Search results for: clinical deterioration prediction
4245 Signal Processing of the Blood Pressure and Characterization
Authors: Hadj Abd El Kader Benghenia, Fethi Bereksi Reguig
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In clinical medicine, blood pressure, raised blood hemodynamic monitoring is rich pathophysiological information of cardiovascular system, of course described through factors such as: blood volume, arterial compliance and peripheral resistance. In this work, we are interested in analyzing these signals to propose a detection algorithm to delineate the different sequences and especially systolic blood pressure (SBP), diastolic blood pressure (DBP), and the wave and dicrotic to do their analysis in order to extract the cardiovascular parameters.Keywords: blood pressure, SBP, DBP, detection algorithm
Procedia PDF Downloads 4394244 Gender Identify and Agency of Traumatized Subjects in Incestuous Family
Authors: Jenyu Peng
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Incestuous abuse can be considered a form of domestic violence that exemplifies gender inequality. It challenges the common image of home as “haven of safety”. In Taiwan, even after years of feminist NGOs’ effort to encourage victims to speak up, the shared cultural representations of family, still praising piety towards the parents, seem to keep the incest trauma in secret. As clinical practitioners have observed, most devastating psychological sequels of incest trauma are often related to silencing. Thus one can expect that in families centered cultures, the difficulties for victims to disclose are greater, and the traumatic consequences more severe. This poses crucial therapeutic issues for clinicians working in those cultures. Since 2009, the author, a trained psychoanalyst and researcher, has been conducting “clinical fieldwork” on incest trauma in Taiwan. Employing ethnographical method, our theoretical references are both psychoanalytical and anthropological. The necessity of interdisciplinary efforts in incest trauma research will be addressed and discussed. The analyses of the present paper will focus on five incestuous families: four Han families, and one aboriginal. Although Taiwanese aboriginal peoples have been pretty much sinicized since decades, it is worth observing the convergent and divergent aspects in these two cultures. Moreover, findings of a previous research conducted in France during 2002-2004 will serve as background for the purpose of comparison. The results will be presented along with three questions: 1) How the perception of family influences the process of disclosure? 2) How the incestuous experience comes into play with victims’ gender identity and sexuality, pivotal for the subjectification? 3) How victims more successful in gendered subjectification modify their dynamics with their traumatizing family? This research finds that most victims tend to defend their own incestuous families, and that victims’ subjectivity and agency are actually entangled in the power structure of incestuous family.Keywords: incestuous family, subjectification, gender identity, agency
Procedia PDF Downloads 3524243 Case Report and Literature Review of Opalski Syndrome: A Rare Brainstem Stroke
Authors: Ramuel Spirituel Mattathiah A. San Juan, Neil Ambasing
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Background: In lateral medullary strokes, hemiparesis doesn't typically manifest due to the distinct vascular supply to the corticospinal tract located within the medulla's tegmentum. Hemiparesis resulting from a medullary infarct would likely be attributable to a medial medullary stroke characterized by contralateral hemiparesis since the corticospinal tract fibers at this level have yet to cross over. This paper reports a unique case of a lateral medullary stroke variant that presented with ipsilateral hemiparesis. Objective: There have only been 23 other cases of reported Opalski syndrome, making this only the 24th and 25th case reported worldwide. Case Presentation: A 53-year-old male was admitted with slurring of speech with gait instability, numbness on the right face, Horner’s syndrome, and 4/5 motor strength on the right extremities. Hyperreflexia was noted on the right, together with a Babinski’s sign. Cranial magnetic resonance imaging (MRI) showed an infarct on the right dorsolateral medulla. A 48-year-old male was admitted complaining of dizziness, ataxic gait, veering to the left during ambulation, left facial numbness, left hemiplegia, crossed sensory disturbance, and right limb ataxia. MRI revealed an acute left lateral medullary infarction. Conclusion: A rare type of lateral medullary infarction, the Opalski Syndrome, is a weakness ipsilateral to the lesion of the infarct. The lesion involves the ipsilateral corticospinal tract below the pyramidal decussation. The considerable diversity in the posterior brain circulation serves as a contributing factor to the clinical observation of incomplete textbook syndromes, underscoring the significance of the neurological clinical approach and a solid foundation in neuroanatomy.Keywords: Opalski syndrome, rare stroke, stroke, Wallenberg's syndrome
Procedia PDF Downloads 764242 Empathy in the Work of Physiotherapists in Slovakia
Authors: Vladimir Littva, Peter Kutis
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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.Keywords: empathy, approach, clinical practice, physiotherapists
Procedia PDF Downloads 1864241 Use of Polymeric Materials in the Architectural Preservation
Authors: F. Z. Benabid, F. Zouai, A. Douibi, D. Benachour
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These Fluorinated polymers and polyacrylics have known a wide use in the field of historical monuments. PVDF provides a great easiness to processing, a good UV resistance and good chemical inertia. Although the quality of physical characteristics of the PMMA and its low price with a respect to PVDF, its deterioration against UV radiations limits its use as protector agent for the stones. On the other hand, PVDF/PMMA blend is a compromise of a great development in the field of architectural restoration, since it is the best method in term of quality and price to make new polymeric materials having enhanced properties. Films of different compositions based on the two polymers within an adequate solvent (DMF) were obtained to perform an exposition to artificial ageing and to the salted fog, a spectroscopic analysis (FTIR and UV) and optical analysis (refractive index). Based on its great interest in the field of building, a variety of standard tests has been elaborated for the first time at the central laboratory of ENAP (Souk-Ahras) in order to evaluate our blend performance. The obtained results have allowed observing the behavior of the different compositions of the blend under various tests. The addition of PVDF to PMMA enhances the properties of this last to know the exhibition to the natural and artificial ageing and to the saline fog. On the other hand, PMMA enhances the optical properties of the blend. Finally, 70/30 composition of the blend is in concordance with results of previous works and it is the adequate proportion for an eventual application.Keywords: blend, PVDF, PMMA, preservation, historic monuments
Procedia PDF Downloads 3094240 Study of Corrosion Behavior of Experimental Alloys with Different Levels of Cr and High Levels of Mo Compared to Aisi 444
Authors: Ana P. R. N. Barroso, Maurício N. Kleinberg, Frederico R. Silva, Rodrigo F. Guimarães, Marcelo M. V. Parente, Walney S. Araújo
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The fight against accelerated wear of the equipment used in the oil and gas sector is a challenge for minimizing maintenance costs. Corrosion being one of the main agents of equipment deterioration, we seek alternative materials that exhibit improved corrosion resistance at low cost of production. This study aims to evaluate the corrosion behavior of experimental alloys containing 15% and 17% of chromium (Cr) and 5% of molybdenum (Mo) in comparison with an AISI 444 commercial alloy. Microstructural analyzes were performed on samples of the alloys before and after the electrochemical tests. Two samples of each solubilized alloy were also taken for analysis of the corrosion behavior by testing potentiodynamic polarization (PP) and Electrochemical Impedance Spectroscopy (EIS) with immersion time of 24 hours in electrolytic solution with acidic character. The graphics obtained through electrochemical tests of PP and EIS indicated that among the experimental alloys, the alloy with higher chromium content (17%) had a higher corrosion resistance, confirming the beneficial effect of adding chromium. When comparing the experimental alloys with the AISI 444 commercial alloy, it is observed that the AISI 444 commercial alloy showed superior corrosion resistance to that of the experimental alloys for both assays, PP and EIS. The microstructural analyzes performed after the PP and EIS tests confirmed the results previously described. These results suggest that the addition of these levels of molybdenum did not favor the electrochemical behavior of experimental ferritic alloys for the electrolytic medium studied.Keywords: corrosion, molybdenum, electrochemical tests, experimental alloys
Procedia PDF Downloads 5734239 A Compressor Map Optimizing Tool for Prediction of Compressor Off-Design Performance
Authors: Zhongzhi Hu, Jie Shen, Jiqiang Wang
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A high precision aeroengine model is needed when developing the engine control system. Compared with other main components, the axial compressor is the most challenging component to simulate. In this paper, a compressor map optimizing tool based on the introduction of a modifiable β function is developed for FWorks (FADEC Works). Three parameters (d density, f fitting coefficient, k₀ slope of the line β=0) are introduced to the β function to make it modifiable. The comparison of the traditional β function and the modifiable β function is carried out for a certain type of compressor. The interpolation errors show that both methods meet the modeling requirements, while the modifiable β function can predict compressor performance more accurately for some areas of the compressor map where the users are interested in.Keywords: beta function, compressor map, interpolation error, map optimization tool
Procedia PDF Downloads 2674238 Application of Active Chitosan Coating Incorporated with Spirulina Extract as a Potential Food Packaging Material for Enhancing Quality and Shelf Life of Shrimp
Authors: Rafik Balti, Nourhene Zayoud, Mohamed Ben Mansour, Abdellah Arhaliass, Anthony Masse
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Application of edible films and coatings with natural active compounds for enhancing storage stability of food products is a promising active packaging approach. Shrimp are generally known as valuable seafood products around the world because of their delicacy and good nutritional. However, shrimp is highly vulnerable to quality deterioration associated with biochemical, microbiological or physical changes during postmortem storage, which results in the limited shelf life of the product. Chitosan is considered as a functional packaging component for maintaining the quality and increasing the shelf life of perishable foods. The present study was conducted to evaluate edible coating of crab chitosan containing variable levels of ethanolic extract of Spirulina on microbiological (mesophilic aerobic, psychrotrophic, lactic acid bacteria, and enterobacteriacea), chemical (pH, TVB-N, TMA-N, PV, TBARS) and sensory (odor, color, texture, taste, and overall acceptance) properties of shrimp during refrigerated storage. Also, textural and color characteristics of coated shrimp were performed. According to the obtained results, crab chitosan in combination with Spirulina extract was very effective in order to extend the shelf life of shrimp during storage in refrigerated condition.Keywords: food packaging, chitosan, spirulina extract, white shrimp, shelf life
Procedia PDF Downloads 2104237 Rt-Pcr Negative COVID-19 Infection in a Bodybuilding Competitor Using Anabolic Steroids: A Case Report
Authors: Mariana Branco, Nahida Sobrino, Cristina Neves, Márcia Santos, Afonso Granja, João Rosa Oliveira, Joana Costa, Luísa Castro Leite
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This case reports a COVID-19 infection in an unvaccinated adult man with no history of COVID-19 and no relevant clinical history besides anabolic steroid use, undergoing weaning with tamoxifen after a bodybuilding competition. The patient presented a 4cm cervical mass 3 weeks after COVID-19 infection in his cohabitants. He was otherwise asymptomatic and tested negative to multiple RT-PCR tests. Nevertheless, the IgG COVID-19 antibody was positive, suggesting the previous infection. This report raises a potential link between anabolic steroid use and atypical COVID-19 onset. Objectives: The goals of this paper are to raise a potential link between anabolic steroid use and atypical COVID-19 onset but also to report an uncommon case of COVID-19 infection with consecutive negative gold standard tests. Methodology: The authors used CARE guidelines for case report writing. Introduction: This case reports a COVID-19 infection case in an unvaccinated adult man, with multiple serial negative reverse transcription polymerase chain reaction (RT-PCR) test results, presenting with single cervical lymphadenopathy. Although the association between COVID-19 and lymphadenopathy is well established, there are no cases with this presentation, and consistently negative RT-PCR tests have been reported. Methodologies: The authors used CARE guidelines for case report writing. Case presentation: This case reports a 28-year-old Caucasian man with no previous history of COVID-19 infection or vaccination and no relevant clinical history besides anabolic steroid use undergoing weaning with tamoxifendue to participation in a bodybuilding competition. He visits his primary care physician because of a large (4 cm) cervical lump, present for 3 days prior to the consultation. There was a positive family history for COVID-19 infection 3 weeks prior to the visit, during which the patient cohabited with the infected family members. The patient never had any previous clinical manifestation of COVID-19 infection and, despite multiple consecutive RT-PCR testing, never tested positive. The patient was treated with an NSAID and a broad-spectrum antibiotic, with little to no effect. Imagiological testing was performed via a cervical ultrasound, followed by a needle biopsy for histologic analysis. Serologic testing for COVID-19 immunity was conducted, revealing a positive Anti-SARS-CoV-2 IgG (Spike S1) antibody, suggesting the previous infection, given the unvaccinated status of our patient Conclusion: In patients with a positive epidemiologic context and cervical lymphadenopathy, physicians should still consider COVID-19 infection as a differential diagnosis, despite negative PCR testing. This case also raises a potential link between anabolic steroid use and atypical COVID-19 onset, never before reported in scientific literature.Keywords: COVID-19, cervical lymphadenopathy, anabolic steroids, primary care
Procedia PDF Downloads 1164236 Partial Triphallia: The First Case Report of External and Internal Penile Triplication in a Cadaver
Authors: Madeleine Gadd, Rose How, Edward Mathews, John Buchanan, Vicky Cottrell, Andre Coetzee, Karuna Katti
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Introduction: Triphallia, a congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report describes the serendipitous discovery of the first reported human case of partial orthotopic triphallia during cadaveric dissection. Case Summary: Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old male revealed a remarkable anatomical variation: two small supernumerary penises situated in a transverse orientation postero inferiorly to the primary penis. The main and the larger supernumerary penile shafts displayed their own corpora cavernosa and glans penis, sharing a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. The smallest of the supernumerary penises was similar in dimension to the secondary penis, at 3.7cm long and 1.2cm wide (compared to the secondary penis at 3.8cm long and 1.3cm wide). However, it lacked a urethra and a typical arrangement of the corpora cavernosa and spongiosum, making this a case of partial triphallia rather than true triphallia. Conclusion: This case report provides a comprehensive anatomical description of partial triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. This case report underscores the importance of meticulous anatomical dissections, particularly since, without dissection, this anatomical variation would have remained undiscovered. Although we can only speculate the functional implications of this condition, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management, should the condition be encountered in living individuals.Keywords: triphallia, diphallia, congenital abnormalities, genitourinary abnormalities, urology
Procedia PDF Downloads 684235 A Computational Model of the Thermal Grill Illusion: Simulating the Perceived Pain Using Neuronal Activity in Pain-Sensitive Nerve Fibers
Authors: Subhankar Karmakar, Madhan Kumar Vasudevan, Manivannan Muniyandi
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Thermal Grill Illusion (TGI) elicits a strong and often painful sensation of burn when interlacing warm and cold stimuli that are individually non-painful, excites thermoreceptors beneath the skin. Among several theories of TGI, the “disinhibition” theory is the most widely accepted in the literature. According to this theory, TGI is the result of the disinhibition or unmasking of the pain-sensitive HPC (Heat-Pinch-Cold) nerve fibers due to the inhibition of cold-sensitive nerve fibers that are responsible for masking HPC nerve fibers. Although researchers focused on understanding TGI throughexperiments and models, none of them investigated the prediction of TGI pain intensity through a computational model. Furthermore, the comparison of psychophysically perceived TGI intensity with neurophysiological models has not yet been studied. The prediction of pain intensity through a computational model of TGI can help inoptimizing thermal displays and understanding pathological conditions related to temperature perception. The current studyfocuses on developing a computational model to predict the intensity of TGI pain and experimentally observe the perceived TGI pain. The computational model is developed based on the disinhibition theory and by utilizing the existing popular models of warm and cold receptors in the skin. The model aims to predict the neuronal activity of the HPC nerve fibers. With a temperature-controlled thermal grill setup, fifteen participants (ten males and five females) were presented with five temperature differences between warm and cold grills (each repeated three times). All the participants rated the perceived TGI pain sensation on a scale of one to ten. For the range of temperature differences, the experimentally observed perceived intensity of TGI is compared with the neuronal activity of pain-sensitive HPC nerve fibers. The simulation results show a monotonically increasing relationship between the temperature differences and the neuronal activity of the HPC nerve fibers. Moreover, a similar monotonically increasing relationship is experimentally observed between temperature differences and the perceived TGI intensity. This shows the potential comparison of TGI pain intensity observed through the experimental study with the neuronal activity predicted through the model. The proposed model intends to bridge the theoretical understanding of the TGI and the experimental results obtained through psychophysics. Further studies in pain perception are needed to develop a more accurate version of the current model.Keywords: thermal grill Illusion, computational modelling, simulation, psychophysics, haptics
Procedia PDF Downloads 1714234 Tuberculosis (TB) and Lung Cancer
Authors: Asghar Arif
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Lung cancer has been recognized as one of the greatest common cancers, causing the annual mortality rate of about 1.2 million people in the world. Lung cancer is the most prevalent cancer in men and the third-most common cancer among women (after breast and digestive cancers).Recent evidences have shown the inflammatory process as one of the potential factors of cancer. Tuberculosis (TB), pneumonia, and chronic bronchitis are among the most important inflammation-inducing factors in the lungs, among which TB has a more profound role in the emergence of cancer.TB is one of the important mortality factors throughout the world, and 205,000 death cases are reported annually due to this disease. Chronic inflammation and fibrosis due to TB can induce genetic mutation and alternations. Parenchyma tissue of lung is involved in both diseases of TB and lung cancer, and continuous cough in lung cancer, morphological vascular variations, lymphocytosis processes, and generation of immune system mediators such as interleukins, are all among the factors leading to the hypothesis regarding the role of TB in lung cancer Some reports have shown that the induction of necrosis and apoptosis or TB reactivation, especially in patients with immune-deficiency, may result in increasing IL-17 and TNF_α, which will either decrease P53 activity or increase the expression of Bcl-2, decrease Bax-T, and cause the inhibition of caspase-3 expression due to decreasing the expression of mitochondria cytochrome oxidase. It has been also indicated that following the injection of BCG vaccine, the host immune system will be reinforced, and in particular, the rates of gamma interferon, nitric oxide, and interleukin-2 are increased. Therefore, CD4 + lymphocyte function will be improved, and the person will be immune against cancer.Numerous prospective studies have so far been conducted on the role of TB in lung cancer, and it seems that this disease is effective in that particular cancer.One of the main challenges of lung cancer is its correct and timely diagnosis. Unfortunately, clinical symptoms (such as continuous cough, hemoptysis, weight loss, fever, chest pain, dyspnea, and loss of appetite) and radiological images are similar in TB and lung cancer. Therefore, anti-TB drugs are routinely prescribed for the patients in the countries with high prevalence of TB, like Pakistan. Regarding the similarity in clinical symptoms and radiological findings of lung cancer, proper diagnosis is necessary for TB and respiratory infections due to nontuberculousmycobacteria (NTM). Some of the drug resistive TB cases are, in fact, lung cancer or NTM lung infections. Acid-fast staining and histological study of phlegm and bronchial washing, culturing and polymerase chain reaction TB are among the most important solutions for differential diagnosis of these diseases. Briefly, it is assumed that TB is one of the risk factors for cancer. Numerous studies have been conducted in this regard throughout the world, and it has been observed that there is a significant relationship between previous TB infection and lung cancer. However, to prove this hypothesis, further and more extensive studies are required. In addition, as the clinical symptoms and radiological findings of TB, lung cancer, and non-TB mycobacteria lung infections are similar, they can be misdiagnosed as TB.Keywords: TB and lung cancer, TB people, TB servivers, TB and HIV aids
Procedia PDF Downloads 734233 Comparison of Two Transcranial Magnetic Stimulation Protocols on Spasticity in Multiple Sclerosis - Pilot Study of a Randomized and Blind Cross-over Clinical Trial
Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa
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Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation
Procedia PDF Downloads 894232 A New Perspective in Cervical Dystonia: Neurocognitive Impairment
Authors: Yesim Sucullu Karadag, Pinar Kurt, Sule Bilen, Nese Subutay Oztekin, Fikri Ak
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Background: Primary cervical dystonia is thought to be a purely motor disorder. But recent studies revealed that patients with dystonia had additional non-motor features. Sensory and psychiatric disturbances could be included into the non-motor spectrum of dystonia. The Basal Ganglia receive inputs from all cortical areas and throughout the thalamus project to several cortical areas, thus participating to circuits that have been linked to motor as well as sensory, emotional and cognitive functions. However, there are limited studies indicating cognitive impairment in patients with cervical dystonia. More evidence is required regarding neurocognitive functioning in these patients. Objective: This study is aimed to investigate neurocognitive profile of cervical dystonia patients in comparison to healthy controls (HC) by employing a detailed set of neuropsychological tests in addition to self-reported instruments. Methods: Totally 29 (M/F: 7/22) cervical dystonia patients and 30 HC (M/F: 10/20) were included into the study. Exclusion criteria were depression and not given informed consent. Standard demographic, educational data and clinical reports (disease duration, disability index) were recorded for all patients. After a careful neurological evaluation, all subjects were given a comprehensive battery of neuropsychological tests: Self report of neuropsychological condition (by visual analogue scale-VAS, 0-100), RAVLT, STROOP, PASAT, TMT, SDMT, JLOT, DST, COWAT, ACTT, and FST. Patients and HC were compared regarding demographic, clinical features and neurocognitive tests. Also correlation between disease duration, disability index and self report -VAS were assessed. Results: There was no difference between patients and HCs regarding socio-demographic variables such as age, gender and years of education (p levels were 0.36, 0.436, 0.869; respectively). All of the patients were assessed at the peak of botulinum toxine effect and they were not taking an anticholinergic agent or benzodiazepine. Dystonia patients had significantly impaired verbal learning and memory (RAVLT, p<0.001), divided attention and working memory (ACTT, p<0.001), attention speed (TMT-A and B, p=0.008, 0.050), executive functions (PASAT, p<0.001; SDMT, p= 0.001; FST, p<0.001), verbal attention (DST, p=0.001), verbal fluency (COWAT, p<0.001), visio-spatial processing (JLOT, p<0.001) in comparison to healthy controls. But focused attention (STROOP-spontaneous correction) was not different between two groups (p>0.05). No relationship was found regarding disease duration and disability index with any neurocognitive tests. Conclusions: Our study showed that neurocognitive functions of dystonia patients were worse than control group with the similar age, sex, and education independently clinical expression like disease duration and disability index. This situation may be the result of possible cortical and subcortical changes in dystonia patients. Advanced neuroimaging techniques might be helpful to explain these changes in cervical dystonia patients.Keywords: cervical dystonia, neurocognitive impairment, neuropsychological test, dystonia disability index
Procedia PDF Downloads 4204231 Molecular Detection of Tuberculosis in Dogs in the Three North-Eastern States Assam, Mizoram and Nagaland of India
Authors: A. G. Barua, Uttam Rajkhowa, Pranjal Moni Nath, Nur Abdul Kadir
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Mycobacterium tuberculosis (MTB) is one of the most closely-related intracellular bacterial pathogens, grouped as the M. tuberculosis complex (MTC). MTB, the primary agent of human tuberculosis (TB), can develop clinical TB in animals as 75 percent of canine mycobacterial infection is caused by close contact with an infected human being. In the present study, molecular detection of TB in dogs in three North-eastern states of India, Assam Mizoram, and Nagaland was carried out. So far, there has been a lack of systematic study in these regions, hampered by slow diagnostic methods and poor infrastructure. In an attempt to rectify this situation, molecular epidemiology was carried out for nine months to detect canine TB in a sample of 340 dogs. Isolation of DNA was done with swabs (throat/nasal), nodules of lungs and fluids from 100 suspected dogs and the molecular study were carried out with the help of conventional and real-time PCR. Post-mortem study was also carried out. Our results showed that the prevalence of clinical TB in dogs from a high-risk setting was 1 percent. However, the prevalence of immunological sensitization to M. tuberculosis antigen in dogs living in contact with sputum smeared positive TB cases was almost 50 percent. The latter setting had the maximum impact in terms of TB transmission. During the study period, a survey with a standard questionnaire was carried out in the TB hospitals to study reverse zoonosis. It was observed that an infected human being was one of the major risk factors for dogs to contract the infection. This observation was drawn by examining the probable airborne transmission from humans to their pets or strays. The present study helped to discover the nuances of TB transmission more clearly and systematically as compared to other sporadic tests to detect MTB in canine.Keywords: Assam and Nagaland, canine TB, India, molecular detection, tuberculosis
Procedia PDF Downloads 1444230 COVID-19: The Dark Side of an Unprecedented Social Isolation in the Elderly
Authors: L. Paulino Ferreira, M. Gomes Neto, M. Duarte, S. Serra
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Objectives: COVID-19 pandemic has caused older adults to experience a degree of social isolation and loneliness that is unprecedented. Our aim is to review state of the art regarding the consequences of social isolation due to COVID-19 in elderly people. Methods: The authors conducted a search on Medscape and PubMed with the keywords mentioned below, and the most relevant articles were selected. Results: Social isolation leads many elderlies to experience loneliness, anxiety, depression, alcohol abuse, and feelings of abandonment with a perception of being a burden on society. Thus, social isolation has increased the risk for suicide in older people. It is also noteworthy that the exacerbation of psychiatric disorders (such as depression, anxiety, and post-traumatic stress disorder) without correct treatment and follow-up also increases suicide risk. Loneliness is also associated with accelerated cognitive deterioration and dementia. Besides that, during social isolation, it could be more difficult for older people to get medication as well as proper health care. It is also noticed an increase in the risk of falls, poor nutrition, and lack of exercise. All this contributes to weakening elderlies’ immune systems leading to a higher risk of developing infections, cardiovascular events, and cancer, increasing hospitalization and morbimortality. Conclusion: Social isolation in the elderly has a significant impact on physical and mental health, as well as morbimortality and hospitalizations due to non-COVID causes. Nevertheless, further studies will be needed to assess the real dimension of the effects of social isolation due to COVID-19.Keywords: social isolation, COVID-19, elderly, mental health
Procedia PDF Downloads 944229 Pineapple Waste Valorization through Biogas Production: Effect of Substrate Concentration and Microwave Pretreatment
Authors: Khamdan Cahyari, Pratikno Hidayat
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Indonesia has produced more than 1.8 million ton pineapple fruit in 2013 of which turned into waste due to industrial processing, deterioration and low qualities. It was estimated that this waste accounted for more than 40 percent of harvested fruits. In addition, pineapple leaves were one of biomass waste from pineapple farming land, which contributed even higher percentages. Most of the waste was only dumped into landfill area without proper pretreatment causing severe environmental problem. This research was meant to valorize the pineapple waste for producing renewable energy source of biogas through mesophilic (30℃) anaerobic digestion process. Especially, it was aimed to investigate effect of substrate concentration of pineapple fruit waste i.e. peel, core as well as effect of microwave pretreatment of pineapple leaves waste. The concentration of substrate was set at value 12, 24 and 36 g VS/liter culture whereas 800-Watt microwave pretreatment conducted at 2 and 5 minutes. It was noticed that optimum biogas production obtained at concentration 24 g VS/l with biogas yield 0.649 liter/g VS (45%v CH4) whereas microwave pretreatment at 2 minutes duration performed better compare to 5 minutes due to shorter exposure of microwave heat. This results suggested that valorization of pineapple waste could be carried out through biogas production at the aforementioned process condition. Application of this method is able to both reduce the environmental problem of the waste and produce renewable energy source of biogas to fulfill local energy demand of pineapple farming areas.Keywords: pineapple waste, substrate concentration, microwave pretreatment, biogas, anaerobic digestion
Procedia PDF Downloads 5804228 Neurological Complication of Bariatric Surgery: A Cross-sectional Study from Saudi Arabia
Authors: H. A. Algahtani, A. S. Khan, O. Alzahrani, N. Hussein, M. A. Khan, Loudhi Y. I. Soliman
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Objective: To report on the Saudi experience (developing country) of neurological complications from bariatric surgery. The literature on the subject is reviewed. Method: This is a cross sectional study done in King Abdul Aziz Medical City Jeddah, WR, where we reviewed all charts of the patients who underwent bariatric surgery between January 1st, 2009 to December 31st , 2014. Personal and clinical data including age, sex, BMI, comorbidities, type of procedure, duration of stay in hospital, complications and postoperative follow up were collected. In addition follow up visit and remote complication if present were collected. All patients with neurological complications were reviewed in details including their clinical examination, laboratory and imaging results, treatment and prognosis. This report is essentially descriptive with no statistical analysis performed. Results: Fifteen cases were collected in this study (3%). Axonal polyneuropathy was the most frequent neurological complica¬tion, but cases of Wernicke syndrome, vitamin B12 deficiency, Guillain-Barre syndrome and cupper deficiency were also identified. Fourteen patients (93.3%) had full recovery from the neurological signs and symptoms but unfortunately one patient died. Conclusion: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications. A clear education, guidelines and follow-up program should be planned and practiced. Facts should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.Keywords: bariatric surgery, neurological complications, neuropathy, Wenicke syndrome
Procedia PDF Downloads 3294227 Women Retelling the Iranian Revolution: A Comparative Study of Novelists Maryam Madjidi and Negar Djavadi
Authors: Alessandro Giardino
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The Iranian Revolution has been the object of numberless historical and semi-fictional accounts, often providing a monolithic perspective on the events, due to the westerner positioning of those recounting them. Against this tradition, two contemporary French-Iranian novels "Disoriental" (2016) by Negar Djavadi and "Marx and The Doll" (2017) by Maryam Madjidi have offered readers a female-oriented and interestingly layered representation of the Iranian Revolution, hence addressing the responsibilities and misconceptions of Western countries. Furthermore, these two women writers have shed light on the disenchantment of the Iranian intellectual class vis-à-vis the foundation of the Islamic Republic, by particularly focusing on the deterioration of women’s rights, as well as the repression of political, ethnical, religious and sexual minorities. By a psycholinguistic and semasiological analysis of the two novels by Djavadi and Madjidi, this essay will focus on alternative accounts of the revolution in order to reflect upon the role of intersectional literature to the understanding of history. More specifically, as both women, refugees, and bi-cultural writers, Djavadi and Madjidi unearthed moments and figures of the revolution which had disappeared from the prevalent narrative. In doing so, however, these two writers resorted to entirely opposite styles of writing that, it will be argued, stem from different types of female resistance. In defining these two approaches as a "narrative resistance" and a "photographic resistance," the essay will elucidate the dependence of these writers’ language on generational and psychological factors, but it will also stir a reflection on their different communicative strategies.Keywords: Iranian revolution, French-Iranian, intersectionality, literature, women writers
Procedia PDF Downloads 1584226 Clinical Audit on the Introduction of Apremilast into Ireland
Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane
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Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.Keywords: Apremilast, introduction, Ireland, clinical audit
Procedia PDF Downloads 1494225 Development of Coastal Inundation–Inland and River Flow Interface Module Based on 2D Hydrodynamic Model
Authors: Eun-Taek Sin, Hyun-Ju Jang, Chang Geun Song, Yong-Sik Han
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Due to the climate change, the coastal urban area repeatedly suffers from the loss of property and life by flooding. There are three main causes of inland submergence. First, when heavy rain with high intensity occurs, the water quantity in inland cannot be drained into rivers by increase in impervious surface of the land development and defect of the pump, storm sewer. Second, river inundation occurs then water surface level surpasses the top of levee. Finally, Coastal inundation occurs due to rising sea water. However, previous studies ignored the complex mechanism of flooding, and showed discrepancy and inadequacy due to linear summation of each analysis result. In this study, inland flooding and river inundation were analyzed together by HDM-2D model. Petrov-Galerkin stabilizing method and flux-blocking algorithm were applied to simulate the inland flooding. In addition, sink/source terms with exponentially growth rate attribute were added to the shallow water equations to include the inland flooding analysis module. The applications of developed model gave satisfactory results, and provided accurate prediction in comprehensive flooding analysis. The applications of developed model gave satisfactory results, and provided accurate prediction in comprehensive flooding analysis. To consider the coastal surge, another module was developed by adding seawater to the existing Inland Flooding-River Inundation binding module for comprehensive flooding analysis. Based on the combined modules, the Coastal Inundation – Inland & River Flow Interface was simulated by inputting the flow rate and depth data in artificial flume. Accordingly, it was able to analyze the flood patterns of coastal cities over time. This study is expected to help identify the complex causes of flooding in coastal areas where complex flooding occurs, and assist in analyzing damage to coastal cities. Acknowledgements—This research was supported by a grant ‘Development of the Evaluation Technology for Complex Causes of Inundation Vulnerability and the Response Plans in Coastal Urban Areas for Adaptation to Climate Change’ [MPSS-NH-2015-77] from the Natural Hazard Mitigation Research Group, Ministry of Public Safety and Security of Korea.Keywords: flooding analysis, river inundation, inland flooding, 2D hydrodynamic model
Procedia PDF Downloads 3624224 Polyethylene Terephthalate Plastic Degradation by Fungus Rasamsonia Emersonii
Authors: Naveen Kumar
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Microplastics, tiny plastic particles less than 5 mm in size formed by the disposal and breakdown of industrial and consumer products, have become a primary environmental concern due to their ubiquitous presence and application in the environment and their potential to cause harm to the ecosystem, wildlife and human health. In this, we study the ability of the fungus Rasamsonia emersonii IMI 393752 to degrade the rigid microplastics of Coke bottles. Microplastics were extracted from Coke bottles and incubated with Rasamsonia emersonii in Sabouraud dextrose agar media. Microplastics were pre-sterilized without altering the chemistry of microplastic. Preliminary analysis was performed by observing radial growth assessment of microplastic-containing media enriched with fungi vs. control. The assay confirmed no impedance or change in the fungi's growth pattern and rate by introducing microplastics. The degradation of the microplastics was monitored over time using microscopy and FTIR, and biodegradation/deterioration on the plastic surface was observed. Furthermore, the liquid assay was performed. HPLC and GCMS will be conducted to check the biodegradation and presence of enzyme release by fungi to counteract the presence of microplastics. These findings have important implications for managing plastic waste, as they suggest that fungi such as Rasamsonia emersonii can potentially degrade microplastics safely and effectively. However, further research to optimise the conditions for microplastic degradation by Rasamsonia emersonii and to develop strategies for scaling up the process for industrial applications will be beneficial.Keywords: bioremediation, mycoremediation, plastic degradtion, polyethylene terephthalate
Procedia PDF Downloads 974223 Development of Sustainable Building Environmental Model (SBEM) in Hong Kong
Authors: Kwok W. Mui, Ling T. Wong, F. Xiao, Chin T. Cheung, Ho C. Yu
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This study addresses a concept of the Sustainable Building Environmental Model (SBEM) developed to optimize energy consumption in air conditioning and ventilation (ACV) systems without any deterioration of indoor environmental quality (IEQ). The SBEM incorporates two main components: an adaptive comfort temperature control module (ACT) and a new carbon dioxide demand control module (nDCV). These two modules take an innovative approach to maintain satisfaction of the Indoor Environmental Quality (IEQ) with optimum energy consumption, they provide a rational basis of effective control. A total of 2133 sets of measurement data of indoor air temperature (Ta), relative humidity (Rh) and carbon dioxide concentration (CO2) were conducted in some Hong Kong offices to investigate the potential of integrating the SBEM. A simulation was used to evaluate the dynamic performance of the energy and air conditioning system with the integration of the SBEM in an air-conditioned building. It allows us make a clear picture of the control strategies and performed any pre-tuned of controllers before utilized in real systems. With the integration of SBEM, it was able to save up to 12.3% in simulation and 15% in field measurement of overall electricity consumption, and maintain the average carbon dioxide concentration within 1000ppm and occupant dissatisfaction in 20%.Keywords: sustainable building environmental model (SBEM), adaptive comfort temperature (ACT), new demand control ventilation (nDCV), energy saving
Procedia PDF Downloads 6364222 Evaluating the Latest Advances in Dry Powder Inhaler Technology
Authors: Leila Asadollahi
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Dry powder inhalers (DPIs) have come a long way since their creation, starting with the Spinhaler Fisons in 1967. For optimal performance, it is important to consider the interplay between formulation, device, and patient. DPIs have shown great potential in treating systemic disorders, as evidenced by their success in clinical practices. Ongoing clinical trials and market availability of DPI products for systemic disease treatment are also examined. Furthermore, the current COVID-19 pandemic has sparked increased interest in dry powder inhalation as a potential avenue for vaccines and antiviral drugs, prompting further exploration of its applications. To achieve optimal treatment outcomes for respiratory diseases, a thorough understanding of the various types of DPIs currently available is crucial. These include single-dose, multiple-unit dose, and multi-dose DPIs. This informative article delves into the administration of drugs via inhalation, examining its diverse routes of administration. Additionally, it illuminates the exciting advancements in inhalation delivery systems and investigates the latest therapeutic approaches for the treatment of respiratory ailments. Additionally, the article discusses the historical development of DPIs and the need for improved designs to enhance efficacy and patient adherence. The potential of DPIs in treating systemic diseases is also examined. Overall, this review provides valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders. The review aims to provide valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders.Keywords: dry powder inhalers (DPIs), respiratory diseases, systemic disorders, pulmonary drug delivery
Procedia PDF Downloads 704221 Natural Gas Production Forecasts Using Diffusion Models
Authors: Md. Abud Darda
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Different options for natural gas production in wide geographic areas may be described through diffusion of innovation models. This type of modeling approach provides an indirect estimate of an ultimately recoverable resource, URR, capture the quantitative effects of observed strategic interventions, and allow ex-ante assessments of future scenarios over time. In order to ensure a sustainable energy policy, it is important to forecast the availability of this natural resource. Considering a finite life cycle, in this paper we try to investigate the natural gas production of Myanmar and Algeria, two important natural gas provider in the world energy market. A number of homogeneous and heterogeneous diffusion models, with convenient extensions, have been used. Models validation has also been performed in terms of prediction capability.Keywords: diffusion models, energy forecast, natural gas, nonlinear production
Procedia PDF Downloads 2274220 Integration of Microarray Data into a Genome-Scale Metabolic Model to Study Flux Distribution after Gene Knockout
Authors: Mona Heydari, Ehsan Motamedian, Seyed Abbas Shojaosadati
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Prediction of perturbations after genetic manipulation (especially gene knockout) is one of the important challenges in systems biology. In this paper, a new algorithm is introduced that integrates microarray data into the metabolic model. The algorithm was used to study the change in the cell phenotype after knockout of Gss gene in Escherichia coli BW25113. Algorithm implementation indicated that gene deletion resulted in more activation of the metabolic network. Growth yield was more and less regulating gene were identified for mutant in comparison with the wild-type strain.Keywords: metabolic network, gene knockout, flux balance analysis, microarray data, integration
Procedia PDF Downloads 5794219 Influence of Aluminum Content on the Microstructural, Mechanical and Tribological Properties of TiAlN Coatings for Using in Dental and Surgical Instrumentation
Authors: Hernan D. Mejia, Gilberto B. Gaitan, Mauricio A. Franco
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420 steel is normally used in the manufacture of dental and surgical instrumentation, as well as parts in the chemical, pharmaceutical, and food industries, among others, where they must withstand heavy loads and often be in contact with corrosive environments, which leads to wear and deterioration of these steels in relatively short times. In the case of medical applications, the instruments made of this steel also suffer wear and corrosion during the repetitive sterilization processes due to the relatively low achievable hardness of just 50 HRC and its hardly acceptable resistance to corrosion. In order to improve the wear resistance of 420 steel, TiAlN coatings were deposited, increasing the aluminum content in the alloy by varying the power applied to the aluminum target of 900, 1100, and 1300 W. Evaluations using XRD, Micro Raman, XPS, AFM, SEM, and TEM showed a columnar growth crystal structure with an average thickness of 2 microns and consisting of the TiN and TiAlN phases, whose roughness and grain size decrease with a higher Al content. The AlN phase also appears in the sample deposited at 1300W. The hardness, determined by nanoindentation, initially increases with the aluminum content from 9.7 GPa to 17.1 GPa, but then decreases to 15.4 GPa for the sample with the highest aluminum content due to the appearance of hexagonal AlN and a decrease of harder TiN and TiAlN phases. It was observed that the wear coefficient had a contrary behavior, which took values of 2.7; 1.7 and 6.6x10⁻⁶ mm³/N.m, respectively. All the coated samples significantly improved the wear resistance of the uncoated 420 steel.Keywords: hard coatings, magnetron sputtering, TiAlN coatings, surgical instruments, wear resistance
Procedia PDF Downloads 1244218 Reduction of Transient Receptor Potential Vanilloid 1 for Chronic Pain and Depression Co-Morbidity through Electroacupuncture and Gene Deletion in Mice Brain
Authors: Bernice Lottering, Yi-Wen Lin
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Chronic pain and depression have an estimated 80% rate of comorbidity with unsatisfactory treatment interventions signifying the importance of developing effective therapeutic interventions for a serious chronic condition affecting a large majority of the global population. Chronic pain is defined as persistent pain presenting for over 3 months. This disease state increases the risk of developing depression in comparison to healthy individuals. In the current study, complete Freund’s adjuvant (CFA) was used to induce cell-mediated chronic inflammatory pain in a murine model. Significant mechanical and thermal hyperalgesia was induced, alongside observable depression-like behaviors. These conditions were attenuated through the use of electroacupuncture (EA). Similarly, these effects were also investigated with respect to the transient receptor potential vanilloid 1 (TRPV1), by analyzing the effects of TRPV1 gene deletion on the comorbidity of chronic pain and depression. The expression of the TRPV1 inflammatory response, and related downstream molecules, including protein kinases (PKs), mitogen-activated protein kinase (MAPKs), and transcriptional factors, were significantly reduced in the thalamus, prefrontal cortex (PFC), hippocampus, and periaqueductal gray (PAG) of CFA-treated mice. In addition, phosphorylated N-methyl-D-aspartate (NMDA) receptor 1 was also found to be reduced in the aforementioned areas, suggesting potential application and validity in a clinical setting. Our study determined the prospective therapeutic effects of EA in the treatment of chronic inflammatory pain and depression comorbidity and provides a novel and detailed mechanism underlying EA-mediated analgesia. These findings may be relevant in the utilization of clinical intervention approaches related to chronic pain and depression comorbidity.Keywords: chronic pain, depression, NMDA, prefrontal cortex, TRPV1
Procedia PDF Downloads 1334217 Challenging the Traditional Practice of Continuous Abscess Cavity Packing – A Single Center, Single Blind Randomized Controlled Trial
Authors: Lakmali Anthony, Bushra Oathman, Anshini Jain, Raaj Chandra
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Introduction: Abscesses are traditionally treated by incision and drainage with the packing of the residual abscess cavity until healing. This method requires regular visits from community nurses for continuous wound packing upon discharge from the hospital and causes considerable patient discomfort. Whether abscess cavity packing offers any advantage over non-packing has not yet been adequately studied to the best of our knowledge. This study aims to determine if there are differences in clinical outcomes of time to healing, fistula formation and recurrence of abscess between abscess cavity packing vs. non-packing groups. Methods: This study was a single-center, single-blind, randomized controlled trial where patients were randomized into packing and non-packing arms. All patients over 18 years presenting to Eastern Health with an abscess requiring incision and drainage in the theatre were invited to participate. Those with underlying conditions that cause recurrent abscesses were excluded. Data were collected from December 2018 to April 2020. Results: There were 63 patients who had abscesses treated with incision and drainage that were enrolled in the study, 52 of which were suitable for analysis. Demographic characteristics were similar in both groups. The packing group had a significantly longer time to heal compared to the non-packing group. Rates of fistula formation and recurrence of abscess were low and there were no statistically significant differences between groups. The packing group had more patients with delayed healing (defined as >60 days) and required more follow-up visits compared to the non-packing group. Conclusion: This pilot study indicates that abscesses can not only be managed safely with incision and drainage alone without the need for continuous abscess cavity packing but also that non-packing may offer clinical benefits to patients with earlier healing of abscesses compared to continuous cavity packing.Keywords: abscess packing, subcutaneous, perianal, pilonidal
Procedia PDF Downloads 734216 Assessment of Kinetic Trajectory of the Median Nerve from Wrist Ultrasound Images Using Two Dimensional Baysian Speckle Tracking Technique
Authors: Li-Kai Kuo, Shyh-Hau Wang
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The kinetic trajectory of the median nerve (MN) in the wrist has shown to be capable of being applied to assess the carpal tunnel syndrome (CTS), and was found able to be detected by high-frequency ultrasound image via motion tracking technique. Yet, previous study may not quickly perform the measurement due to the use of a single element transducer for ultrasound image scanning. Therefore, previous system is not appropriate for being applied to clinical application. In the present study, B-mode ultrasound images of the wrist corresponding to movements of fingers from flexion to extension were acquired by clinical applicable real-time scanner. The kinetic trajectories of MN were off-line estimated utilizing two dimensional Baysian speckle tracking (TDBST) technique. The experiments were carried out from ten volunteers by ultrasound scanner at 12 MHz frequency. Results verified from phantom experiments have demonstrated that TDBST technique is able to detect the movement of MN based on signals of the past and present information and then to reduce the computational complications associated with the effect of such image quality as the resolution and contrast variations. Moreover, TDBST technique tended to be more accurate than that of the normalized cross correlation tracking (NCCT) technique used in previous study to detect movements of the MN in the wrist. In response to fingers’ flexion movement, the kinetic trajectory of the MN moved toward the ulnar-palmar direction, and then toward the radial-dorsal direction corresponding to the extensional movement. TDBST technique and the employed ultrasound image scanner have verified to be feasible to sensitively detect the kinetic trajectory and displacement of the MN. It thus could be further applied to diagnose CTS clinically and to improve the measurements to assess 3D trajectory of the MN.Keywords: baysian speckle tracking, carpal tunnel syndrome, median nerve, motion tracking
Procedia PDF Downloads 495