Search results for: group pile
5905 MATLAB Supported Learning and Students' Conceptual Understanding of Functions of Two Variables: Experiences from Wolkite University
Authors: Eyasu Gemech, Kassa Michael, Mulugeta Atnafu
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A non-equivalent group's quasi-experiment research was conducted at Wolkite University to investigate MATLAB supported learning and students' conceptual understanding in learning Applied Mathematics II using four different comparative instructional approaches: MATLAB supported traditional lecture method, MATLAB supported collaborative method, only collaborative method, and only traditional lecture method. Four intact classes of mechanical engineering groups 1 and 2, garment engineering and textile engineering students were randomly selected out of eight departments. The first three departments were considered as treatment groups and the fourth one 'Textile engineering' was assigned as a comparison group. The departments had 30, 29, 35 and 32 students respectively. The results of the study show that there is a significant mean difference in students' conceptual understanding between groups of students learning through MATLAB supported collaborative method and the other learning approaches. Students who were learned through MATLAB technology-supported learning in combination with collaborative method were found to understand concepts of functions of two variables better than students learning through the other methods of learning. These, hence, are informative of the potential approaches universities would follow for a better students’ understanding of concepts.Keywords: MATLAB supported collaborative method, MATLAB supported learning, collaborative method, conceptual understanding, functions of two variables
Procedia PDF Downloads 2785904 Toxicological Study of Umbilicus rupesris L. Leaves: Hematological, Biochemical, and Histopathological Studies
Authors: Afaf Benhouda, Mouloud Yahia, Hachani Khadraoui, Asma Meddour, Souhila Benbia, Abdelmoudjib Ghecham, Djahida Benhouda
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Umbilicus rupestris (UR) is an herbal medicine traditionally applied against the ignitions of the skin. The present paper aimed to study the acute and subacute toxicity with orally administered methanolic leaves extract of Umbilicus rupestris L (URMeOH). In acute toxicity tests, four groups of rats (n = 6/group/female) were orally treated with doses of 500, 1000, 1500 and 2000 mg/kg, and general behaviour, adverse effects, and mortality were recorded for up to 14 days. In subacute toxicity study, rats received URAMeOH by gavage at the doses of 100, 200 mg/kg/day (n = 6/group) for 28 days, and biochemical, hematological, and histopathological changes in tissues (liver, kidney) were determined. URMeOH did not produce any hazardous symptoms or death and in the acute toxicity test. Subacute treatment with URMeOH did not show any change in body weight, and hematological and biochemical profiles. In addition, no change was observed either in macroscopic or microscopic aspects of vital organs in rats. Our result showed that Umbilicus rupestris extract could be safe for human use.Keywords: acute toxicity, biochemical parameters, hematological parameters, Umbilicus rupestris, subacute toxicity
Procedia PDF Downloads 3455903 Effect of pH-Dependent Surface Charge on the Electroosmotic Flow through Nanochannel
Authors: Partha P. Gopmandal, Somnath Bhattacharyya, Naren Bag
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In this article, we have studied the effect of pH-regulated surface charge on the electroosmotic flow (EOF) through nanochannel filled with binary symmetric electrolyte solution. The channel wall possesses either an acidic or a basic functional group. Going beyond the widely employed Debye-Huckel linearization, we develop a mathematical model based on Nernst-Planck equation for the charged species, Poisson equation for the induced potential, Stokes equation for fluid flow. A finite volume based numerical algorithm is adopted to study the effect of key parameters on the EOF. We have computed the coupled governing equations through the finite volume method and our results found to be in good agreement with the analytical solution obtained from the corresponding linear model based on low surface charge condition or strong electrolyte solution. The influence of the surface charge density, reaction constant of the functional groups, bulk pH, and concentration of the electrolyte solution on the overall flow rate is studied extensively. We find the effect of surface charge diminishes with the increase in electrolyte concentration. In addition for strong electrolyte, the surface charge becomes independent of pH due to complete dissociation of the functional groups.Keywords: electroosmosis, finite volume method, functional group, surface charge
Procedia PDF Downloads 4195902 The Comparison Study of Human Microbiome in Chronic Rhinosinusitis between Adults and Children
Authors: Il Ho Park, Joong Seob Lee, Sung Hun Kang, Jae-Min Shin, Il Seok Park, Seok Min Hong, Seok Jin Hong
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Introduction: The human microbiota is the aggregate of microorganisms, and the bacterial microbiome of the human digestive tract contributes to both health and disease. In health, bacteria are key components in the development of mucosal barrier function and in innate and adaptive immune responses, and they also work to suppress the establishment of pathogens. In human upper airway, the sinonasal microbiota might play an important role in chronic rhinosinusitis (CRS). The purpose of this study is to investigate the human upper airway microbiome in CRS patients and to compare the sinonasal microbiome of adults with children. Materials and methods: A total of 19 samples from 19 patients (Group1; 9 CRS in children, aged 5 to 14 years versus Group 2; 10 CRS in adults aged 21 to 59 years) were examined. Swabs were collected from the middle meatus and/or anterior ethmoid region under general anesthesia during endoscopic sinus surgery or tonsillectomy. After DNA extraction from swab samples, we analysed bacterial microbiome consortia using 16s rRNA gene sequencing approach (the Illumina MiSeq platform). Results: In this study, relatively abundance of the six bacterial phyla and tremendous genus and species found in substantial amounts in the individual sinus swab samples, include Corynebacterium, Hemophilus, Moraxella, and Streptococcus species. Anaerobes like Fusobacterium and Bacteroides were abundantly present in the children group, Bacteroides and Propionibacterium were present in adults group. In genus, Haemophilus was the most common CRS microbiome in children and Corynebacterium was the most common CRS microbiome in adults. Conclusions: Our results show the diversity of human upper airway microbiome, and the findings will suggest that CRS is a polymicrobial infection. The Corynebacterium and Hemophilus may live as commensals on mucosal surfaces of sinus in the upper respiratory tract. The further study will be needed for analysis of microbiome-human interactions in upper airway and CRS.Keywords: microbiome, upper airway, chronic rhinosinusitis, adult and children
Procedia PDF Downloads 1265901 Sociodemographic Risk Factors of Cervical Cancer in Imphal, Manipur
Authors: Arundhati Devi Maibam, K. Ingocha Singh
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Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.Keywords: cervical cancer, Manipuri women, RIIMS, socio-demographic risk factors
Procedia PDF Downloads 2765900 The Effect of Acute Muscular Exercise and Training Status on Haematological Indices in Adult Males
Authors: Ibrahim Musa, Mohammed Abdul-Aziz Mabrouk, Yusuf Tanko
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Introduction: Long term physical training affect the performance of athletes especially the females. Soccer which is a team sport, played in an outdoor field, require adequate oxygen transport system for the maximal aerobic power during exercise in order to complete 90 minutes of competitive play. Suboptimal haematological status has often been recorded in athletes with intensive physical activity. It may be due to the iron depletion caused by hemolysis or haemodilution results from plasma volume expansion. There is lack of data regarding the dynamics of red blood cell variables, in male football players. We hypothesized that, a long competitive season involving frequent matches and intense training could influence red blood cell variables, as a consequence of applying repeated physical loads when compared with sedentary. Methods: This cross sectional study was carried on 40 adult males (20 athletes and 20 non athletes) between 18-25 years of age. The 20 apparently healthy male non athletes were taken as sedentary and 20 male footballers comprise the study group. The university institutional review board (ABUTH/HREC/TRG/36) gave approval for all procedures in accordance with the Declaration of Helsinki. Red blood cell (RBC) concentration, packed cell volume (PCV), and plasma volume were measured in fasting state and immediately after exercise. Statistical analysis was done by using SPSS/ win.20.0 for comparison within and between the groups, using student’s paired and unpaired “t” test respectively. Results: The finding from our study shows that, immediately after termination of exercise, the mean RBC counts and PCV significantly (p<0.005) decreased with significant increased (p<0.005) in plasma volume when compared with pre-exercised values in both group. In addition the post exercise RBC was significantly higher in untrained (261.10±8.5) when compared with trained (255.20±4.5). However, there was no significant differences in the post exercise hematocrit and plasma volume parameters between the sedentary and the footballers. Moreover, beside changes in pre-exercise values among the sedentary and the football players, the resting red blood cell counts and Plasma volume (PV %) was significantly (p < 0.05) higher in the sedentary group (306.30±10.05 x 104 /mm3; 58.40±0.54%) when compared with football players (293.70±4.65 x 104 /mm3; 55.60±1.18%). On the other hand, the sedentary group exhibited significant (p < 0.05) decrease in PCV (41.60±0.54%) when compared with the football players (44.40±1.18%). Conclusions: It is therefore proposed that the acute football exercise induced reduction in RBC and PCV is entirely due to plasma volume expansion, and not of red blood cell hemolysis. In addition, the training status also influenced haematological indices of male football players differently from the sedentary at rest due to adaptive response. This is novel.Keywords: Haematological Indices, Performance Status, Sedentary, Male Football Players
Procedia PDF Downloads 2575899 Assessment on the Improvement of the Quality of Life after One Year of Regular Physical Activity and Treatment in Patients with Postmenopausal Osteoporosis
Authors: Stoyanka Georgieva Vladeva, Elena Kirilova Kirilova, Nikola Kirilov Kirilov
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Summary: WHO (World Health Organization) recommends the elder people a certain amount of regular physical activity in order to prevent some of the health issues. Postmenopausal osteoporosis is one of the chronic diseases which requires the maintaining of regular physical activity. The regular activity combined with an adequate medical treatment greatly improves the quality of life of the patient. Objectives: Assessment of the effect of the regular physical activity recommended by WHO on the quality of life in patients with postmenopausal osteoporosis. Material and methods: For the period of one year 68 female patients treated with Denosumab have been monitored. The bone density has been measured with the DEXA method in accordance to the T-score. No patients having any oncologic diseases and secondary osteoporosis have been included in the study. The subjects have been divided into groups by their age. The first group – women aged under 65 years (27 subjects) and the second group – women aged over 65 years (41 subjects). All patients have been advised to maintain regular physical activity included in the recommendations of the WHO in accordance with the age and the disease. The quality of life has been assessed in the beginning and at the end of the one-year period using the SF 36V2 questionnaire. Results: Only 31% of the subjects have engaged into regular increased physical activities for the whole period. Among them are mostly patients of the second group (aged over 65 years, 71%). The women from the both groups who were engaging into regular activities for this one-year period all experience an improvement of the quality of life. These results show that older patients understand the necessity of the physical activity for their health. The comparison of the output data to the scales of physical activity, durability, body pain, vitality, social activity and emotional stability has found an improvement at the end of the period in all patients. The osteodensitometry showed general improvement of the T-score. Patients with additional visits to their rheumatologist have better results. Conclusion: Combination of regular physical activity in accordance to the recommendations of WHO and medical treatment including anti-osteoporotic drugs improves the quality of life of women with postmenopausal osteoporosis.Keywords: elderly patients, osteoporosis, physical activity, quality of life
Procedia PDF Downloads 3315898 Unsupervised Part-of-Speech Tagging for Amharic Using K-Means Clustering
Authors: Zelalem Fantahun
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Part-of-speech tagging is the process of assigning a part-of-speech or other lexical class marker to each word into naturally occurring text. Part-of-speech tagging is the most fundamental and basic task almost in all natural language processing. In natural language processing, the problem of providing large amount of manually annotated data is a knowledge acquisition bottleneck. Since, Amharic is one of under-resourced language, the availability of tagged corpus is the bottleneck problem for natural language processing especially for POS tagging. A promising direction to tackle this problem is to provide a system that does not require manually tagged data. In unsupervised learning, the learner is not provided with classifications. Unsupervised algorithms seek out similarity between pieces of data in order to determine whether they can be characterized as forming a group. This paper explicates the development of unsupervised part-of-speech tagger using K-Means clustering for Amharic language since large amount of data is produced in day-to-day activities. In the development of the tagger, the following procedures are followed. First, the unlabeled data (raw text) is divided into 10 folds and tokenization phase takes place; at this level, the raw text is chunked at sentence level and then into words. The second phase is feature extraction which includes word frequency, syntactic and morphological features of a word. The third phase is clustering. Among different clustering algorithms, K-means is selected and implemented in this study that brings group of similar words together. The fourth phase is mapping, which deals with looking at each cluster carefully and the most common tag is assigned to a group. This study finds out two features that are capable of distinguishing one part-of-speech from others these are morphological feature and positional information and show that it is possible to use unsupervised learning for Amharic POS tagging. In order to increase performance of the unsupervised part-of-speech tagger, there is a need to incorporate other features that are not included in this study, such as semantic related information. Finally, based on experimental result, the performance of the system achieves a maximum of 81% accuracy.Keywords: POS tagging, Amharic, unsupervised learning, k-means
Procedia PDF Downloads 4515897 Anti-Obesity Effect of Cordyceps militaris Fermented Black Rice
Authors: Chih-Hung Liang, Jung-Jung Chen, Shen-Shih Chiang
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Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health, which are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer. Cordyceps militaris (CM) is a well-known traditional medicine in Asian countries and a rich source of biologically active components. Black rice (Oryza sativa L.) is a special cultivar of rice that contains rich anthocyanins and regarded as a health-promoting food in China and other Eastern. The aim of this study was to investigate the anti-obesity effect of Cordyceps militaris fermented black rice (CB) on HFD-induced BALB/c mice model. The results indicated that administration of low and high dosage of CB powder significantly reduced the body weights (7.38% and 7.78%), body fat ratio (2.37% and 2.78%), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels compared to the HF group (p<0.05). Histopathological analysis showed that the score of fatty liver in HF group (5.0) was significantly higher than CB groups (2.1 and 3.6) (p<0.05). In conclusion, Cordyceps militaris fermented black rice can reduce the body weight via inhibition of the fat accumulation in liver and body and possess the anti-obesity potency.Keywords: Cordyceps militaris, black rice, obesity, HFD-induced mice
Procedia PDF Downloads 3105896 Evaluation of Microleakage of a New Generation Nano-Ionomer in Class II Restoration of Primary Molars
Authors: Ghada Salem, Nihal Kabel
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Objective: This in vitro study was carried out to assess the microleakage properties of nano-filled glass ionomer in comparison to resin-reinforced glass ionomers. Material and Methods: 40 deciduous molar teeth were included in this study. Class-II cavity was prepared in a standard form for all the specimens. The teeth were randomly distributed into two groups (20 per group) according to the restorative material used either nano-glass ionomer or Photac Fill glass ionomer restoration. All specimens were thermocycled for 1000 cycles between 5 and 55 °C. After that, the teeth were immersed in 2% methylene blue dye then sectioned and evaluated under a stereomicroscope. Microleakage was assessed using linear dye penetration and on a scale from zero to five. Results: Two way ANOVA test revealed a statistically significant lower degree of microleakage in both occlusal and gingival restorations (0.4±0.2), (0.9±0.1) for nano-filled glass ionomer group in comparison to resin modified glass ionomer (2.3±0.7), (2.4±0.5). No statistical difference was found between gingival and occlusal leakage regarding the effect of the measured site. Conclusion: Nano-filled glass ionomer shows superior sealing ability which enables this type of restoration to be used in minimum invasive treatment.Keywords: microleakage, nanoionomer, resin-reinforced glass ionomer, proximal cavity preparation
Procedia PDF Downloads 2355895 High-Pressure Steam Turbine for Medium-Scale Concentrated Solar Power Plants
Authors: Ambra Giovannelli, Coriolano Salvini
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Many efforts have been spent in the design and development of Concentrated Solar Power (CPS) Plants worldwide. Most of them are for on-grid electricity generation and they are large plants which can benefit from the economies of scale. Nevertheless, several potential applications for Small and Medium-Scale CSP plants can be relevant in the industrial sector as well as for off-grid purposes (i.e. in rural contexts). In a wide range of industrial processes, CSP technologies can be used for heat generation replacing conventional primary sources. For such market, proven technologies (usually hybrid solutions) already exist: more than 100 installations, especially in developing countries, are in operation and performance can be verified. On the other hand, concerning off-grid applications, solar technologies are not so mature. Even if the market offers a potential deployment of such systems, especially in countries where the access to grid is strongly limited, optimized solutions have not been developed yet. In this context, steam power plants can be taken into consideration for medium scale installations, due to the recent results achieved with direct steam generation systems based on paraboloidal dish or Fresnel lens solar concentrators. Steam at 4.0-4.5 MPa and 500°C can be produced directly by means of innovative solar receivers (some prototypes already exist). Although it could seem a promising technology, presently, steam turbines commercially available do not cover the required cycle specifications. In particular, while low-pressure turbines already exist on the market, high-pressure groups, necessary for the abovementioned applications, are not available. The present paper deals with the preliminary design of a high-pressure steam turbine group for a medium-scale CSP plant (200-1000 kWe). Such a group is arranged in a single geared package composed of four radial expander wheels. Such wheels have been chosen on the basis of automotive turbocharging technology and then modified to take the new requirements into account. Results related to the preliminary geometry selection and to the analysis of the high-pressure turbine group performance are reported and widely discussed.Keywords: concentrated solar power (CSP) plants, steam turbine, radial turbine, medium-scale power plants
Procedia PDF Downloads 2175894 Comparison of the Effect of Nano Calcium Carbonate and CaCO₃ on Egg Production, Egg Traits and Calcium Retention in Laying Japanese Quail
Authors: Farhad Ahmadi, Hammed Kimiaee
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Context: This research study focuses on the effect of different levels and sources of calcium on egg production, egg traits, and calcium retention in laying Japanese quail. The study aims to determine the impact of nano calcium carbonate (NCC) and calcium carbonate (CC) on these factors. Research Aim: The main objective of this research is to investigate the effect of different levels and sources of calcium on egg production, egg traits, and calcium retention in laying Japanese quail. Specifically, the study aims to compare the effects of NCC and CC on these parameters. Methodology: The research was conducted using a total of 280 laying quail with an average age of 8 weeks. The quails were randomly distributed in a completely randomized design (CRD) with 7 treatments, 4 replications, and 10 quails in each pen. The study lasted for 90 days. The experimental diets included a control group (T1) with a basal diet consisting of 3.17% CaCO₃, and other groups supplemented with different levels (0.5%, 0.1%, and 0.15%) of either calcium carbonate (CC) or nano calcium carbonate (NCC). The quails had free access to water and feed throughout the study period. Findings: The results of the study showed that NCC at the levels of 0.1% and 0.15% (T6 and T7) improved eggshell thickness, shell thickness, and shell breaking strength compared to the control group. Although not statistically significant, there was an increasing trend in quail egg production and calcium retention in the calcareous shell of the egg in birds that consumed the experimental diets containing different levels of NCC compared to the control and other treatment groups. Theoretical Importance: This research contributes to our understanding of the effect of NCC and CC on egg production, egg traits, and calcium retention in laying Japanese quail. It highlights the potential benefits of using NCC as a calcium source in quail diets, specifically in improving the quantity and quality of eggs and calcium retention. Data Collection and Analysis Procedures: Quail egg production was recorded monthly for each treatment group. At the end of the study, a total of 40 eggs (10 eggs/replicate) from each treatment group were randomly selected for analysis. Parameters such as eggshell thickness, shell thickness, shell breaking strength, and calcium retention were measured. Statistical analysis was performed to compare the results between the different treatment groups. Questions Addressed: This research aimed to answer the following questions: What is the effect of different levels and sources of calcium on egg production, egg traits, and calcium retention in laying Japanese quail? How does nano calcium carbonate compare to calcium carbonate in terms of these parameters? Conclusion: In conclusion, this study suggests that NCC at the levels of 0.1% and 0.15% can improve the quantity and quality of eggs and calcium retention in laying Japanese quail. These findings highlight the potential benefits of using NCC as a calcium source in quail diets. Further research could be conducted to explore the mechanisms behind these improvements and optimize the dosage of NCC for maximum effect.Keywords: egg, calcium, nanoparticles, retention
Procedia PDF Downloads 815893 Prevention of Heart Failure Progression in Patients with Post-Infarction Cardiosclerosis After Coronavirus Infection
Authors: Sujayeva V. A., Karpova I. S., Koslataya O. V., Kolyadko M. G., Russkikh I. I., Vankovich E. A.
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Objective: The goal of this study is to develop a method for the prevention of the progression of heart failure (HF) in patients with post-infarction cardiosclerosis who have suffered coronavirus infection. Methods: 135 patients with post-infarction cardiosclerosis were divided into 2 groups: Group I - patients who had suffered COVID-19 - 85 people, and Group II - patients who had not suffered COVID-19 - 50 people. Patients of group I, depending on the level of N-terminal fragment of natriuretic peptide (NTproBNP), were divided into 2 subgroups - subgroup A - with HF - 40 people, subgroup B - without HF - 45 people. All patients underwent a clinical examination, echocardiography, electrocardiotopography in 60 leads, computed angiography of the coronary arteries, heart magnetic resonance imaging, NTproBNP. Results: In the post-Covid period, in patients with post-infarction cardiosclerosis, remodeling of the left ventricle and right parts of the heart, deterioration of the systolic-diastolic function of both ventricles, increased pressure in the pulmonary artery, progression of coronary artery atherosclerosis, and an increase in the size of myocardial fibrosis were revealed. The consequence of these changes was the progression of heart failure. The developed method of medical prevention made it possible to improve the clinical course of coronary artery disease and prevent the progression of chronic heart failure in patients with post-infarction cardiosclerosis. Conclusions: In patients with post-infarction cardiosclerosis who initially had HF, after 1 year, according to laboratory and instrumental data, a slight decrease in its severity was revealed. In patients with post-infarction cardiosclerosis who did not have HF before COVID-19, HF developed 1 year after the coronavirus disease, which may be due to the identified process of myocardial fibrosis, which dictates the need to prevent the development of HF in patients with post-infarction cardiosclerosis, even those who did not initially have HF. The proposed method of medical prevention made it possible to improve the clinical course of coronary artery disease in patients with post-infarction cardiosclerosis after COVID-19, both in persons with and without HF, when included in the study. A method of medical prevention in people with post-infarction cardiosclerosis after COVID-19 infection, including spironolactone, loop diuretics, empagliflozin, sacubitril/valsartan, helped prevent the progression of HF.Keywords: elderly, myocardial infarction, COVID-19, prevention
Procedia PDF Downloads 225892 The Predictive Value of Extensor Grip Test for the Effectiveness of Treatment for Tennis Elbow: A Randomized Controlled Trial
Authors: Mohammad Javad Zehtab, S. Alireza Mirghasemi, Ali Majlesara, Parvin Tajik, Babak Siavashi
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Objective: There are different modalities proposed for tennis elbow treatment with few randomized trials comparing them. We designed a study to compare the effectiveness of five different modalities and determine the usefulness of recently proposed extensor grip test (EGT) in predicting the response to treatment. Methods: In a randomized controlled clinical trial 92 of 98 tennis elbow patients in Sina hospital of Tehran, Iran between 2006 and 2007 fulfill trial entry criteria, among these patients 56 (60.9%) had positive EGT result. Stratified on EGT result, patients allocated randomly to 5 treatment groups: Brace (B) group, physiotherapy (P), brace + physiotherapy (BP), injection (I) and injection + physiotherapy (IP). Results: Patients who had positive result of EGT had better response to treatments: less SOC (p = 0.06), less PFFQ and patients’ satisfaction scores (p < 0.001). Among the treatment IP was the most successful, then BP, P and B, respectively; injection was the worst treatment modality. Response to treatment was comparable in all groups between EGT positive and negative patients except bracing; in which positive EGT was correlated with a dramatic response to treatment. Conclusion: In all patients IP and then BP is recommended but in EGT negatives, bracing seems to be of no use. Injection alone is not recommended in either group.Keywords: tennis elbow, extensor grip test, physiotherapy, tennis elbow treatment
Procedia PDF Downloads 2845891 The Effectiveness of Probiotics in the Treatment of Minimal Hepatic Encephalopathy Among Patients with Cirrhosis: An Expanded Meta-Analysis
Authors: Erwin Geroleo, Higinio Mappala
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Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy
Procedia PDF Downloads 455890 Developing a Quality Mentor Program: Creating Positive Change for Students in Enabling Programs
Authors: Bianca Price, Jennifer Stokes
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Academic and social support systems are critical for students in enabling education; these support systems have the potential to enhance the student experience whilst also serving a vital role for student retention. In the context of international moves toward widening university participation, Australia has developed enabling programs designed to support underrepresented students to access to higher education. The purpose of this study is to examine the effectiveness of a mentor program based within an enabling course. This study evaluates how the mentor program supports new students to develop social networks, improve retention, and increase satisfaction with the student experience. Guided by Social Learning Theory (SLT), this study highlights the benefits that can be achieved when students engage in peer-to-peer based mentoring for both social and learning support. Whilst traditional peer mentoring programs are heavily based on face-to-face contact, the present study explores the difference between mentors who provide face-to-face mentoring, in comparison with mentoring that takes place through the virtual space, specifically via a virtual community in the shape of a Facebook group. This paper explores the differences between these two methods of mentoring within an enabling program. The first method involves traditional face-to-face mentoring that is provided by alumni students who willingly return to the learning community to provide social support and guidance for new students. The second method requires alumni mentor students to voluntarily join a Facebook group that is specifically designed for enabling students. Using this virtual space, alumni students provide advice, support and social commentary on how to be successful within an enabling program. Whilst vastly different methods, both of these mentoring approaches provide students with the support tools needed to enhance their student experience and improve transition into University. To evaluate the impact of each mode, this study uses mixed methods including a focus group with mentors, in-depth interviews, as well as engaging in netnography of the Facebook group ‘Wall’. Netnography is an innovative qualitative research method used to interpret information that is available online to better understand and identify the needs and influences that affect the users of the online space. Through examining the data, this research will reflect upon best practice for engaging students in enabling programs. Findings support the applicability of having both face-to-face and online mentoring available for students to assist enabling students to make a positive transition into University undergraduate studies.Keywords: enabling education, mentoring, netnography, social learning theory
Procedia PDF Downloads 1215889 Gender Role Attitudes and Work-Life Balance among Dual-Earner Couples: A Case Study of Pakistan
Authors: Tipu Sultan
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The proposed research intends to explore the gender role attitudes and work-life balance among dual-earner couples in Pakistan. With the increase of female labor force participation in Pakistan, the trend of dual-earner couples has been increased than ever before. This new trend of dual-earner families has significantly affected the personal life of dual-earner couples. Due to major change in household structures, the traditions and the routine activities are in continuous transition. Balancing work and family life is more complex in the patriarchal society of Pakistan because of the social expectations of gender roles. A dichotomous behavioral reflection is being observed in Pakistani society. The one group of people having an egalitarian attitude are supporting the new gender roles of females, whereas the other group of people having a traditional mindset is still in the favor of patriarchy. Therefore, gender roles are re-evaluated, and it would be more interesting to raise questions on the interplay of new gender roles and work-life balance among dual-earners. The semi-structured interview guide will be utilized to explore gender role attitudes, ideal and in-practice gender roles, experiences of work-life imbalances/balances, possible strategies to create a balance between work and family life among dual-earner couples.Keywords: dual-earner couples, gender role attitudes, Pakistan, work-life balance
Procedia PDF Downloads 1515888 Effect of Low-Intensity Laser on Severe Tinnitus in Idiopathic Sudden Hearing Loss Patients
Authors: Z. Mowafy Emam Mowafy, Ahmed R. Sayed, M. El Sayed Mohmmed Hassan
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Purpose: to evaluate the effect of low intensity laser on severe tinnitus in idiopathic sudden hearing loss patients. Methods of evaluation (Visual analogue scale and tinnitus handicap inventory scale):- Thirty patients who had unilateral tinnitus with sensorineural hearing loss were participated in the study. Subjects aged from 40 to 50 were randomly divided into two equal groups: group (A): composed of 15 patients who received the routine medical care (Systemic steroids) in addition to the low-intensity laser therapy (LILT) while group (B): composed of 15 patients who received only the routine medical care. Continuous 632.8nm He-Ne laser was used with 5mW power for 15 min\day, 3 days per week for 3 months. Results and conclusion: Results showed that application of the LILT had a valuable effect on severe tinnitus in idiopathic sudden hearing loss patients as evidenced by the highly decreased visual analogue scale and tinnitus handicap inventory scale.Keywords: idiopathic sudden hearing loss, low intensity laser, tinnitus, tinnitus handicap inventory scale and visual analogue scale
Procedia PDF Downloads 3955887 Post-Exercise Effects of Cold Water Immersion over a 48-Hour Recovery Period on the Physical and Haematological Parameters of Male University-Level Rugby Players
Authors: Adele Broodryk, Cindy Pienaar, Martinique Sparks, Ben Coetzee
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Background: Cold water immersion (CWI) is a popular recovery modality utilised. However, discrepancies exist regarding the results over a 48 hour recovery period. Aim: To evaluate the effects of CWI and passive recovery (PAR) on a range of haematological and physical parameters over a 48-hour using a cross-sectional, pre-post-test design. Subjects and Methods: Both the and physical parameters were evaluated at baseline, after a 15-min fitness session, and at 0, 24 and 48 hours post-recovery in 23 male university rugby players. The CWI group sat in a cold water pool (8°C) for 20 min whereas the PAR group remained seated. Results: At 0 hours post-CWI, three (blood lactate (BLa-), Sodium (Na+) and haemoglobin) returned to baseline values, however Vertical Jump Test (VJT) height results decreased whereas after PAR it improved. From 0 to 24 and/or 48 h, four (Partial Oxygen (PO2) VJT-height, plasma glucose, and Na+) significantly increased (p ≤ 0.05) in either and/or both groups. Significant intergroup differences (p ≤ 0.05) were noticed in the physical tests. Conclusions: PAR is superior as an acute modality (0 hours) due to CWI cooling the body down. However, CWI demonstrates advantageous over a 24-hour period in a wide range of haematological variables.Keywords: cryotherapy, recuperation, haematological, rugby
Procedia PDF Downloads 2645886 The Effects of Leadership on the Claim of Responsibility
Authors: Katalin Kovacs
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In most forms of violence the perpetrators intend to hide their identities. Terrorism is different. Terrorist groups often take responsibility for their attacks, and consequently they reveal their identities. This unique characteristic of terrorism has been largely overlooked, and scholars are still puzzled as to why terrorist groups claim responsibility for their attacks. Certainly, the claim of responsibility is worth analysing. It would help to have a clearer picture of what terrorist groups try to achieve and how, but also to develop an understanding of the strategic planning of terrorist attacks and the message the terrorists intend to deliver. The research aims to answer the question why terrorist groups choose to claim responsibility for some of their attacks and not for others. In order to do so the claim of responsibility is considered to be a tactical choice, based on the assumption that terrorists weigh the costs and benefits of claiming responsibility. The main argument is that terrorist groups do not claim responsibility in cases when there is no tactical advantage gained from claiming responsibility. The idea that the claim of responsibility has tactical value offers the opportunity to test these assertions using a large scale empirical analysis. The claim of responsibility as a tactical choice depends on other tactical choices, such as the choice of target, the internationality of the attack, the number of victims and whether the group occupies territory or operates as an underground group. The structure of the terrorist groups and the level of decision making also affects the claim of responsibility. Terrorists on the lower level are less disciplined than the leaders. This means that the terrorists on lower levels pay less attention to the strategic objectives and engage easier in indiscriminate violence, and consequently they would less like to claim responsibility. Therefore, the research argues that terrorists, who are on a highest level of decision making would claim responsibility for the attacks as those are who takes into account the strategic objectives. As most studies on terrorism fail to provide definitions; therefore the researches are fragmented and incomparable. Separate, isolated researches do not support comprehensive thinking. It is also very important to note that there are only a few researches using quantitative methods. The aim of the research is to develop a new and comprehensive overview of the claim of responsibility based on strong quantitative evidence. By using well-established definitions and operationalisation the current research focuses on a broad range of attributes that can have tactical values in order to determine circumstances when terrorists are more likely to claim responsibility.Keywords: claim of responsibility, leadership, tactical choice, terrorist group
Procedia PDF Downloads 3135885 The Relationship between Eating Disorders (Anorexia and Bulimia Nervosa) with Some of the Demographic Factors among University Students
Authors: Shima Hashemi, Firoozeh Ghazanfari
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Introduction: Eating disorder is a psychiatric disorder that is increasingly growing. This study aimed to determine the relationship between eating disorders (anorexia and bulimia nervosa) with some of the demographic factors among Lorestan University of Medical Sciences students. Materials and Methods: This study is a cross-sectional and descriptive study that was done at Lorestan University of Medical Sciences in 2019. Four hundred fifty students were studied by stratified and cluster sampling methods. For gathering data, we use the standard questionnaire Eating Attitudes Test EAT (26). Data were analyzed using statistical software SPSS. Results: According to the results, 144 (32%) males and 305 (67.8%) females were studied. 88.7% were single, and 8.9% were married. In the anorexia nervosa group, the results showed that there was a significant meaning between demographic information, and the number of family members, marital status, BMI, level of education, family income, father and mother education, as well as in the bulimia nervosa group, there was no significant meaning with any demographic information (p>0.05). Conclusion: Anorexia and bulimia nervosa are two known types of eating disorders, and some demographic factors can be effective in causing or aggravating these disorders.Keywords: eating disorder, anorexia nervosa, bulimia nervosa, students
Procedia PDF Downloads 975884 The Effectiveness of Implementing Interactive Training for Teaching Kazakh Language
Authors: Samal Abzhanova, Saule Mussabekova
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Today, a new system of education is being created in Kazakhstan in order to develop the system of education and to satisfy the world class standards. For this purpose, there have been established new requirements and responsibilities to the instructors. Students should not be limited with providing only theoretical knowledge. Also, they should be encouraged to be competitive, to think creatively and critically. Moreover, students should be able to implement these skills into practice. These issues could be resolved through the permanent improvement of teaching methods. Therefore, a specialist who teaches the languages should use up-to-date methods and introduce new technologies. The result of the investigation suggests that an interactive teaching method is one of the new technologies in this field. This paper aims to provide information about implementing new technologies in the process of teaching language. The paper will discuss about necessity of introducing innovative technologies and the techniques of organizing interactive lessons. At the same time, the structure of the interactive lesson, conditions, principles, discussions, small group works and role-playing games will be considered. Interactive methods are carried out with the help of several types of activities, such as working in a team (with two or more group of people), playing situational or role-playing games, working with different sources of information, discussions, presentations, creative works and learning through solving situational tasks and etc.Keywords: interactive education, interactive methods, system of education, teaching a language
Procedia PDF Downloads 2945883 Bio-Psycho-Social Consequences and Effects in Fall-Efficacy Scale in Seniors Using Exercise Intervention of Motor Learning According to Yoga Techniques
Authors: Milada Krejci, Martin Hill, Vaclav Hosek, Dobroslava Jandova, Jiri Kajzar, Pavel Blaha
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The paper declares effects of exercise intervention of the research project “Basic research of balance changes in seniors”, granted by the Czech Science Foundation. The objective of the presented study is to define predictors, which influence bio-psycho-social consequences and effects of balance ability in senior 65 years old and above. We focused on the Fall-Efficacy Scale changes evaluation in seniors. Comprehensive hypothesis of the project declares, that motion uncertainty (dyskinesia) can negatively affect the well-being of a senior in bio-psycho-social context. In total, random selection and testing of 100 seniors (30 males, 70 females) from Prague and Central Bohemian region was provided. The sample was divided by stratified random selection into experimental and control groups, who underwent input and output testing. For diagnostics the methods of Medical Anamnesis, Functional anthropological examinations, Tinetti Balance Assessment Tool, SF-36 Health Survey, Anamnestic comparative self-assessment scale were used. Intervention method called "Life in Balance" based on yoga techniques was applied in four-week cycle. Results of multivariate regression were verified by repeated measures ANOVA: subject factor, phase of intervention (between-subject factor), body fluid (within-subject factor) and phase of intervention × body fluid interaction). ANOVA was performed with a repetition involving the factors of subjects, experimental/control group, phase of intervention (independent variable), and x phase interaction followed by Bonferroni multiple comparison assays with a test strength of at least 0.8 on the probability level p < 0.05. In the paper results of the first-year investigation of the three years running project are analysed. Results of balance tests confirmed no significant difference between females and males in pre-test. Significant improvements in balance and walking ability were observed in experimental group in females comparing to males (F = 128.4, p < 0.001). In the females control group, there was no significant change in post- test, while in the female experimental group positive changes in posture and spine flexibility in post-tests were found. It seems that females even in senior age react better to incentives of intervention in balance and spine flexibility. On the base of results analyses, we can declare the significant improvement in social balance markers after intervention in the experimental group (F = 10.5, p < 0.001). In average, seniors are used to take four drugs daily. Number of drugs can contribute to allergy symptoms and balance problems. It can be concluded that static balance and walking ability of seniors according Tinetti Balance scale correlate significantly with psychic and social monitored markers.Keywords: exercises, balance, seniors 65+, health, mental and social balance
Procedia PDF Downloads 1375882 The Lamination and Arterial Blood Supply of the Masseter Muscle of Camel (Camelus dromedarius)
Authors: Elsyed Fath Khalifa, Samer Mohamed Daghash
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The present study was carried out to investigate the structure of the masseter muscle of camel and its attachments to the skull as well as the relationships with its arterial blood supply. Fourteen heads of clinically healthy camels of different ages and sexes were used in the present investigation. The both common carotid arteries of six specimens were cannulated and flushed with warm normal saline solution (0.9%) then injected with red colored neoprine (60%) latex in order to study the pattern of the blood supply to the masseter muscle. Two heads were injected with an eventually mixture of 75gm red lead oxide in 150cc latex and preserved in a cold room for 3-4 days then divided sagittaly along the median plane to avoid super imposition of the arteries. The arteries of the masseter muscle of each half were radiographed. Four heads were used in manual dissection to describe the laminar arrangement of the masseter muscle. The masseter muscle of the camel was very tendinous and was situated far caudally, which enable the camel to open its jaw very wide. In the camel, the masseter muscle was recognized into proper and improper masseter groups. The proper group included the first, second superficial, intermediate and deep masseter layers. The improper group consisted of maxillo-mandibularis and zygomatico-mandibularis. The remaining two heads were used for clearance.Keywords: anatomy, camel, masseter, lamination, blood supply
Procedia PDF Downloads 3225881 Comprehensive Approach to Enhance Green Buildings in Urban Areas
Authors: M. Pena, J. Shin, H. Park
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The main objective of any engineering activity is the development of a system that fulfills the specific economic, social or environmental needs. Green growth policies, as a system, targets to satisfy two main needs: economic and environmental growth. Cities are complex systems composed of varied characteristics such as differences in socio-environmental conditions and local affordability, among others. Thus, commissioned policies are required to address these differences and to ensure green development. A more maintainable and justifiable, resource-efficient green growth can be obtained in urban areas if multi-criteria framework of policies relevant to green buildings is designed. Reason is that, this approach fits to target the differences and unique conditions of urban areas. By following the principles of axiomatic design, this paper urges to derive a framework for the application of green buildings policies in urban areas with distinctive socio-economic and environmental characteristics. Functional requirements defined as principles to ensure green growth and design parameters are identified in each set of conditions. Design matrices are constructed for each group of urban areas. Thus, the understanding of the needs and differences for each group of urban areas and the methodology to ensure green buildings is achieved.Keywords: axiomatic design, green growth, sustainable development, urban planning
Procedia PDF Downloads 3525880 Effect of Surface-Modification of Indium Tin Oxide Particles on Their Electrical Conductivity
Authors: Y. Kobayashi, T. Kurosaka, K. Yamamura, T. Yonezawa, K. Yamasaki
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The present work reports an effect of surface- modification of indium tin oxide (ITO) particles with chemicals on their electronic conductivity properties. Examined chemicals were polyvinyl alcohol (nonionic polymer), poly(diallyl dimethyl ammonium chloride) (cationic polymer), poly(sodium 4-styrene-sulfonate) (anionic polymer), (2-aminopropyl) trimethoxy silane (APMS) (silane coupling agent with amino group), and (3-mercaptopropyl) trimethoxy silane (MPS) (silane coupling agent with thiol group). For all the examined chemicals, volume resistivities of surface-modified ITO particles did not increase much when they were aged in air at 80 oC, compared to a volume resistivity of un-surface-modified ITO particles. Increases in volume resistivities of ITO particles surface-modified with the silane coupling agents were smaller than those with the polymers, since hydrolysis of the silane coupling agents and condensation of generated silanol and OH groups on ITO particles took place to provide efficient immobilization of them on particles. The APMS gave an increase in volume resistivity smaller than the MPS, since a larger solubility in water of APMS providing a larger amount of APMS immobilized on particles.Keywords: indium tin oxide, particles, surface-modification, volume resistivity
Procedia PDF Downloads 2535879 Implementing Service Innovation in Public Transport Sector: Drivers and Challenges
Authors: Chaoren Lu
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Public policy is playing as one driving force that influencing service innovation implementation in public sector. However, public policy implications cannot be automatically derived from the analyses of innovation issues, and there lacks of researches about the influences of public policy onto innovation. Moreover, innovation in service system is hard to predictable and whether policy encourages or hidden innovation is still lack of study. Especially, by given the context that multiple actors are active involving within the service delivery process in public transport sector, the complex driving forces and challenges are emerged towards the service operation. This study is aim to analysis the service innovation practices within service operating organizations to understand the drivers and challenges of service operation based on policy requirements, and where the innovation idea generating from. The case studies of Changzhou Transit Group and Nanjing Jiangnan Public Transit Group will be launched. This paper reveals the ambidexterity between top-down and bottom-up demands within the public transport service operating organizations contribute to the innovation ideas. Meanwhile, it contributes to the understanding of fundamental elements of service innovation is the new relationship creation and new way of sharing knowledge. The policy contributes to the trigger of creation of such relationship. The research question is: what are the sources of service innovation practices in local public transport system in China in in facing the policy implementation?Keywords: public value, service innovation, public transport service, China
Procedia PDF Downloads 3215878 Re-Emergence of Religious Militancy in Pakistan after Return of Afghan Taliban to Power Corridors in Afghanistan (2021-2022)
Authors: Syed Sibtain Hussain Shah
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The Afghan Taliban returned to power corridors in Afghanistan in August 2021 after waging a twenty-year insurgency in the country. U.S.-led forces completed their withdrawal from Afghanistan on August 30, 2021, but the Taliban took control of the whole country till August 15, 2021. At the same time, some of the militant groups such as Tehrik-e-Taliban Pakistan (TTP) and Islamic State Khurasan (IS-K) reappeared in Pakistan’s borders and other areas and by increasing attacks on the armed forces of Pakistan and minorities communities. These groups once again created a crucial challenge to the internal security of the country. Since mid of 2021, many of the terrorist incidents in the countries specified in the areas of Pakistan bordering Afghanistan were committed by TTP and IS-K. The aim of this paper is to investigate the reappearance of TTP and IS-K in 2021 and 2022 as a crucial threat to the internal security of Pakistan. The author will particularly probe threats to the security of military personnel and their installations and threats to human security, including danger to religious minority communities in the different areas of the country, including border areas such as Waziristan, which was once a hub of TTP and other militant groups in the 2000s. The author will employ the relevant method and appropriate theories of security studies, such as religious extremism and terrorism, in this study. TTP, inspired by the Afghan Taliban, initially emerged in Pakistan in 2007 and this group has so far targeted various religious and ethnic communities and government installations in Pakistan. The group is not only against Pakistan’s government policies, but it also committed terrorist attacks on the communities of the other Muslim sects and as well as non-Muslim communities. Most of the prominent figures of this violent group disappeared or escaped to Afghanistan after military actions, such as the larger “Zarb-e-Azb” operation in Pakistan in 2015. IS-K, which established its branch of Khurasan covering Pakistan and Afghanistan in 2015, with its main formation in Iraq and Syria in 2015, by targeting religious minorities such as Shia Muslims, has so far created a vital security challenge for the security of the country.Keywords: Pakistan, Afghanistan, Afghan Taliban, Pakistani Taliban, Islamic state Khorasan, security threat
Procedia PDF Downloads 1415877 Enablers of Total Quality Management for Social Enterprises: A Study of UAE Social Organizations
Authors: Farhat Sultana
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Originality: TQM principles are considered the tools to enhance organizational performance for most organizations. The paper contributes to the literature on the social enterprise because social organizations are still far behind in implementing TQM as compared to other private, public, and nonprofit organizations. Study design: The study is based on the data and information provided by two case studies and one focus group of social enterprises. Purpose: The purpose of the study is to get a deep understating of TQM implementation and to recognize the enablers of TQM in social enterprises that enhance the organizational performance of social enterprises located in UAE. Findings: As per the findings of the study, key enablers of Total Quality management in the case enterprises are leadership support, strategic approach for quality, continuous improvement, process improvement, employee empowerment and customer focus practices, though some inhibitors for TQM implementation such as managerial structure for quality assurance and performance appraisal mechanism are also pointed out by the study. Research limitations: The study findings are only based on two case studies and one focus group, which is not enough to generalize the findings to all social organizations. Practical Implications: Identified TQM enablers can help management to implement TQM successfully in social enterprises. Social implications: The study provides enabling path for Social enterprises to implement TQM to seek quality output to build a better society.Keywords: TQM, social enterprise, enablers of TQM, UAE
Procedia PDF Downloads 1115876 Combination of Lamotrigine and Duloxetine: A Potential Approach for the Treatment of Acute Bipolar Depression
Authors: Kedar S. Prabhavalkar, Nimmy Baby Poovanpallil
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Lamotrigine is approved for maintenance treatment of bipolar I disorder. However, its role in the treatment of acute bipolar depression is not well clear. Its efficacy in the treatment of major depressive disorders including refractory unipolar depression suggested the use of lamotrigine as an augmentation drug for acute bipolar depression. The present study aims to evaluate and perform a comparative analysis of the therapeutic effects of lamotrigine, an epileptic mood stabilizer, when used alone and in combination with duloxetine in treating acute bipolar depression at different doses of lamotrigine. Male swiss albino mice were used. For evaluation of efficacy of combination, immobility period was analyzed 30 min after the treatment from forced swim and tail suspension tests. Further amount of sucrose consumed in sucrose preference test was estimated. The combination of duloxetine and lamotrigine showed potentiation of antidepressant activity in acute models. Decrease in immobility time and increase in the amount of sucrose consumption in stressed mice were higher in combined group compared to lamotrigine monotherapy group. Brain monoamine levels were also attenuated more with combination compared to monotherapy. Results of the present study suggest potential role of lamotrigine and duloxetine combination in the treatment of acute bipolar depression.Keywords: lamotrigine, duloxetine, acute bipolar depression, augmentation
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