

Authors: Ana Violante, Jodie Maccarrone, Maria Fimiani

Abstract:

In the United States, over 30 million people are hospitalized annually for conditions that require acute, 24-hour, supervised care. The experience of hospitalization can be traumatic, exposing the patient to loss of control, autonomy, and productivity. Furthermore, 40% of patients admitted to hospitals for general medical illness have a comorbid psychiatric diagnosis. Research suggests individuals admitted with psychiatric comorbidities experience poorer health outcomes, higher utilization rates and increased overall cost of care. Empirical work suggests hospital settings that include a consultation liaison (CL) service report reduced length of stay, lower costs per patient, improved medical staff and patient satisfaction and reduced readmission after 180 days. Despite the overall positive impact CL services can have on patient care, it is estimated that only 1% - 2.8% of hospital admits receive these services, and most research has been conducted by the field of psychiatry. Health psychologists could play an important role in increasing access to this valuable service, though the extent to which health psychologists participate in CL settings is not well known. Objective: Outline the preliminary findings from an empirical study to understand how many APPIC internship training programs offer adult consultation liaison rotations within inpatient hospital settings nationally, as well as describe the specific nature of these training experiences. Research Method/Design: Data was exported into Excel from the 2022-2023 APPIC Directory categorized as “health psychology” sites. It initially returned a total of 537 health training programs out 1518 total programs (35% of all APPIC programs). A full review included a quantitative and qualitative comprehensive review of the APPIC program summary, the site website, and program brochures. The quantitative review extracted the number of training positions; amount of stipend; location or state of program, patient, population, and rotation. The qualitative review examined the nature of the training experience. Results: 29 (5%) of all APPIC health psychology internship training programs (2%) respectively of all APPIC training internship programs offering internship CL training were identified. Of the 29 internship training programs, 16 were exclusively within a pediatric setting (55%), 11 were exclusively within an adult setting (38%), and two were a mix of pediatric and adult settings (7%). CL training sites were located to 19 states, offering a total of 153 positions nationally, with Florida containing the largest number of programs (4). Only six programs offered 12-month training opportunities while the rest offered CL as a major (6 month) to minor (3-4 month) rotation. The program’s stipend for CL training positions ranged from $25,000 to $62,400, with an average of $32,056. Conclusions: These preliminary findings suggest CL training and services are currently limited. Training opportunities that do exist are mostly limited to minor, short rotations and governed by psychiatry. Health psychologists are well-positioned to better define the role of psychology in consultation liaison services and enhance and formalize existing training protocols. Future research should explore in more detail empirical outcomes of CL services that employ psychology and delineate the contributions of psychology from psychiatry and other disciplines within an inpatient hospital setting.

Keywords: consultation liaison, health psychology, hospital setting, training

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3557 The Effect of Vitamin D Supplements and Aerobic Exercise on Hunger and Serum Insulin Levels in Adolescents With Metabolic Syndrome

Authors: Vahab Behmanesh

Abstract:

Metabolic syndrome is defined as having at least three of the five metabolic risk factors, including abdominal obesity, high blood pressure, high triglycerides, low HDL, and insulin resistance. Lifestyle changes towards reducing physical activity, unhealthy eating habits Especially the high-fat and high-carbohydrate diet is directly related to metabolic syndrome, and due to the epidemic of overweight and sedentary life, metabolic syndrome is a serious problem worldwide. On the other hand, vitamin D deficiency is considered as one of the most common problems in the world, which is related to the dysfunction of beta cells and insulin resistance, and therefore, vitamin D deficiency is considered as a factor in the occurrence of metabolic syndrome. 40 subjects (age: 16.12 ± 4.4 years and body mass index 25.61 ± 4.4 kg/m2) were randomly assigned to groups of aerobic exercise and placebo, aerobic exercise and vitamin D and placebo (no exercise) were divided. Vitamin D was taken at a dose of 50,000 units per week in a double-blind format for eight weeks, and the daily aerobic exercise program was performed for 50 to 60 minutes, three doses per week, with an intensity of 50-60% of the maximum heart rate. From one-way analysis of variance, Factorial variance analysis (2x2) repeated measurement and correlated t-test were used for data analysis. Aerobic exercise and vitamin D intake reduced all metabolic risk indicators and blood insulin (P < 0.05). However, the subjective feeling of hunger did not change significantly (P < 0.05). Regarding waist circumference and blood glucose, the effect of exercise combined with vitamin D consumption was greater than the corresponding effect in the vitamin D group (P < 0.05). Aerobic exercises and vitamin D intake are safe and effective for improving cardiometabolic health, Imam adds vitamin D to the exercise program has more benefits for weight and blood sugar control, which suggests prescribing it for patients with metabolic syndrome.

Keywords: vitamin D, aerobic exercise, metabolic control, adolescents

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3556 Population Ecology of the House Rat (Rattus rattus) in Rural Human Dwelling of Pothwar Plateau, Pakistan

Authors: Surrya Khanam

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Understanding the population characteristics of pest species is crucial to develop suitable management plans. The present study was aimed to determine the population ecology of House rat (Rattus rattus) in rural human dwellings of Pothwar, Pakistan. Seasonal rodent trapping was conducted in four villages of Pothwar area from March 2012 to February 2014. A total of 217 individuals of R.rattus were captured from houses, shops, and farm houses. There was no significant difference in the abundance of species across different trapping seasons. The species sex ratio was unbiased and did not differ significantly from 1:1 at all the sites and across all the trapping seasons. The population of R. Rattus had individuals of different age groups, viz., juvenile, sub adults and adults. Overall, more adult individuals were captured in spring and summer season. Breeding activity was continuous throughout the year and reproductively active individuals relatively outnumbered inactive individuals. The results showed that village indoor habitats provided a suitable habitat for rat populations all the year round. The information obtained from this study will be helpful in the development of control strategies for R. rattus populations in commensal habitats.

Keywords: ecology, indoor pests, Rattus rattus, population characteristics

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3555 Evaluation of Potential Production of Maize Genotypes of Early Maturity in Rainfed Lowland

Authors: St. Subaedah, A. Takdir, Netty, D. Hidrawati

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Maize development at the rainfed lowland after rice is often confronted with the occurrence of drought stress at the time of entering the generative phase, which will cause be hampered crop production. Consequently, in the utilization of the rainfed lowland areas optimally, an effort that can be done using the varieties of early maturity to minimize crop failures due to its short rainy season. The aim of this research was evaluating the potential yield of genotypes of candidates of maize early maturity in the rainfed lowland areas. The study was conducted during May to August 2016 at South Sulawesi, Indonesia. The study used randomized block design to compare 12 treatments and consists of 8 genotypes namely CH1, CH2, CH3, CH4, CH5, CH6, CH7, CH8 and the use of four varieties, namely Bima 3, Bima 7, Lamuru and Gumarang. The results showed that genotype of CH2, CH3, CH5, CH 6, CH7 and CH8 harvesting has less than 90 days. There are two genotypes namely genotypes of CH7 and CH8 that have a fairly high production respectively of 7.16 tons / ha and 8.11 tons/ ha and significantly not different from the superior varieties Bima3.

Keywords: evaluation, early maturity, maize, yield potential

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3554 Multi-Scale Urban Spatial Evolution Analysis Based on Space Syntax: A Case Study in Modern Yangzhou, China

Authors: Dai Zhimei, Hua Chen

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The exploration of urban spatial evolution is an important part of urban development research. Therefore, the evolutionary modern Yangzhou urban spatial texture was taken as the research object, and Spatial Syntax was used as the main research tool, this paper explored Yangzhou spatial evolution law and its driving factors from the urban street network scale, district scale and street scale. The study has concluded that at the urban scale, Yangzhou urban spatial evolution is the result of a variety of causes, including physical and geographical condition, policy and planning factors, and traffic conditions, and the evolution of space also has an impact on social, economic, environmental and cultural factors. At the district and street scales, changes in space will have a profound influence on the history of the city and the activities of people. At the end of the article, the matters needing attention during the evolution of urban space were summarized.

Keywords: block, space syntax and methodology, street, urban space, Yangzhou

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3553 Performance in the Delivery of Environmental Management Programs of the Local Government Unit of Malay, Aklan, Philippines

Authors: Tomas O. Ortega, Cecilia T. Reyes, Cecile O. Legaspi, Cylde G. Abayon, Anna Mae C. Relingo, Mary Eden M. Teruel

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A study was conducted to evaluate the performance in the delivery of environmental management programs of the local government of Malay, Aklan, Philippines. The samples were determined by adopting the Multi-Stage Random Probability Sampling technique. The 150 respondents were drawn from barangays with larger shares of the population based on the Philippine Statistical Authority’s Data on Census Population and Housing for the year 2015. The qualified sample respondents were selected using the Kish Grid. Female respondents were targeted for even numbered questionnaires while male respondents were targeted for odd numbers. The four major core concepts namely awareness, availment, satisfaction and need for action were used in measuring the rating of the respondents and presented in frequency and percentage distributions. The reasons for their response were likewise gathered. The study inferred that a large portion of the respondents was profoundly aware of the environmental management programs implemented by their local government unit especially the solid waste management and the clean-up programs/projects. Programs to control air pollution and waste water management obtained the least awareness ratings from the respondents. A high percentage of respondents had availed of environmental management programs, particularly solid waste management. Overall, majority of the respondents were satisfied with the environmental management programs rendered by the local government unit and therefore needs less action. It is recommended that the local government unit must strengthen air pollution control program. Appropriate action must be taken to support the people’s interest in this program most particularly to the individuals who burn their garbage. Seminars and training-workshops about appropriate waste disposal will most likely help settle this issue.

Keywords: availment, awareness, environmental management, need for action, satisfaction

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3552 Effect of Cadmium on Oxidative Enzymes Activity in Persian Clover (Trifolium resupinatum L.)

Authors: Homayun Ghasemi, Mojtaba Yousefirad, Mozhgan Farzamisepehr

Abstract:

Heavy metals are among soil pollutant resources that in case of accumulation in the soil and absorption by the plant, enter into the food chain and poison the plants or the people who consume those plants. This research was performed in order to examine the role of cadmium as a heavy metal in the activity of catalase and peroxidase as well as protein concentration in Trifolium resupinatum L. based on a randomized block design with three repetitions. The used treatments included consumption of Cd (NO3)2 at four levels, namely, 0, 100, 200, and 300 ppm. The plants under study were treated for 10 days. The results of the study showed that catalase activity decreased by the increase of cadmium. Moreover, peroxidase activity increased by an increase inthe consumption of cadmium. The analysis of protein level showed that plantlet protein decreased in high cadmium concentrations. The findings also demonstrated that cadmium concentration in roots was higher than in shoots.

Keywords: catalase, heavy metal, peroxidase, protein

Procedia PDF Downloads 235
3551 Estimating the Efficiency of a Meta-Cognitive Intervention Program to Reduce the Risk Factors of Teenage Drivers with Attention Deficit Hyperactivity Disorder While Driving

Authors: Navah Z. Ratzon, Talia Glick, Iris Manor

Abstract:

Attention Deficit Hyperactivity Disorder (ADHD) is a chronic disorder that affects the sufferer’s functioning throughout life and in various spheres of activity, including driving. Difficulties in cognitive functioning and executive functions are often part and parcel of the ADHD diagnosis, and thus form a risk factor in driving. Studies examining the effectiveness of intervention programs for improving and rehabilitating driving in typical teenagers have been conducted in relatively small numbers; while studies on similar programs for teenagers with ADHD have been especially scarce. The aim of the present study has been to examine the effectiveness of a metacognitive occupational therapy intervention program for reducing risk factors in driving among teenagers with ADHD. The present study included 37 teenagers aged 17 to 19. They included 23 teenagers with ADHD divided into experimental (11) and control (12) groups; as well as 14 non-ADHD teenagers forming a second control group. All teenagers taking part in the study were examined in the Tel Aviv University driving lab, and underwent cognitive diagnoses and a driving simulator test. Every subject in the intervention group took part in 3 assessment meetings, and two metacognitive treatment meetings. The control groups took part in two assessment meetings with a follow-up meeting 3 months later. In all the study’s groups, the treatment’s effectiveness was tested by comparing monitoring results on the driving simulator at the first and second evaluations. In addition, the driving of 5 subjects from the intervention group was monitored continuously from a month prior to the start of the intervention, a month during the phase of the intervention and another month until the end of the intervention. In the ADHD control group, the driving of 4 subjects was monitored from the end of the first evaluation for a period of 3 months. The study’s findings were affected by the fact that the ADHD control group was different from the two other groups, and exhibited ADHD characteristics manifested by impaired executive functions and lower metacognitive abilities relative to their peers. The study found partial, moderate, non-significant correlations between driving skills and cognitive functions, executive functions, and perceptions and attitudes towards driving. According to the driving simulator test results and the limited sampling results of actual driving, it was found that a metacognitive occupational therapy intervention may be effective in reducing risk factors in driving among teenagers with ADHD relative to their peers with and without ADHD. In summary, the results of the present study indicate a positive direction that speaks to the viability of using a metacognitive occupational therapy intervention program for reducing risk factors in driving. A further study is required that will include a bigger number of subjects, add actual driving monitoring hours, and assign subjects randomly to the various groups.

Keywords: ADHD, driving, driving monitoring, metacognitive intervention, occupational therapy, simulator, teenagers

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3550 Unique Interprofessional Mental Health Education Model: A Pre/Post Survey

Authors: Michele L. Tilstra, Tiffany J. Peets

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Interprofessional collaboration in behavioral healthcare education is increasingly recognized for its value in training students to address diverse client needs. While interprofessional education (IPE) is well-documented in occupational therapy education to address physical health, limited research exists on collaboration with counselors to address mental health concerns and the psychosocial needs of individuals receiving care. Counseling education literature primarily examines the collaboration of counseling students with psychiatrists, psychologists, social workers, and marriage and family therapists. This pretest/posttest survey research study explored changes in attitudes toward interprofessional teams among 56 Master of Occupational Therapy (MOT) (n = 42) and Counseling and Human Development (CHD) (n = 14) students participating in the Counselors and Occupational Therapists Professionally Engaged in the Community (COPE) program. The COPE program was designed to strengthen the behavioral health workforce in high-need and high-demand areas. Students accepted into the COPE program were divided into small MOT/CHD groups to complete multiple interprofessional multicultural learning modules using videos, case studies, and online discussion board posts. The online modules encouraged reflection on various behavioral healthcare roles, benefits of team-based care, cultural humility, current mental health challenges, personal biases, power imbalances, and advocacy for underserved populations. Using the Student Perceptions of Interprofessional Clinical Education- Revision 2 (SPICE-R2) scale, students completed pretest and posttest surveys using a 5-point Likert scale (Strongly Agree = 5 to Strongly Disagree = 1) to evaluate their attitudes toward interprofessional teamwork and collaboration. The SPICE-R2 measured three different factors: interprofessional teamwork and team-based practice (Team), roles/responsibilities for collaborative practice (Roles), and patient outcomes from collaborative practice (Outcomes). The mean total scores for all students improved from 4.25 (pretest) to 4.43 (posttest), Team from 4.66 to 4.58, Roles from 3.88 to 4.30, and Outcomes from 4.08 to 4.36. A paired t-test analysis for the total mean scores resulted in a t-statistic of 2.54, which exceeded both one-tail and two-tail critical values, indicating statistical significance (p = .001). When the factors of the SPICE-R2 were analyzed separately, only the Roles (t Stat=4.08, p =.0001) and Outcomes (t Stat=3.13, p = .002) were statistically significant. The item ‘I understand the roles of other health professionals’ showed the most improvement from a mean score for all students of 3.76 (pretest) to 4.46 (posttest). The significant improvement in students' attitudes toward interprofessional teams suggests that the unique integration of OT and CHD students in the COPE program effectively develops a better understanding of the collaborative roles necessary for holistic client care. These results support the importance of IPE through structured, engaging interprofessional experiences. These experiences are essential for enhancing students' readiness for collaborative practice and align with accreditation standards requiring interprofessional education in OT and CHD programs to prepare practitioners for team-based care. The findings contribute to the growing body of evidence supporting the integration of IPE in behavioral healthcare curricula to improve holistic client care and encourage students to engage in collaborative practice across healthcare settings.

Keywords: behavioral healthcare, counseling education, interprofessional education, mental health education, occupational therapy education

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3549 The Relationship Between Quality of Life, Psychological Distress and Coping Strategies of Persons Living with HIV/AIDS in Cairo, Egypt

Authors: Sumaia Jawad, Shalaweh Salem, Walid Kamal, Nicolette Roman

Abstract:

Background: HIV patients have many social problems like depression, which adversely affects their quality of life. HIV infection is linked to psychological distress such as anxiety. In terms of coping styles, avoidant emotion-focused strategies such as fatalism, wishful thinking and self-blame are associated with higher levels of psychological distress in persons with HIV. In Cairo, Egypt current services are not adapted to provide advice and psychological support to people living with HIV to help them develop problem-solving skills to cope with the stress of living with HIV. Yet, no studies have examined the relationship between quality of life, psychological distress and coping strategies of persons living with HIV/AIDS in Egypt. Therefore, the purpose of this study was to examine the relationship between quality of life, psychological distress and coping strategies of persons living with HIV/AIDS in Cairo, Egypt. Methods: This study used a quantitative methodology with a cross-sectional correlational design. The data was collected using: Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Depression, Anxiety and Stress Scale (DASS) and Cope Inventory. The sample consisted of 202 participants who accessed the National AIDS Program (NAP). The data was analysed using the Statistical Program for Social Science V23 (SPSS). Results: The results show that psychological distress and certain coping styles such as substance abuse and behavioural disengagement negatively predict the quality of life of patients with HIV/AIDS. Positive predictors included coping styles such as active coping, self-distraction, venting, positive reframing, humor, acceptance, and religion. Conclusions: It would probably be best to reduce psychological distress and increase coping styles in order to improve the quality of life of patients with HIV/AIDS.

Keywords: HIV/AIDS, quality of life, psychological distress, coping strategies

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3548 'Marching into the Classroom' a Second Career in Education for Ex-Military Personnel

Authors: Mira Karnieli, Shosh Veitzman

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In recent years, due to transitions in teacher education, professional identities are changing. In many countries, the education system is absorbing ex-military personnel. The aim of this research is to investigate the phenomenon of retired officers in Israel who choose education as a second career and the training provided. The phenomenon of retired military permanent-service officers pursuing a career in education is not unique to Israel. In the United States and the United Kingdom, for example, government-supported accelerated programs (Troops to Teachers) are run for ex-military personnel (soldiers and officers) with a view to their entry into the education system. These programs direct the ex-military personnel to teacher education and training courses to obtain teaching certification. The present study, however, focused specifically on senior officers who have a full academic education, most of the participants hold second degrees in a variety of fields. They all retired from a rich military career, including roles in command, counseling, training, guidance, and management. The research included 80 participants' men and women. Data was drowning from in-depth interviews and questioner. The conceptual framework which guided this study was mixed methods. The qualitative-phenomenological methodology, using in-depth interviews, and a questioner. The study attempted to understand the motives and personal perceptions behind the choice of teaching. Were they able to identify prior skills that they had accumulated throughout their years of service? What were these skills? In addition, which (if any) would stand them in good stead for a career in teaching? In addition, they were asked how they perceived the training program’s contribution to their professionalization and integration in the education system. The data was independently coded by the researchers. Subsequently, the data was discussed by both researchers, codes were developed, and conceptual categories were formed. Analysis of the data shows this population to be characterized by the high motivation for studying, professionalization, contribution to society and a deep sense of commitment to education. All of them had a profession which they acquired in the past which is not related to education. However, their motives for choosing to teach are related to their wish to give expression to their leadership experience and ability, the desire to have an influence and to bring about change. This is derived from personal commitment, as well as from a worldview and value system that are supportive of education. In other words, they feel committed and act out of a sense of vocation. In conclusion, it will emphasize that all the research participants began working in education immediately upon completing the training program. They perceived this path as a way of realizing a mission despite the low status of the teaching profession in Israel and low teacher salaries.

Keywords: cross-boundary skills, lifelong learning, professional identities, teaching as a second career, training program

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3547 Organic Tuber Production Fosters Food Security and Soil Health: A Decade of Evidence from India

Authors: G. Suja, J. Sreekumar, A. N. Jyothi, V. S. Santhosh Mithra

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Worldwide concerns regarding food safety, environmental degradation and threats to human health have generated interest in alternative systems like organic farming. Tropical tuber crops, cassava, sweet potato, yams, and aroids are food-cum-nutritional security-cum climate resilient crops. These form stable or subsidiary food for about 500 million global population. Cassava, yams (white yam, greater yam, and lesser yam) and edible aroids (elephant foot yam, taro, and tannia) are high energy tuberous vegetables with good taste and nutritive value. Seven on-station field experiments at ICAR-Central Tuber Crops Research Institute, Thiruvananthapuram, India and seventeen on-farm trials in three districts of Kerala, were conducted over a decade (2004-2015) to compare the varietal response, yield, quality and soil properties under organic vs conventional system in these crops and to develop a learning system based on the data generated. The industrial, as well as domestic varieties of cassava, the elite and local varieties of elephant foot yam and taro and the three species of Dioscorea (yams), were on a par under both systems. Organic management promoted yield by 8%, 20%, 9%, 11% and 7% over conventional practice in cassava, elephant foot yam, white yam, greater yam and lesser yam respectively. Elephant foot yam was the most responsive to organic management followed by yams and cassava. In taro, slight yield reduction (5%) was noticed under organic farming with almost similar tuber quality. The tuber quality was improved with higher dry matter, starch, crude protein, K, Ca and Mg contents. The anti-nutritional factors, oxalate content in elephant foot yam and cyanogenic glucoside content in cassava were lowered by 21 and 12.4% respectively. Organic plots had significantly higher water holding capacity, pH, available K, Fe, Mn and Cu, higher soil organic matter, available N, P, exchangeable Ca and Mg, dehydrogenase enzyme activity and microbial count. Organic farming scored significantly higher soil quality index (1.93) than conventional practice (1.46). The soil quality index was driven by water holding capacity, pH and available Zn followed by soil organic matter. Organic management enhanced net profit by 20-40% over chemical farming. A case in point is the cost-benefit analysis in elephant foot yam which indicated that the net profit was 28% higher and additional income of Rs. 47,716 ha-1 was obtained due to organic farming. Cost-effective technologies were field validated. The on-station technologies developed were validated and popularized through on-farm trials in 10 sites (5 ha) under National Horticulture Mission funded programme in elephant foot yam and seven sites in yams and taro. The technologies are included in the Package of Practices Recommendations for crops of Kerala Agricultural University. A learning system developed using artificial neural networks (ANN) predicted the performance of elephant foot yam organic system. Use of organically produced seed materials, seed treatment in cow-dung, neem cake, bio-inoculant slurry, farmyard manure incubated with bio-inoculants, green manuring, use of neem cake, bio-fertilizers and ash formed the strategies for organic production. Organic farming is an eco-friendly management strategy that enables 10-20% higher yield, quality tubers and maintenance of soil health in tuber crops.

Keywords: eco-agriculture, quality, root crops, healthy soil, yield

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3546 Peripheral Neuropathiy After Locoregional Anesthesia

Authors: Dalila Chaid, Yacine Houmel, Mohamed Lamine Belloulou

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Peripheral neuropathy is a rare but worrying complication of peripheral local anaesthesia. It is caused either by needle contact with the nerve root or by the direct toxicity of local anaesthetics, leading to nerve damage, injury or irritation. Although uncommon, it remains a major concern for anaesthetists. The aim of the study was to assess the prevalence of nerve block-associated neuropathy in knee surgery and to identify the contributing factors in order to minimise the occurrence of this complication. The study also assessed the severity and evolution of lesions, as well as the factors leading to neuropathic pain. Methodology: It is a retrospective observational study on cases of neuropathy related to nerve blocks of the lower limb for knee surgery over a period of seven years (2016-2022). The study included a total of 6,000 patients Analyse the anaesthetic and neuropathic pain-related parameters received from these patients to determine the prevalence and severity of neuropathy. Findings: the prevalence of nerve block-related neuropathy in our study is 5.8‰ for the sciatic nerve and 0.9‰ for the femoral nerve. This was higher compared to the reported rates in the literature, which were between 0.0 to 5‰ for the Sciatic nerve and 0.0 to 3.4‰ for the femoral nerve. These findings highlight the importance of identifying and implementing an ideal anesthesia procedure to reduce the risk of neuropathy associated with nerve blocks. Theoretical Importance: The findings of this study contribute to the existing literature on peripheral neuropathy following locoregional anesthesia. By identifying the prevalence and severity of neuropathy related to nerve blocks, as well as the underlying factors, we provide valuable insights for anesthetists to improve patient safety. This study also emphasizes the need for compliance with technical safety rules to minimize the occurrence of neuropathy. Data Collection and Analysis Procedures: For this study, 25 clinics with retrospective data were collected of neuropathy associated with nerve blocks for knee surgery over a span of seven years. Parameters related to anaesthesia and neuropathic pain were analysed to determine prevalence,severity, and progression of neuropathy. Comparison of our results with the existing literature in order to assess their significance. Questions Addressed: This study aims to define the following points: 1. The prevalence of neuropathy associated with nerve blocks for knee surgery. 2. The factors underlying the development of neuropathy after nerve blocks. 3. Reducing the risk of neuropathy by complying with technical safety rules. 4. Assessing the severity and evolution of neuropathic pain in these cases. Conclusion: this study highlights the need for careful consideration and implementation of anesthesia procedures during nerve blocks for knee surgery. The prevalence of neuropathy linked to these blocks was higher compared to the literature, emphasizing the importance of identifying and minimizing contributing factors. Compliance with technical safety rules is crucial to reduce the risk of peripheral neuropathy. This study provides valuable insights to anesthetists and contributes to improving patient safety in the field of locoregional anesthesia.

Keywords: phantom limb, neuropathic pain, lower limb amputee, ultrasound-guided locoreginal anesthesia

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3545 Assessment of the Production System and Management Practices in Selected Layer Chicken Farms in Batangas, Philippines

Authors: Monette S. De Castro, Veneranda A. Magpantay, Christine B. Adiova, Mark D. Arboleda

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One-hundred-layer chicken farmers were randomly selected and interviewed using structured questionnaires to assess the production system and management practices in layer chicken farms. The respondents belonged to the commercial scale operation. Results showed that the predominant rearing and housing systems were intensive/complete confinement and open-sided, while slatted was the common type of flooring used during the brood-grow period. Dekalb and Lohmann were the common chicken layer strains reared by farmers. The majority of commercial chicken layer farms preferred ready-to-lay (RTL) pullets as their replacement stocks. Selling was the easiest way for farmers to dispose of and utilize poultry manure, while veterinary waste and mortality were disposed of in pits. Biosecurity practices employed by the farmers conformed with the ASEAN Biosecurity Management Manual for Commercial Poultry Farming. Flies and odor were the major problems in most layer farms that are associated with their farm wastes. Therefore, the application of new technologies and husbandry practices through training and actual demonstrations could be implemented to further improve the layer chicken raising in the province.

Keywords: layer chicken farms, marketing, production system, waste management

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3544 Design of a High Performance T/R Switch for 2.4 GHz RF Wireless Transceiver in 0.13 µm CMOS Technology

Authors: Mohammad Arif Sobhan Bhuiyan, Mamun Bin Ibne Reaz

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The rapid advancement of CMOS technology, in the recent years, has led the scientists to fabricate wireless transceivers fully on-chip which results in smaller size and lower cost wireless communication devices with acceptable performance characteristics. Moreover, the performance of the wireless transceivers rigorously depends on the performance of its first block T/R switch. This article proposes a design of a high performance T/R switch for 2.4 GHz RF wireless transceivers in 0.13 µm CMOS technology. The switch exhibits 1- dB insertion loss, 37.2-dB isolation in transmit mode and 1.4-dB insertion loss, 25.6-dB isolation in receive mode. The switch has a power handling capacity (P1dB) of 30.9-dBm. Besides, by avoiding bulky inductors and capacitors, the size of the switch is drastically reduced and it occupies only (0.00296) mm2 which is the lowest ever reported in this frequency band. Therefore, simplicity and low chip area of the circuit will trim down the cost of fabrication as well as the whole transceiver.

Keywords: CMOS, ISM band, SPDT, t/r switch, transceiver

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3543 Incorporating Ground Sand in Production of Self-Consolidating Concrete to Decrease High Paste Volume and Improve Passing Ability of Self-Consolidating Concrete

Authors: S. K. Ling, A. K. H. Kwan

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The production of SCC (self-consolidating concrete) generally requires a fairy high paste volume, ranging from 35% to 40% of the total concrete volume. Such high paste volume would lead to low dimensional stability and high carbon footprint. Direct lowering the paste volume would deteriorate the performance of SCC, especially the passing ability. It is often observed that at narrow gap of congested reinforcements, the paste often flows in the front leaving the coarse aggregate particle behind to block the subsequent flow of concrete. Herein, it is suggested to increase the mortar volume through incorporating ground sand with a mean size of 0.3 mm while keeping the paste volume small. Trial concrete mixes with paste volumes of 30% and 34% and different ground sand contents have been tested to demonstrate how the paste volume can be lowered without sacrificing the passing ability. Overall, the results demonstrated that the addition of ground sand would enable the achievement of high passing ability at a relatively small paste volume.

Keywords: ground sand, mortar volume, paste volume, self-consolidating concrete

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3542 The Predictors of Head and Neck Cancer-Head and Neck Cancer-Related Lymphedema in Patients with Resected Advanced Head and Neck Cancer

Authors: Shu-Ching Chen, Li-Yun Lee

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The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

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3541 Block N Lvi from the Northern Side of Parthenon Frieze: A Case Study of Augmented Reality for Museum Application

Authors: Donato Maniello, Alessandra Cirafici, Valeria Amoretti

Abstract:

This paper aims to present a new method that consists in the use of video mapping techniques – that is a particular form of augmented reality, which could produce new tools - different from the ones that are actually in use - for an interactive Museum experience. With the words 'augmented reality', we mean the addition of more information than what the visitor would normally perceive; this information is mediated by the use of computer and projector. The proposed application involves the creation of a documentary that depicts and explains the history of the artifact and illustrates its features; this must be projected on the surface of the faithful copy of the freeze (obtained in full-scale with a 3D printer). This mode of operation uses different techniques that allow passing from the creation of the model to the creation of contents through an accurate historical and artistic analysis, and finally to the warping phase, that will permit to overlap real and virtual models. The ultimate step, that is still being studied, includes the creation of interactive contents that would be activated by visitors through appropriate motion sensors.

Keywords: augmented reality, multimedia, parthenon frieze, video mapping

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3540 Measuring Biobased Content of Building Materials Using Carbon-14 Testing

Authors: Haley Gershon

Abstract:

The transition from using fossil fuel-based building material to formulating eco-friendly and biobased building materials plays a key role in sustainable building. The growing demand on a global level for biobased materials in the building and construction industries heightens the importance of carbon-14 testing, an analytical method used to determine the percentage of biobased content that comprises a material’s ingredients. This presentation will focus on the use of carbon-14 analysis within the building materials sector. Carbon-14, also known as radiocarbon, is a weakly radioactive isotope present in all living organisms. Any fossil material older than 50,000 years will not contain any carbon-14 content. The radiocarbon method is thus used to determine the amount of carbon-14 content present in a given sample. Carbon-14 testing is performed according to ASTM D6866, a standard test method developed specifically for biobased content determination of material in solid, liquid, or gaseous form, which requires radiocarbon dating. Samples are combusted and converted into a solid graphite form and then pressed onto a metal disc and mounted onto a wheel of an accelerator mass spectrometer (AMS) machine for the analysis. The AMS instrument is used in order to count the amount of carbon-14 present. By submitting samples for carbon-14 analysis, manufacturers of building materials can confirm the biobased content of ingredients used. Biobased testing through carbon-14 analysis reports results as percent biobased content, indicating the percentage of ingredients coming from biomass sourced carbon versus fossil carbon. The analysis is performed according to standardized methods such as ASTM D6866, ISO 16620, and EN 16640. Products 100% sourced from plants, animals, or microbiological material are therefore 100% biobased, while products sourced only from fossil fuel material are 0% biobased. Any result in between 0% and 100% biobased indicates that there is a mixture of both biomass-derived and fossil fuel-derived sources. Furthermore, biobased testing for building materials allows manufacturers to submit eligible material for certification and eco-label programs such as the United States Department of Agriculture (USDA) BioPreferred Program. This program includes a voluntary labeling initiative for biobased products, in which companies may apply to receive and display the USDA Certified Biobased Product label, stating third-party verification and displaying a product’s percentage of biobased content. The USDA program includes a specific category for Building Materials. In order to qualify for the biobased certification under this product category, examples of product criteria that must be met include minimum 62% biobased content for wall coverings, minimum 25% biobased content for lumber, and a minimum 91% biobased content for floor coverings (non-carpet). As a result, consumers can easily identify plant-based products in the marketplace.

Keywords: carbon-14 testing, biobased, biobased content, radiocarbon dating, accelerator mass spectrometry, AMS, materials

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3539 Barrier Lowering in Contacts between Graphene and Semiconductor Materials

Authors: Zhipeng Dong, Jing Guo

Abstract:

Graphene-semiconductor contacts have been extensively studied recently, both as a stand-alone diode device for potential applications in photodetectors and solar cells, and as a building block to vertical transistors. Graphene is a two-dimensional nanomaterial with vanishing density-of-states at the Dirac point, which differs from conventional metal. In this work, image-charge-induced barrier lowering (BL) in graphene-semiconductor contacts is studied and compared to that in metal Schottky contacts. The results show that despite of being a semimetal with vanishing density-of-states at the Dirac point, the image-charge-induced BL is significant. The BL value can be over 50% of that of metal contacts even in an intrinsic graphene contacted to an organic semiconductor, and it increases as the graphene doping increases. The dependences of the BL on the electric field and semiconductor dielectric constant are examined, and an empirical expression for estimating the image-charge-induced BL in graphene-semiconductor contacts is provided.

Keywords: graphene, semiconductor materials, schottky barrier, image charge, contacts

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3538 Research on Dynamic Practical Byzantine Fault Tolerance Consensus Algorithm

Authors: Cao Xiaopeng, Shi Linkai

Abstract:

The practical Byzantine fault-tolerant algorithm does not add nodes dynamically. It is limited in practical application. In order to add nodes dynamically, Dynamic Practical Byzantine Fault Tolerance Algorithm (DPBFT) was proposed. Firstly, a new node sends request information to other nodes in the network. The nodes in the network decide their identities and requests. Then the nodes in the network reverse connect to the new node and send block information of the current network. The new node updates information. Finally, the new node participates in the next round of consensus, changes the view and selects the master node. This paper abstracts the decision of nodes into the undirected connected graph. The final consistency of the graph is used to prove that the proposed algorithm can adapt to the network dynamically. Compared with the PBFT algorithm, DPBFT has better fault tolerance and lower network bandwidth.

Keywords: practical byzantine, fault tolerance, blockchain, consensus algorithm, consistency analysis

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3537 Bronchospasm Analysis Following the Implementation of a Program of Maximum Aerobic Exercise in Active Men

Authors: Sajjad Shojaeidoust, Mohsen Ghanbarzadeh, Abdolhamid Habibi

Abstract:

Exercise-induced bronchospasm (EIB) is a transitory condition of airflow obstruction that is associated with physical activities. It is noted that high ventilation can lead to an increase in the heat and reduce in the moisture in airways resistance of trachea. Also causes of pathophysiological mechanism are EIB. Accordingly, studying some parameters of pulmonary function (FVC, FEV1) among active people seems quintessential. The aim of this study was to analyze bronchospasm following the implementation of a program of maximum aerobic exercise in active men at Chamran University of Ahwaz. Method: In this quasi-experimental study, the population consisted of all students at Chamran University. Among from 55 participants, of which, 15 were randomly selected as the experimental group. In this study, the size of the maximum oxygen consumption was initially measured, and then, based on the maximum oxygen consumed, the active individuals were identified. After five minutes’ warm-up, Strand treadmill exercise test was taken (one session) and pulmonary parameters were measured at both pre- and post-tests (spirometer). After data normalization using KS and non-normality of the data, the Wilcoxon test was used to analyze the data. The significance level for all statistical surveys was considered p≤0/05. Results: The results showed that the ventilation factors and bronchospasm (FVC, FEV1) in the pre-test and post-test resulted in no significant difference among the active people (p≥0/05). Discussion and conclusion: Based on the results observed in this study, it appears that pulmonary indices in active individuals increased after aerobic test. The increase in this indicator in active people is due to increased volume and elasticity of the lungs as well. In other words, pulmonary index is affected by rib muscles. It is considered that progress over respiratory muscle strength and endurance has raised FEV1 in the active cases.

Keywords: aerobic active maximum, bronchospasm, pulmonary function, spirometer

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3536 Smart Cities’ Sustainable Modular Houses Architecture

Authors: Khaled Elbehiery, Hussam Elbehiery

Abstract:

Smart cities are a framework of technologies along with sustainable infrastructure to provide their citizens an improved quality of life, safer environment, affordability, and more, which in turn helps with the society's economic growth. The proposed research will focus on the primary building block of the smart city; the infrastructure of the house itself. The traditional method of building houses has been, for a long time, nothing but a costly manufacturing process, and consequently, buying a house becomes not an option for everyone anymore. The smart cities' Modular Houses are not using traditional building construction materials; the design reduces the common lengthy construction times and associated high costs. The Modular Houses are technological homes, low-cost and customizable based on a family's requirements. In addition, the Modular Houses are environmentally friendly and healthy enough to assist with the pandemic situation.

Keywords: smart cities, modular houses, single-unit property, multi-unit property, mobility features, chain-supply, livable environment, carbon footprint

Procedia PDF Downloads 111
3535 Monitoring and Evaluation of Web-Services Quality and Medium-Term Impact on E-Government Agencies' Efficiency

Authors: A. F. Huseynov, N. T. Mardanov, J. Y. Nakhchivanski

Abstract:

This practical research is aimed to improve the management quality and efficiency of public administration agencies providing e-services. The monitoring system developed will provide continuous review of the websites compliance with the selected indicators, their evaluation based on the selected indicators and ranking of services according to the quality criteria. The responsible departments in the government agencies were surveyed; the questionnaire includes issues of management and feedback, e-services provided, and the application of information systems. By analyzing the main affecting factors and barriers, the recommendations will be given that lead to the relevant decisions to strengthen the state agencies competencies for the management and the provision of their services. Component 1. E-services monitoring system. Three separate monitoring activities are proposed to be executed in parallel: Continuous tracing of e-government sites using built-in web-monitoring program; this program generates several quantitative values which are basically related to the technical characteristics and the performance of websites. The expert assessment of e-government sites in accordance with the two general criteria. Criterion 1. Technical quality of the site. Criterion 2. Usability/accessibility (load, see, use). Each high-level criterion is in turn subdivided into several sub-criteria, such as: the fonts and the color of the background (Is it readable?), W3C coding standards, availability of the Robots.txt and the site map, the search engine, the feedback/contact and the security mechanisms. The on-line survey of the users/citizens – a small group of questions embedded in the e-service websites. The questionnaires comprise of the information concerning navigation, users’ experience with the website (whether it was positive or negative), etc. Automated monitoring of web-sites by its own could not capture the whole evaluation process, and should therefore be seen as a complement to expert’s manual web evaluations. All of the separate results were integrated to provide the complete evaluation picture. Component 2. Assessment of the agencies/departments efficiency in providing e-government services. - the relevant indicators to evaluate the efficiency and the effectiveness of e-services were identified; - the survey was conducted in all the governmental organizations (ministries, committees and agencies) that provide electronic services for the citizens or the businesses; - the quantitative and qualitative measures are covering the following sections of activities: e-governance, e-services, the feedback from the users, the information systems at the agencies’ disposal. Main results: 1. The software program and the set of indicators for internet sites evaluation has been developed and the results of pilot monitoring have been presented. 2. The evaluation of the (internal) efficiency of the e-government agencies based on the survey results with the practical recommendations related to the human potential, the information systems used and e-services provided.

Keywords: e-government, web-sites monitoring, survey, internal efficiency

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3534 Music Education in Aged Care: Positive Ageing through Instrumental Music Learning

Authors: Ellina Zipman

Abstract:

This research investigates the place of music education in aged care facilities through the implementation of a program of regular piano lessons for residents. Using a qualitative case study methodology, the research explores aged care residents’ experiences in learning to play the piano. Since the aged care homes are unlikely places for formal learning and since older adults, especially in residential care, are not considered likely candidates for learning, this research opens the door for innovative and transformative thinking about where and to whom educational programs can be delivered. By addressing the educational needs of residents in aged care facilities, this research fills the gap in the literature. The research took place in Australia in two of Melbourne’s residential aged care facilities, engaging two residents (a nonagenarian female and an octogenarian male) to participate in 12-months weekly individual piano lessons. The data was collected through video recording of lessons, observations, interviews, emails, and a reflective journal. Data analysis was done using Nvivo and hard copy analysis with identifications of themes. The case studies revealed that passion for music was a major driver in participants’ motivation to engage in a long-term piano lessons program. This participation led to experiences of positive emotions, positive attitude, successes and challenges, the exercise of control, maintaining and building new relationships, improved self-confidence through autonomy and independent skills development, and discovering new identities through finding a new purpose and new roles in life. Speaking through participants’ voices, this research project demonstrates the importance of music education for older adults and hopes to influence transformation in the residential aged care sector.

Keywords: adult music education, quality of life, passion, positive ageing, wellbeing

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3533 Reliability of Swine Estrous Detector Probe in Dairy Cattle Breeding

Authors: O. O. Leigh, L. C. Agbugba, A. O. Oyewunmi, A. E. Ibiam, A. Hassan

Abstract:

Accuracy of insemination timing is a key determinant of high pregnancy rates in livestock breeding stations. The estrous detector probes are a recent introduction into the Nigerian livestock farming sector. Many of these probes are species-labeled and they measure changes in the vaginal mucus resistivity (VMR) during the stages of the estrous cycle. With respect to size and shaft conformation, the Draminski® swine estrous detector probe (sEDP) is quite similar to the bovine estrous detector probe. We investigated the reliability of the sEDP at insemination time on two farms designated as FM A and FM B. Cows (Bunaji, n=20 per farm) were evaluated for VMR at 16th h post standard OvSynch protocol, with concurrent insemination on FM B only. The difference in the mean VMR between FM A (221 ± 24.36) Ohms and FM B (254 ± 35.59) Ohms was not significant (p > 0.05). Sixteen cows (80%) at FM B were later (day 70) confirmed pregnant via rectal palpation and calved at term. These findings suggest consistency in VMR evaluated with sEDP at insemination as well as a high predictability for VMR associated with good pregnancy rates in dairy cattle. We conclude that Draminski® swine estrous detector probe is reliable in determining time of insemination in cattle breeding stations.

Keywords: dairy cattle, insemination, swine estrous probe, vaginal mucus resistivity

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3532 Computational Aerodynamics and Aeroacoustics of a Nose Landing Gear

Authors: Kamal Haider

Abstract:

Numerical simulations over landing gear of simplified and partially-dressed configurations with closed cavity have been performed to compute aerodynamically and aeroacoustics parameters using commercial engineering software. The objective of numerical computations is two folds. Firstly, to validate experimental data of newly built nose landing gear and secondly perform high-fidelity calculations using CFD/FW-H hybrid approach, as future engineering challenges need more advanced aircraft configurations such as performance noise and efficiency. Both geometries are used for multi-block structured, and unstructured/hybrid meshed to develop some understanding of physics in terms of aerodynamics and aeroacoustics. Detached Eddy Simulation (DES) approach is employed to compute surface pressure. Also far-field noise calculations have been generated by Ffowcs-William and Hawking solver. Both results of aerodynamics and aeroacoustics are compared with experimental data.

Keywords: landing gear, computational aeroacoustics, computational aerodynamics, detached eddy simulation

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3531 Assessing of Social Comfort of the Russian Population with Big Data

Authors: Marina Shakleina, Konstantin Shaklein, Stanislav Yakiro

Abstract:

The digitalization of modern human life over the last decade has facilitated the acquisition, storage, and processing of data, which are used to detect changes in consumer preferences and to improve the internal efficiency of the production process. This emerging trend has attracted academic interest in the use of big data in research. The study focuses on modeling the social comfort of the Russian population for the period 2010-2021 using big data. Big data provides enormous opportunities for understanding human interactions at the scale of society with plenty of space and time dynamics. One of the most popular big data sources is Google Trends. The methodology for assessing social comfort using big data involves several steps: 1. 574 words were selected based on the Harvard IV-4 Dictionary adjusted to fit the reality of everyday Russian life. The set of keywords was further cleansed by excluding queries consisting of verbs and words with several lexical meanings. 2. Search queries were processed to ensure comparability of results: the transformation of data to a 10-point scale, elimination of popularity peaks, detrending, and deseasoning. The proposed methodology for keyword search and Google Trends processing was implemented in the form of a script in the Python programming language. 3. Block and summary integral indicators of social comfort were constructed using the first modified principal component resulting in weighting coefficients values of block components. According to the study, social comfort is described by 12 blocks: ‘health’, ‘education’, ‘social support’, ‘financial situation’, ‘employment’, ‘housing’, ‘ethical norms’, ‘security’, ‘political stability’, ‘leisure’, ‘environment’, ‘infrastructure’. According to the model, the summary integral indicator increased by 54% and was 4.631 points; the average annual rate was 3.6%, which is higher than the rate of economic growth by 2.7 p.p. The value of the indicator describing social comfort in Russia is determined by 26% by ‘social support’, 24% by ‘education’, 12% by ‘infrastructure’, 10% by ‘leisure’, and the remaining 28% by others. Among 25% of the most popular searches, 85% are of negative nature and are mainly related to the blocks ‘security’, ‘political stability’, ‘health’, for example, ‘crime rate’, ‘vulnerability’. Among the 25% most unpopular queries, 99% of the queries were positive and mostly related to the blocks ‘ethical norms’, ‘education’, ‘employment’, for example, ‘social package’, ‘recycling’. In conclusion, the introduction of the latent category ‘social comfort’ into the scientific vocabulary deepens the theory of the quality of life of the population in terms of the study of the involvement of an individual in the society and expanding the subjective aspect of the measurements of various indicators. Integral assessment of social comfort demonstrates the overall picture of the development of the phenomenon over time and space and quantitatively evaluates ongoing socio-economic policy. The application of big data in the assessment of latent categories gives stable results, which opens up possibilities for their practical implementation.

Keywords: big data, Google trends, integral indicator, social comfort

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3530 Research and Application of the Three-Dimensional Visualization Geological Modeling of Mine

Authors: Bin Wang, Yong Xu, Honggang Qu, Rongmei Liu, Zhenji Gao

Abstract:

Today's mining industry is advancing gradually toward digital and visual direction. The three dimensional visualization geological modeling of mine is the digital characterization of mineral deposit, and is one of the key technology of digital mine. The three-dimensional geological modeling is a technology that combines the geological spatial information management, geological interpretation, geological spatial analysis and prediction, geostatistical analysis, entity content analysis and graphic visualization in three-dimensional environment with computer technology, and is used in geological analysis. In this paper, the three-dimensional geological modeling of an iron mine through the use of Surpac is constructed, and the weight difference of the estimation methods between distance power inverse ratio method and ordinary kriging is studied, and the ore body volume and reserves are simulated and calculated by using these two methods. Compared with the actual mine reserves, its result is relatively accurate, so it provided scientific bases for mine resource assessment, reserve calculation, mining design and so on.

Keywords: three-dimensional geological modeling, geological database, geostatistics, block model

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3529 Effect of Cerebellar High Frequency rTMS on the Balance of Multiple Sclerosis Patients with Ataxia

Authors: Shereen Ismail Fawaz, Shin-Ichi Izumi, Nouran Mohamed Salah, Heba G. Saber, Ibrahim Mohamed Roushdi

Abstract:

Background: Multiple sclerosis (MS) is a chronic, inflammatory, mainly demyelinating disease of the central nervous system, more common in young adults. Cerebellar involvement is one of the most disabling lesions in MS and is usually a sign of disease progression. It plays a major role in the planning, initiation, and organization of movement via its influence on the motor cortex and corticospinal outputs. Therefore, it contributes to controlling movement, motor adaptation, and motor learning, in addition to its vast connections with other major pathways controlling balance, such as the cerebellopropriospinal pathways and cerebellovestibular pathways. Hence, trying to stimulate the cerebellum by facilitatory protocols will add to our motor control and balance function. Non-invasive brain stimulation, both repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), has recently emerged as effective neuromodulators to influence motor and nonmotor functions of the brain. Anodal tDCS has been shown to improve motor skill learning and motor performance beyond the training period. Similarly, rTMS, when used at high frequency (>5 Hz), has a facilitatory effect on the motor cortex. Objective: Our aim was to determine the effect of high-frequency rTMS over the cerebellum in improving balance and functional ambulation of multiple sclerosis patients with Ataxia. Patients and methods: This was a randomized single-blinded placebo-controlled prospective trial on 40 patients. The active group (N=20) received real rTMS sessions, and the control group (N=20) received Sham rTMS using a placebo program designed for this treatment. Both groups received 12 sessions of high-frequency rTMS over the cerebellum, followed by an intensive exercise training program. Sessions were given three times per week for four weeks. The active group protocol had a frequency of 10 Hz rTMS over the cerebellar vermis, work period 5S, number of trains 25, and intertrain interval 25s. The total number of pulses was 1250 pulses per session. The control group received Sham rTMS using a placebo program designed for this treatment. Both groups of patients received an intensive exercise program, which included generalized strengthening exercises, endurance and aerobic training, trunk abdominal exercises, generalized balance training exercises, and task-oriented training such as Boxing. As a primary outcome measure the Modified ICARS was used. Static Posturography was done with: Patients were tested both with open and closed eyes. Secondary outcome measures included the expanded Disability Status Scale (EDSS) and 8 Meter walk test (8MWT). Results: The active group showed significant improvements in all the functional scales, modified ICARS, EDSS, and 8-meter walk test, in addition to significant differences in static Posturography with open eyes, while the control group did not show such differences. Conclusion: Cerebellar high-frequency rTMS could be effective in the functional improvement of balance in MS patients with ataxia.

Keywords: brain neuromodulation, high frequency rTMS, cerebellar stimulation, multiple sclerosis, balance rehabilitation

Procedia PDF Downloads 75