Search results for: physical therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7488

Search results for: physical therapy

5538 The Effect of Ultrasound Pretreatment on Bioactive Compounds of Freeze-Dried Carrots

Authors: Gulcin Yildiz

Abstract:

Although drying is one of the most prevalent techniques applied to enhance food stability, it is a complicated method covering simultaneous coupled heat and mass transfer phenomena and the theoretical application of these phenomena to food products becomes challenging because of the complex structure and to the physical and chemical changes that happen at drying. Pretreatment of materials before drying has been shown to be effective in solving drying problems such as long drying times and poor product quality. The study was conducted to examine the effect of ultrasound (US) pre-treatment on physical and chemical/nutritional attributes of freeze-dried carrot slices. The carrots were washed, hand-peeled, and cut with dimensions of 1 cm (L) x 0.2 (W) cm x 1 cm (H). The carrot samples were treated in an ultrasonic bath in two different times, which were 15 and 30 minutes. Untreated and ultrasound pre-treated carrot samples were dried in a freeze dryer. Freeze-dried samples were analyzed in terms of bioactive compounds, including total phenols, ascorbic acid, and antioxidant capacity. Significant differences were found among dried carrot samples with and without ultrasound. The freeze-dried carrot slices treated with a US (especially 30 minutes - treatment) showed higher preservation of bioactive compounds. In overall, US pretreatment is a promising process, as demonstrated in current research by its capability to better retain freeze-dried carrot quality.

Keywords: bioactive compounds, carrot, freeze drying, ultrasound-pretreatment

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5537 Facial Infiltrating Lipomatosis, a Rare Cause of Facial Asymmetry to Be Known: Case Report and Literature Review

Authors: Shantanu Vyas, Neerja Meena

Abstract:

Facial infiltrating lipomatosis is a rare lipomatous lesion, first described by Slavin in 1983. It is a benign pseudotumor pathology. It corresponds to a non-encapsulated collection of mature adipocytes infiltrating the local tissue and hyperplasia of underlying bone leading to a craniofacial deformity. Very few cases have been reported in the literature. We report the case of a 19-year-old female patient, who was consulted for a swelling of the right hemiface progressively evolving since birth. Physical examination revealed facial asymmetry. On palpation, the mass was soft, painless, not compressible, not pulsatile, not fluctuating. In view of the asymptomatic nature and slow progression of the lesion, a lipomatous tumour, namely lipoma, was suggested. CT scan image shows a hyperplastic subcutaneous fat on the right hemiface. On the right jugal and temporal areas, there is a subcutaneous formation of fatty density, poorly limited, with no detectable peripheral capsule. It merges with the adjacent fat. In the bone window, there was a hyperplasia of underlying bone. Facial lipomatosis infiltration of the face is a benign pseudotumor pathology. As a result, it can be confused with other disorders, in particular, hemifacial hyperplasia. Combination of physical and radiological findings can establish the diagnosis. Surgical treatment is done for cosmetic purposes.

Keywords: cosmetic correction and facial assemetry, aesthetic results, facial infiltration, surgery

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5536 The Effect of Mindfulness Meditation on Pain, Sleep Quality, and Self-Esteem in Patients Receiving Hemodialysis in Jordan

Authors: Hossam N. Alhawatmeh, Areen I. Albustanji

Abstract:

Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.

Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness

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5535 Robot Control by ERPs of Brain Waves

Authors: K. T. Sun, Y. H. Tai, H. W. Yang, H. T. Lin

Abstract:

This paper presented the technique of robot control by event-related potentials (ERPs) of brain waves. Based on the proposed technique, severe physical disabilities can free browse outside world. A specific component of ERPs, N2P3, was found and used to control the movement of robot and the view of camera on the designed brain-computer interface (BCI). Users only required watching the stimuli of attended button on the BCI, the evoked potentials of brain waves of the target button, N2P3, had the greatest amplitude among all control buttons. An experimental scene had been constructed that the robot required walking to a specific position and move the view of camera to see the instruction of the mission, and then completed the task. Twelve volunteers participated in this experiment, and experimental results showed that the correct rate of BCI control achieved 80% and the average of execution time was 353 seconds for completing the mission. Four main contributions included in this research: (1) find an efficient component of ERPs, N2P3, for BCI control, (2) embed robot's viewpoint image into user interface for robot control, (3) design an experimental scene and conduct the experiment, and (4) evaluate the performance of the proposed system for assessing the practicability.

Keywords: severe physical disabilities, robot control, event-related potentials (ERPs), brain-computer interface (BCI), brain waves

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5534 Effect of High Pressure Treatment on the Microbial Contamination and on Some Chemical and Physical Properties of Minced Chicken

Authors: Siddig H. Hamad, Salah M. Al-Eid, Fahad M. Al-Jassas

Abstract:

Composite samples of minced chicken were vacuum-packaged and pressure treated at 300, 400, 450 and 500 MPa in a Stansted 'FOOD-LAB' model S-FL-850-9-W high hydrostatic pressure research apparatus (Stansted Fluid Power Ltd., Stansted, UK). Treated and untreated samples were then stored at 3°C, and microbial content as well as some chemical and physical properties monitored. The microbial load of the untreated samples reached the spoilage level of 107 cfu/g in about one week, resulting in bad smell and dark brown color. The pressure treatments reduced total bacterial counts by about 1.8 to 3.2 log10 cycles and reduced counts of Enterobacteriaceae and Salmonella to non-detectable levels. The color of meat was slightly affected, but pH, moisture content and the oxidation products of lipids were not substantially changed. The treatment killed mainly gram negative bacteria but also caused sub-lethal injury to part of the population resulting in prolonged lag phase. The population not killed by the 350 to 450 MPa treatments grew relatively slowly during storage, and its loads reached spoilage level in 4 to 6 weeks, while the load of the population treated at 500 MPa did not reach this level till the end of a storage period of 9 weeks.

Keywords: chicken, cold storage, microbial spoilage, high hydrostatic pressure

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5533 Domestic Violence Indictors and Coping Styles among Iranian, Pakistan and Turkish Married Women: A Cultural Study

Authors: Afsaneh Ghanbari Panah, Elyaz Bornak, Shiva Ghadiri Karizi, Amna Ahmad, Burcu Yildirim

Abstract:

This study explores domestic violence (DV) and coping strategies among married women in Iran, Pakistan, and Turkey. DV is a universal issue characterized by physical, psychological, or economic abuse by male family members towards female partners. The study aims to examine the prevalence of DV and the coping mechanisms employed by women in these three countries. The research highlights the significant impact of DV globally, transcending cultural, social, and economic boundaries. Despite the lack of comprehensive state-sponsored reports on Violence Against Women (VAW) in South Asia, fragmented reports by non-governmental agencies indicate high rates of self-reported intimate partner violence (IPV), including sexual violence, across these regions. The study emphasizes the urgent need for effective measures to address VAW, as existing laws often exclude unregistered and unmarried intimate partners. Coping mechanisms play a crucial role in responding to and managing the consequences of DV. The study defines coping as cognitive and behavioral responses to environmental stressors. Common coping strategies identified in the literature include spirituality, temporary or permanent separation, silence, submission, minimizing violence, denial, and seeking external support. Understanding these coping mechanisms is crucial for developing effective prevention and management strategies. The study presents findings from Iran, Pakistan, and Turkey, indicating varying prevalence rates of different forms of violence. Turkish respondents reported higher rates of emotional, physical, economic, and sexual violence, while Iranian respondents reported high levels of psychological, physical, and sexual violence. In Karachi, Pakistan, physical, sexual, and psychological violence were prevalent among women. The study highlights the importance of cross-cultural research and the need to consider individual and collective coping mechanisms in different societal contexts. Factors such as personal ideologies, political agendas, and economic stability influence societal support and cultural acceptance of IPV. To develop sustainable strategies, an in-depth exploration of coping mechanisms is necessary. In conclusion, this comparative study provides insights into DV and coping strategies among married women in Iran, Pakistan, and Turkey. The findings underscore the urgent need for comprehensive measures to address VAW, considering cultural, social, and economic factors. By understanding the prevalence and coping mechanisms employed by women, policymakers can develop effective interventions to support DV survivors and prevent further violence.

Keywords: domestic violence, coping styles, cultural study, violence against women

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5532 Individual and Organisational Outcomes of Psychosocial Hazard Exposures in Disaster and Emergency work: Qualitative Evidence from Ghana

Authors: Elias Kodjo Kekesi

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This study seeks to investigate a critical but neglected area in disaster and emergency management in Ghana. It explores aspects of work within one of the safety-critical work environments that expose workers to psychological, social and physical harm. With much attention to crises’ survivors, deceased and their families, this research attempts to answer a key question: ‘What happens to the rescuer’? Emergency response is associated with immense and unprecedented pressure that puts responders’ physical, mental and social well-being at risk. Despite the negative psychological outcomes, scholars argue that being in a traumatic situation may trigger positive outcomes for some people. Thus, the study also focuses on the positive impact of working in a risky crisis environment. Additionally, people’s interpretation of negative experiences or exposure to adverse conditions differ owing to their personal resources which explains why some people may be negatively affected whiles others are positively impacted. To examine these complex nuances, an exploratory sequential mixed method design is adopted. This paper will highlight the findings of study one, which explores the underlying themes emerging from the Ghanaian disaster and emergency response environment regarding psychosocial hazard exposures and the corresponding outcomes.

Keywords: psychosocial hazards, organisational outcomes, qualitative research, Ghana

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5531 Epidemiology, Clinical, Immune, and Molecular Profiles of Microsporidiosis and Cryptosporidiosis among HIV/AIDS patients

Authors: Roger WUMBA

Abstract:

The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients. In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk. Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of ,100 cells/mm³, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of ,100 cells/mm³, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of ,100 cells/mm³ (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P , 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites. E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human nfection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.

Keywords: diarrhea, enterocytozoon bieneusi, cryptosporidium hominis, cryptosporidium parvum, risk factors, africans

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5530 Utilization of Online Risk Mapping Techniques versus Desktop Geospatial Tools in Making Multi-Hazard Risk Maps for Italy

Authors: Seyed Vahid Kamal Alavi

Abstract:

Italy has experienced a notable quantity and impact of disasters due to natural hazards and technological accidents caused by diverse risk sources on its physical, technological, and human/sociological infrastructures during past decade. This study discusses the frequency and impacts of the most three physical devastating natural hazards in Italy for the period 2000–2013. The approach examines the reliability of a range of open source WebGIS techniques versus a proposed multi-hazard risk management methodology. Spatial and attribute data which include USGS publically available hazard data and thirteen years Munich RE recorded data for Italy with different severities have been processed, visualized in a GIS (Geographic Information System) framework. Comparison of results from the study showed that the multi-hazard risk maps generated using open source techniques do not provide a reliable system to analyze the infrastructures losses in respect to national risk sources while they can be adopted for general international risk management purposes. Additionally, this study establishes the possibility to critically examine and calibrate different integrated techniques in evaluating what better protection measures can be taken in an area.

Keywords: multi-hazard risk mapping, risk management, GIS, Italy

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5529 Application of Nitric Acid Modified Cocos nucifera, Pennisetum glaucum and Sorghum bicolor Activated Carbon for Adsorption of H₂S Gas

Authors: Z. N. Ali, O. A. Babatunde, S. Garba, H. M. S. Haruna

Abstract:

The potency of modified and unmodified activated carbons prepared from shells of Cocos nucifera (coconut shell), straws of Pennisetum glaucum (millet) and Sorghum bicolor (sorghum) for adsorption of hydrogen sulphide gas were investigated using an adsorption apparatus (stainless steel cylinder) at constant temperature (ambient temperature). The adsorption equilibria states were obtained when the pressure indicated on the pressure gauge remained constant. After modification with nitric acid, results of the scanning electron microscopy of the unmodified and modified activated carbons showed that HNO3 greatly improved the formation of micropores and mesopores on the activated carbon surface. The adsorption of H2S gas was found to be highest in modified Cocos nucifera activated carbon with maximum monolayer coverage of 28.17 mg/g, and the adsorption processes were both physical and chemical with the physical process being predominant. The adsorption data were well fitted into the Langmuir isotherm model with the adsorption capacities of the activated carbons in the order modified Cocos nucifera > modified Pennisetum glaucum > modified Sorghum bicolor > unmodified Cocos nucifera > unmodified Pennisetum glaucum > unmodified Sorghum bicolour.

Keywords: activated carbon adsorption, hydrogen sulphide, nitric acid, modification, stainless steel cylinder

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5528 Smart Sensor Data to Predict Machine Performance with IoT-Based Machine Learning and Artificial Intelligence

Authors: C. J. Rossouw, T. I. van Niekerk

Abstract:

The global manufacturing industry is utilizing the internet and cloud-based services to further explore the anatomy and optimize manufacturing processes in support of the movement into the Fourth Industrial Revolution (4IR). The 4IR from a third world and African perspective is hindered by the fact that many manufacturing systems that were developed in the third industrial revolution are not inherently equipped to utilize the internet and services of the 4IR, hindering the progression of third world manufacturing industries into the 4IR. This research focuses on the development of a non-invasive and cost-effective cyber-physical IoT system that will exploit a machine’s vibration to expose semantic characteristics in the manufacturing process and utilize these results through a real-time cloud-based machine condition monitoring system with the intention to optimize the system. A microcontroller-based IoT sensor was designed to acquire a machine’s mechanical vibration data, process it in real-time, and transmit it to a cloud-based platform via Wi-Fi and the internet. Time-frequency Fourier analysis was applied to the vibration data to form an image representation of the machine’s behaviour. This data was used to train a Convolutional Neural Network (CNN) to learn semantic characteristics in the machine’s behaviour and relate them to a state of operation. The same data was also used to train a Convolutional Autoencoder (CAE) to detect anomalies in the data. Real-time edge-based artificial intelligence was achieved by deploying the CNN and CAE on the sensor to analyse the vibration. A cloud platform was deployed to visualize the vibration data and the results of the CNN and CAE in real-time. The cyber-physical IoT system was deployed on a semi-automated metal granulation machine with a set of trained machine learning models. Using a single sensor, the system was able to accurately visualize three states of the machine’s operation in real-time. The system was also able to detect a variance in the material being granulated. The research demonstrates how non-IoT manufacturing systems can be equipped with edge-based artificial intelligence to establish a remote machine condition monitoring system.

Keywords: IoT, cyber-physical systems, artificial intelligence, manufacturing, vibration analytics, continuous machine condition monitoring

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5527 Personal and Social Factors as Barriers to Leisure Walking in Residential Neighborhoods

Authors: Zeinab Aliyas, Diba Mahboubi

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Leisure walking is known as one of the most common types of physical activity that perform in purpose of recreation or health, which in turn may affect resident’s health. In the recent years, promoting leisure walking activity in neighborhood areas become as one of the important issues regarding promoting mental and physical health, however; the level of physical inactivity is rising in many societies including Iran. As it was proven that the tendency to walk out of choice is not encouraging among Iranian people. Hence; understanding the main concern of residents regarding walking activity in their neighborhoods can help in increasing the tendency to do leisure activity among residents. Built environment, social and individual factors are known as the main factors that affect decision to walk, in this regard, the study aimed to investigate the influence of personal and social factors that prevent residents to walk for recreation or exercise in their neighborhoods. Hence the fear of crime and personal barriers were examined in the current research as social and personal factors respectively. To collect the required data, 500 questionnaires by using systematic sampling were distributed from March to May 2016 in four residential neighborhoods of Bandar Abbas in Iran out which 411 questionnaire turned out to be qualified to be used in the study. The Smart-PLS was used to analyze the data. The findings of the study revealed that personal and fear of crime both have significant influence on the level of recreation and exercise walking in the neighborhood areas. The study found that fear of crime has the higher influence on exercise and recreational walking behavior in comparison to individual factors. It was revealed that social factors such as fear of crime in the neighborhoods might be more important than the personal reason for walking optionally in the surrounding environment. The finding of this study can help urban and health researcher to know the significant influence of fear of crime and individual attitudes on the level of leisure walking activity, in addition, the findings of the study suggest that urban planners and designers, as well as public health promoters, need to highly consider the contribution of neighborhoods' social environment variables as well as individual variables to promote walking behavior changes among adult population.

Keywords: exercise walking, fear of crime, neighborhood, personal barriers, recreation walking

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5526 Discover a New Technique for Cancer Recognition by Analysis and Determination of Fractal Dimension Images in Matlab Software

Authors: Saeedeh Shahbazkhany

Abstract:

Cancer is a terrible disease that, if not diagnosed early, therapy can be difficult while it is easily medicable if it is diagnosed in early stages. So it is very important for cancer diagnosis that medical procedures are performed. In this paper we introduce a new method. In this method, we only need pictures of healthy cells and cancer cells. In fact, where we suspect cancer, we take a picture of cells or tissue in that area, and then take some pictures of the surrounding tissues. Then, fractal dimension of images are calculated and compared. Cancer can be easily detected by comparing the fractal dimension of images. In this method, we use Matlab software.

Keywords: Matlab software, fractal dimension, cancer, surrounding tissues, cells or tissue, new method

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5525 Determination of the Walkability Comfort for Urban Green Space Using Geographical Information System

Authors: Muge Unal, Cengiz Uslu, Mehmet Faruk Altunkasa

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Walkability relates to the ability of the places to connect people with varied destinations within a reasonable amount of time and effort, and to offer visual interest in journeys throughout the network. So, the good quality of the physical environment and arrangement of walkway and sidewalk appear to be more crucial in influencing the pedestrian route choice. Also, proximity, connectivity, and accessibility are significant factor for walkability in terms of an equal opportunity for using public spaces. As a result, there are two important points for walkability. Firstly, the place should have a well-planned street network for accessible and secondly facilitate the pedestrian need for comfort. In this respect, this study aims to examine the both physical and bioclimatic comfort levels of the current condition of pedestrian route with reference to design criteria of a street to access the urban green spaces. These aspects have been identified as the main indicators for walkable streets such as continuity, materials, slope, bioclimatic condition, walkway width, greenery, and surface. Additionally, the aim was to identify the factors that need to be considered in future guidelines and policies for planning and design in urban spaces especially streets. Adana city was chosen as a study area. Adana is a province of Turkey located in south-central Anatolia. This study workflow can be summarized in four stages: (1) environmental and physical data were collected by referred to literature and used in a weighted criteria method to determine the importance level of these data , (2) environmental characteristics of pedestrian routes gained from survey studies are evaluated to hierarchies these criteria of the collected information, (3) and then each pedestrian routes will have a score that provides comfortable access to the park, (4) finally, the comfortable routes to park will be mapped using GIS. It is hoped that this study will provide an insight into future development planning and design to create a friendly and more comfort street environment for the users.

Keywords: comfort level, geographical information system (GIS), walkability, weighted criteria method

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5524 The Validation of RadCalc for Clinical Use: An Independent Monitor Unit Verification Software

Authors: Junior Akunzi

Abstract:

In the matter of patient treatment planning quality assurance in 3D conformational therapy (3D-CRT) and volumetric arc therapy (VMAT or RapidArc), the independent monitor unit verification calculation (MUVC) is an indispensable part of the process. Concerning 3D-CRT treatment planning, the MUVC can be performed manually applying the standard ESTRO formalism. However, due to the complex shape and the amount of beams in advanced treatment planning technic such as RapidArc, the manual independent MUVC is inadequate. Therefore, commercially available software such as RadCalc can be used to perform the MUVC in complex treatment planning been. Indeed, RadCalc (version 6.3 LifeLine Inc.) uses a simplified Clarkson algorithm to compute the dose contribution for individual RapidArc fields to the isocenter. The purpose of this project is the validation of RadCalc in 3D-CRT and RapidArc for treatment planning dosimetry quality assurance at Antoine Lacassagne center (Nice, France). Firstly, the interfaces between RadCalc and our treatment planning systems (TPS) Isogray (version 4.2) and Eclipse (version13.6) were checked for data transfer accuracy. Secondly, we created test plans in both Isogray and Eclipse featuring open fields, wedges fields, and irregular MLC fields. These test plans were transferred from TPSs according to the radiotherapy protocol of DICOM RT to RadCalc and the linac via Mosaiq (version 2.5). Measurements were performed in water phantom using a PTW cylindrical semiflex ionisation chamber (0.3 cm³, 31010) and compared with the TPSs and RadCalc calculation. Finally, 30 3D-CRT plans and 40 RapidArc plans created with patients CT scan were recalculated using the CT scan of a solid PMMA water equivalent phantom for 3D-CRT and the Octavius II phantom (PTW) CT scan for RapidArc. Next, we measure the doses delivered into these phantoms for each plan with a 0.3 cm³ PTW 31010 cylindrical semiflex ionisation chamber (3D-CRT) and 0.015 cm³ PTW PinPoint ionisation chamber (Rapidarc). For our test plans, good agreements were found between calculation (RadCalc and TPSs) and measurement (mean: 1.3%; standard deviation: ± 0.8%). Regarding the patient plans, the measured doses were compared to the calculation in RadCalc and in our TPSs. Moreover, RadCalc calculations were compared to Isogray and Eclispse ones. Agreements better than (2.8%; ± 1.2%) were found between RadCalc and TPSs. As for the comparison between calculation and measurement the agreement for all of our plans was better than (2.3%; ± 1.1%). The independent MU verification calculation software RadCal has been validated for clinical use and for both 3D-CRT and RapidArc techniques. The perspective of this project includes the validation of RadCal for the Tomotherapy machine installed at centre Antoine Lacassagne.

Keywords: 3D conformational radiotherapy, intensity modulated radiotherapy, monitor unit calculation, dosimetry quality assurance

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5523 Preparation and Quality Control of a Novel Radiolabeled Complex of 166ho for the Treatment of Somatostatin Receptor Expressing Tumours

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

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

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

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5522 Application of 3D Apparel CAD for Costume Reproduction

Authors: Zi Y. Kang, Tracy D. Cassidy, Tom Cassidy

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3D apparel CAD is one of the remarkable products in advanced technology which enables intuitive design, visualisation and evaluation of garments through stereoscopic drape simulation. The progressive improvements of 3D apparel CAD have led to the creation of more realistic clothing simulation which is used not only in design development but also in presentation, promotion and communication for fashion as well as other industries such as film, game and social network services. As a result, 3D clothing technology is becoming more ubiquitous in human culture and lives today. This study considers that such phenomenon implies that the technology has reached maturity and it is time to inspect the status of current technology and to explore its potential uses in ways to create cultural values to further move forward. For this reason, this study aims to generate virtual costumes as culturally significant objects using 3D apparel CAD and to assess its capability, applicability and attitudes of the audience towards clothing simulation through comparison with physical counterparts. Since the access to costume collection is often limited due to the conservative issues, the technology may make valuable contribution by democratization of culture and knowledge for museums and its audience. This study is expected to provide foundation knowledge for development of clothing technology and for expanding its boundary of practical uses. To prevent any potential damage, two replicas of the costumes in the 1860s and 1920s at the Museum of London were chosen as samples. Their structural, visual and physical characteristics were measured and collected using patterns, scanned images of fabrics and objective fabric measurements with scale, KES-F (Kawabata Evaluation System of Fabrics) and Titan. Commercial software, DC Suite 5.0 was utilised to create virtual costumes applying collected data and the following outcomes were produced for the evaluation: Images of virtual costumes and video clips showing static and dynamic simulation. Focus groups were arranged with fashion design students and the public for evaluation which exposed the outcomes together with physical samples, fabrics swatches and photographs. The similarities, application and acceptance of virtual costumes were estimated through discussion and a questionnaire. The findings show that the technology has the capability to produce realistic or plausible simulation but expression of some factors such as details and capability of light material requires improvements. While the use of virtual costumes was viewed as more interesting and futuristic replacements to physical objects by the public group, the fashion student group noted more differences in detail and preferred physical garments highlighting the absence of tangibility. However, the advantages and potential of virtual costumes as effective and useful visual references for educational and exhibitory purposes were underlined by both groups. Although 3D apparel CAD has sufficient capacity to assist garment design process, it has limits in identical replication and more study on accurate reproduction of details and drape is needed for its technical improvements. Nevertheless, the virtual costumes in this study demonstrated the possibility of the technology to contribute to cultural and knowledgeable value creation through its applicability and as an interesting way to offer 3D visual information.

Keywords: digital clothing technology, garment simulation, 3D Apparel CAD, virtual costume

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5521 The Current Home Hemodialysis Practices and Patients’ Safety Related Factors: A Case Study from Germany

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

Abstract:

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

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

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5520 Advanced Palliative Aquatics Care Multi-Device AuBento for Symptom and Pain Management by Sensorial Integration and Electromagnetic Fields: A Preliminary Design Study

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

Abstract:

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

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

Procedia PDF Downloads 114
5519 Permeable Reactive Pavement for Controlling the Transport of Benzene, Toluene, Ethyl-Benzene, and Xylene (BTEX) Contaminants

Authors: Shengyi Huang, Chenju Liang

Abstract:

Volatile organic compounds such as benzene, toluene, ethyl-benzene, and xylene (BTEX) are common contaminants in environment, which could come from asphalt concrete or exhaust emissions of vehicles. The BTEX may invade to the subsurface environment via wet and dry atmospheric depositions. If there aren’t available ways for controlling contaminants’ fate and transport, they would extensively harm natural environment. In the 1st phase of this study, various adsorbents were screened for a suitable one to be an additive in the porous asphalt mixture. In the 2nd phase, addition of the selected adsorbent was incorporated with the design of porous asphalt concrete (PAC) to produce the permeable reactive pavement (PRP), which was subsequently tested for the potential of adsorbing aqueous BTEX as compared to the PAC, in the 3rd phase. The PRP was prepared according to the following steps: firstly, the suitable adsorbent was chosen based on the analytical results of specific surface area analysis, thermal-gravimetric analysis, adsorption kinetics and isotherms, and thermal dynamics analysis; secondly, the materials of coarse aggregate, fine aggregate, filler, asphalt, and fiber were tested in order to meet regulated specifications (e.g., water adsorption, soundness, viscosity etc.) for preparing the PRP; thirdly, the amount of adsorbent additive was determined in the PRP; fourthly, the prepared PAC and PRP were examined for their physical properties (e.g., abrasion loss, drain-down loss, Marshall stability, Marshall flow, dynamic stability etc.). As a result of comparison between PRP and PAC, the PRP showed better physical performance than the traditional PAC. At last, the Marshall Specimen column tests were conducted to explore the adsorption capacities of PAC and PRPs. The BTEX adsorption capacities of PRPs are higher than those obtained from traditional PAC. In summary, PRPs showed superior physical performance and adsorption capacities, which exhibit the potential of PRP to be applied as a replacement of PAC for better controlling the transport of non-point source pollutants.

Keywords: porous asphalt concrete, volatile organic compounds, permeable reactive pavement, non-point source pollution

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5518 When Talk Is the Cure for the Morning After: Talking Therapy in Conor Mcpherson’s Dublin Carol and Shining City

Authors: Maha Hamoud Alatawi

Abstract:

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

Keywords: Conor McPherson, drama, psychotherapy, storytelling

Procedia PDF Downloads 295
5517 Effects of Length of Time of Fasting upon Subjective and Objective Variables When Controlling Sleep, Food and Fluid Intakes

Authors: H. Alabed, K. Abuzayan. L. Fgie, K. Zarug

Abstract:

Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset; physiological considerations predict that poorer mood, physical performance and mental performance will result. In addition, any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length, and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, dehydration and responses to a short bout of exercise) - but with an unchanged amount of nocturnal sleep, controlled supper the previous evening, controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, though some effect of sleep loss, particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

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5516 Domestic Violence against Rural Women in Haryana State of India

Authors: Jatesh Kathpalia, Subhash Chander

Abstract:

Violence against women has spread into a global epidemic. This has debilitating effect over the performance of women. Due to deep-rooted values, traditional Indian culture women fear the consequences of reporting violence and declare an unwillingness to subject themselves to the shame of being identified as battered women. Main interest was to study types of domestic violence which women face and to encourage them to report the matter. The study involved understanding the nature, extent and types of domestic violence. Two hundred rural women respondents were selected at random, interview schedule was prepared, and victims afflicted with domestic violence were identified. Data were collected and analyzed for different forms of domestic violence faced by women. 60% of the respondents faced domestic violence in different forms. Out of 120 women who were affected, 92.5% faced emotional, 90.8% faced verbal, 49.1% faced economic and 58.3% faced physical violence. 45.0% faced violence within three months of the marriage. Out of these, only 6.6% reported the violence to the police. Frequently faced forms of violence were slapping (27.1%), beating (24.3%) and starvation (25.7%). Number of women who were not allowed to spend money of their own stood at 30.5%. About 50% victims of emotional violence were facing constant criticism by their in-laws. Significant association was found between age, education and socio-economic status of the respondents and domestic violence. Rural women in Haryana face grave problem of domestic violence which need to be curbed for improving condition of women in society.

Keywords: domestic violence against women, economic, emotional, physical and verbal violence, marriage, rural women

Procedia PDF Downloads 378
5515 The Effect of Internal Electrical Ion Mobility on Molten Salts through Atomistic Simulations

Authors: Carlos F. Sanz-Navarro, Sonia Fereres

Abstract:

Binary and ternary mixtures of molten salts are excellent thermal energy storage systems and have been widely used in commercial tanks both in nuclear and solar thermal applications. However, the energy density of the commercially used mixtures is still insufficient, and therefore, new systems based on latent heat storage (or phase change materials, PCM) are currently being investigated. In order to shed some light on the macroscopic physical properties of the molten salt phases, knowledge of the microscopic structure and dynamics is required. Several molecular dynamics (MD) simulations have been performed to model the thermal behavior of (Li,K)2CO3 mixtures. Up to this date, this particular molten salt mixture has not been extensively studied but it is of fundamental interest for understanding the behavior of other commercial salts. Molten salt diffusivities, the internal electrical ion mobility, and the physical properties of the solid-liquid phase transition have been calculated and compared to available data from literature. The effect of anion polarization and the application of a strong external electric field have also been investigated. The influence of electrical ion mobility on local composition is explained through the Chemla effect, well known in electrochemistry. These results open a new way to design optimal high temperature energy storage materials.

Keywords: atomistic simulations, thermal storage, latent heat, molten salt, ion mobility

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5514 Assessment of Water Quality Used for Irrigation: Case Study of Josepdam Irrigation Scheme

Authors: M. A. Adejumobi, J. O. Ojediran

Abstract:

The aim of irrigation is to recharge the available water in the soil. Quality of irrigation water is essential for the yield and quality of crops produced, maintenance of soil productivity and protection of the environment. The analysis of irrigation water arises as a need to know the impact of irrigation water on the yield of crops, the effect, and the necessary control measures to rectify the effect of this for optimum production and yield of crops. This study was conducted to assess the quality of irrigation water with its performance on crop planted, in Josepdam irrigation scheme Bacita, Nigeria. Field visits were undertaken to identify and locate water supply sources and collect water samples from these sources; X1 Drain, Oshin, River Niger loop and Ndafa. Laboratory experiments were then undertaken to determine the quality of raw water from these sources. The analysis was carried for various parameters namely; physical and chemical analyses after water samples have been taken from four sources. The samples were tested in laboratory. Results showed that the raw water sources shows no salinity tendencies with SAR values less than 1me/l and Ecvaules at Zero while the pH were within the recommended range by FAO, there are increase in potassium and sulphate content contamination in three of the location. From this, it is recommended that there should be proper monitoring of the scheme by conducting analysis of water and soil in the environment, preferable test should be carried out at least one year to cover the impact of seasonal variations and to determine the physical and chemical analysis of the water used for irrigation at the scheme.

Keywords: irrigation, salinity, raw water quality, scheme

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5513 Toxicological Analysis of Some Plant Combinations Used for the Treatment of Hypertension by Lay People in Northern Kwazulu-Natal, South Africa

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

Abstract:

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

Keywords: dosage, hypertension, plant combinations, toxicity

Procedia PDF Downloads 333
5512 The Quantitative Analysis of Tourism Carrying Capacity with the Approach of Sustainable Development Case Study: Siahsard Fountain

Authors: Masoumeh Tadayoni, Saeed Kamyabi, Alireza Entezari

Abstract:

Background and goal of the research: In planning and management system, the tourism carrying capacity is used as a holistic approach and supportive instrument. Evaluating the carrying capacity is used in quantitative the resource exploitation in line with sustainable development and as a foundation for identifying the changes in natural ecosystem and for the final evaluation and monitoring the tensions and decays in regressed ecosystem. Therefore, the present research tries to determine the carrying capacity of effective, physical and real range of Siahsard tourism region. Method: In the present research, the quantitative analysis of tourism carrying capacity is studied by used of effective or permissible carrying capacity (EPCC), real carrying capacity (PCC) and physical carrying capacity (RCC) in Siahsard fountain. It is analyzed based on the field survey and various resources were used for collecting information. Findings: The results of the analysis shows that, 3700 people use the Siahsard tourism region every day and 1350500 people use it annually. However, the evaluation of carrying capacity can be annually 1390650 people in this place. It can be an important tourism place along with other places in the region. Results: Siahsard’s tourism region has a little way to reach to its carrying capacity that needs to be analyzed. However, based on the results, some suggestions were offered for sustainable development of this region and as the most logical alternations for tourism management.

Keywords: carrying capacity, evaluation, Siahsard, tourism

Procedia PDF Downloads 253
5511 The Influence of Nutritional and Immunological Status on the Prognosis of Head and Neck Cancer

Authors: Ching-Yi Yiu, Hui-Chen Hsu

Abstract:

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

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

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5510 Perfect Prey: Coercive Control and Subjugation, A Foundation for Dismissing the Truth

Authors: Christine Marie Cocchiola

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This study assesses the relationship between coercive control and subjugation. Coercive control is the foundation of most domestic violence and a serious public health problem, having significant legal and social justice ramifications. Beyond the physical, it oftentimes is preceded by or motivated by a need for control. Subjugation, as a personality trait and a maladaptive schema, leads individuals to minimize their own needs or wants and, thereby, often to a loss of autonomy, a dismissal of what one might know to be true. This includes a dismissal of the trademarks of an abusive relationship. Subjugation may contribute to a person engaging in or remaining in a coercively controlling relationship. One hundred fifty-four female survivors of domestic violence participated in this study, assessing their own level of subjugation. Participants were limited to individuals who experienced non-physical abuse in their relationships. Subjugation was attributed as a “concern” or greater in 137 of the 154 participants. 11 participants were interviewed to determine their personal experiences in this abusive relationship. Common themes emerged from interviews, including that the participants worked diligently to fix these abusive relationships by regulating their own behaviors and attempting to please the offender. The results indicate a continued need for advocacy and support of this vulnerable population. Further education is indicated for mental health professionals and for individuals in or having left an abusive relationship on how to identify signs of subjugation, thereby empowering individuals to avoid future experiences of abuse.

Keywords: coercive control, intimate partner violence, subjugation, schemas, gender oppression, autonomy, gaslighting

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5509 Bulbar Conjunctival Kaposi's Sarcoma Unmasked by Immune Reconstitution Syndrome

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

Abstract:

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

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

Procedia PDF Downloads 321