Search results for: non-pharmacological treatment methods
Commenced in January 2007
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Edition: International
Paper Count: 20858

Search results for: non-pharmacological treatment methods

18368 High Unmet Need and Factors Associated with Utilization of Contraceptive Methods among Women from the Digo Community of Kwale, Kenya

Authors: Mochache Vernon, Mwakusema Omar, Lakhani Amyn, El Busaidy Hajara, Temmerman Marleen, Gichangi Peter

Abstract:

Background: Utilization of contraceptive methods has been associated with improved maternal and child health (MCH) outcomes. Unfortunately, there has been sub-optimal uptake of contraceptive services in the developing world despite significant resources being dedicated accordingly. It is imperative to granulate factors that could influence uptake and utilization of contraception. Methodology: Between March and December 2015, we conducted a mixed-methods cross-sectional study among women of reproductive age (18-45 years) from a pre-dominantly rural coastal Kenyan community. Qualitative approaches involved focus group discussions as well as a series of key-informant interviews. We also administered a sexual and reproductive health survey questionnaire at the household level. Results: We interviewed 745 women from 15 villages in Kwale County. The median (interquartile range, IQR) age was 29 (23-37) while 76% reported being currently in a marital union. Eighty-seven percent and 85% of respondents reported ever attending school and ever giving birth, respectively. Respondents who had ever attended school were more than twice as likely to be using contraceptive methods [Odds Ratio, OR = 2.1, 95% confidence interval, CI: 1.4-3.4, P = 0.001] while those who had ever given birth were five times as likely to be using these methods [OR = 5.0, 95% CI: 1.7-15.0, P = 0.004]. The odds were similarly high among women who reported attending antenatal care (ANC) [OR = 4.0, 95% CI: 1.1-14.8, P = 0.04] as well as those who expressly stated that they did not want any more children or wanted to wait longer before getting another child [OR = 6.7, 95% CI: 3.3-13.8, P<0.0001]. Interviewees reported deferring to the ‘wisdom’ of an older maternal figure in the decision-making process. Conclusions: Uptake and utilization of contraceptive methods among Digo women from Kwale, Kenya is positively associated with demand-side factors including educational attainment, previous birth experience, ANC attendance and a negative future fertility desire. Interventions to improve contraceptive services should focus on engaging dominant maternal figures in the community.

Keywords: unmet need, utilization of contraceptive methods, women, Digo community

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18367 Prednisone and Its Active Metabolite Prednisolone Attenuate Lipid Accumulation in Macrophages

Authors: H. Jeries, N. Volkova, C. G. Iglesias, M. Najjar, M. Rosenblat, M. Aviram, T. Hayek

Abstract:

Background: Synthetic forms of glucocorticoids (e.g., prednisone, prednisolone) are anti-inflammatory drugs which are widely used in clinical practice. The role of glucocorticoids (GCs) in cardiovascular diseases including atherosclerosis is highly controversial, and their impact on macrophage foam cell formation is still unknown. Our aim was to investigate the effects of prednisone or its active metabolite, prednisolone, on macrophage oxidative stress and lipid metabolism using in-vivo, ex-vivo and in-vitro systems. Methods: The in-vivo study included C57BL/6 mice which were intraperitoneally injected with prednisone or prednisolone (5mg/kg) for 4 weeks, followed by lipid metabolism analyses in the mice aorta, and in peritoneal macrophages (MPM). In the ex-vivo study, we analyzed the effect of serum samples obtained from 9 healthy volunteers before or after treatment with oral prednisone (20mg for 5 days), on J774A.1 macrophage atherogenicity. In-vitro studies were conducted using J774A.1 macrophages, human monocyte derived macrophages (HMDM) and fibroblasts. Cells were incubated with increasing concentrations (0-200 ng/ml) of prednisone or prednisolone, followed by determination of cellular oxidative status, triglyceride and cholesterol metabolism. Results: Prednisone or prednisolone treatment resulted in a significant reduction in triglycerides and mainly in cholesterol cellular accumulation in MPM or in J774A.1 macrophages incubated with human serum. Similar resulted were noted in HMDM or in J774A.1 macrophages which were directly incubated with the GCs. These effects were associated with GCs inhibitory effect on triglycerides and cholesterol biosynthesis rates, throughout downregulation of diacylglycerol acyltransferase1 (DGAT1) expression, and of the sterol regulatory element binding protein (SREBP2) and HMGCR expression, respectively. In parallel to prednisone or prednisolone induced reduction in macrophage triglyceride content, paraoxonase 2 (PON2) expression was significantly upregulated. GCs-induced reduction of cellular triglyceride and cholesterol mass was mediated by the GCs receptors on macrophages since the GCs receptor antagonist (RU 486) abolished these effects. In fibroblasts, unlike macrophages, prednisone or prednisolone showed no anti-atherogenic effects. Conclusions: Prednisone or prednisolone are anti-atherogenic since they protected macrophages from lipid accumulation and foam cell formation.

Keywords: atherosclerosis, cholesterol, foam cell, macrophage, prednisone, prednisolone, triglycerides

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18366 Barriers to Tuberculosis Detection in Portuguese Prisons

Authors: M. F. Abreu, A. I. Aguiar, R. Gaio, R. Duarte

Abstract:

Background: Prison establishments constitute high-risk environments for the transmission and spread of tuberculosis (TB), given their epidemiological context and the difficulty of implementing preventive and control measures. Guidelines for control and prevention of tuberculosis in prisons have been described as incomplete and heterogeneous internationally, due to several identified obstacles, for example scarcity of human resources and funding of prisoner health services. In Portugal, a protocol was created in 2014 with the aim to define and standardize procedures of detection and prevention of tuberculosis within prisons. Objective: The main objective of this study was to identify and describe barriers to tuberculosis detection in prisons of Porto and Lisbon districts in Portugal. Methods: A cross-sectional study was conducted from 2ⁿᵈ January 2018 till 30ᵗʰ June 2018. Semi-structured questionnaires were applied to health care professionals working in the prisons of the districts of Porto (n=6) and Lisbon (n=8). As inclusion criteria we considered having work experience in the area of tuberculosis (either in diagnosis, treatment, or follow up). The questionnaires were self-administered, in paper format. Descriptive analyses of the questionnaire variables were made using frequencies and median. Afterwards, a hierarchical agglomerative clusters analysis was performed. After obtaining the clusters, the chi-square test was applied to study the association between the variables collected and the clusters. The level of significance considered was 0.05. Results: From the total of 186 health professionals, 139 met the criteria of inclusion and 82 health professionals were interviewed (62,2% of participation). Most were female, nurses, with a median age of 34 years, with term employment contract. From the cluster analysis, two groups were identified with different characteristics and behaviors for the procedures of this protocol. Statistically significant results were found in: elements of cluster 1 (78% of the total participants) work in prisons for a longer time (p=0.003), 45,3% work > 4 years while 50% of the elements of cluster 2 work for less than a year, and more frequently answered they know and apply the procedures of the protocol (p=0.000). Both clusters answered frequently the need of having theoretical-practical training for TB (p=0.000), especially in the areas of diagnosis, treatment and prevention and that there is scarcity of funding to prisoner health services (p=0.000). Regarding procedures for TB screening (periodic and contact screening) and procedures for transferring a prisoner with this disease, cluster 1 also answered more frequently to perform them (p=0.000). They also referred that the material/equipment for TB screening is accessible and available (p=0.000). From this clusters we identified as barriers scarcity of human resources, the need to theoretical-practical training for tuberculosis, inexperience in working in health services prisons and limited knowledge of protocol procedures. Conclusions: The barriers found in this study are the same described internationally. This protocol is mostly being applied in portuguese prisons. The study also showed the need to invest in human and material resources. This investigation bridged gaps in knowledge that could help prison health services optimize the care provided for early detection and adherence of prisoners to treatment of tuberculosis.

Keywords: barriers, health care professionals, prisons, protocol, tuberculosis

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18365 Device for Thermo-Magnetic Depolymerisation of Plant Biomass Prior to Methane Fermentation

Authors: Mirosław Krzemieniewski, Marcin Zieliński, Marcin Dębowski

Abstract:

This publication presents a device for depolymerisation of plant substrates applicable to agricultural biogas plants and closed-chamber sewage treatment plants where sludge fermentation is bolstered with plant mass. The device consists of a tank with a cover equipped with a heating system, an inlet for the substrate, and an outlet for the depolymerised substrate. Within the tank, a magnet shaft encased in a spiral casing is attached, equipped on its upper end with an internal magnetic disc. A motoreducer is mounted on an external magnetic disc located on the centre of the cover. Depolymerisation of the plant substrate allows for substrate destruction at much lower power levels than by conventional means. The temperature within the reactor can be lowered by 40% in comparison to existing designs. During the depolymerisation process, free radicals are generated within the magnetic field, oxidizing the conditioned substrate and promoting biodegradation. Thus, the fermentation time in the fermenters is reduced by approximately 20%.

Keywords: depolymerisation, pre-treatment, biomass, fermentation

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18364 Assessment of Water Reuse Potential in a Metal Finishing Factory

Authors: Efe Gumuslu, Guclu Insel, Gülten Yuksek, Nilay Sayi Ucar, Emine Ubay Cokgor, Tuğba Olmez Hanci, Didem Okutman Tas, Fatoş Germirli Babuna, Derya Firat Ertem, Ökmen Yildirim, Özge Erturan, Betül Kirci

Abstract:

Although water reclamation and reuse are inseparable parts of sustainable production concept all around the world, current levels of reuse constitute only a small fraction of the total volume of industrial effluents. Nowadays, within the perspective of serious climate change, wastewater reclamation and reuse practices should be considered as a requirement. Industrial sector is one of the largest users of water sources. The OECD Environmental Outlook to 2050 predicts that global water demand for manufacturing will increase by 400% from 2000 to 2050 which is much larger than any other sector. Metal finishing industry is one of the industries that requires high amount of water during the manufacturing. Therefore, actions regarding the improvement of wastewater treatment and reuse should be undertaken on both economic and environmental sustainability grounds. Process wastewater can be reused for more purposes if the appropriate treatment systems are installed to treat the wastewater to the required quality level. Recent studies showed that membrane separation techniques may help in solving the problem of attaining a suitable quality of water that allows being recycled back to the process. The metal finishing factory where this study is conducted is one of the biggest white-goods manufacturers in Turkey. The sheet metal parts used in the cookers production have to be exposed to surface pre-treatment processes composed of degreasing, rinsing, nanoceramics coating and deionization rinsing processes, consecutively. The wastewater generating processes in the factory are enamel coating, painting and styrofoam processes. In the factory, the main source of water is the well water. While some part of the well water is directly used in the processes after passing through resin treatment, some portion of it is directed to the reverse osmosis treatment to obtain required water quality for enamel coating and painting processes. In addition to these processes another important source of water that can be considered as a potential water source is rainwater (3660 tons/year). In this study, process profiles as well as pollution profiles were assessed by a detailed quantitative and qualitative characterization of the wastewater sources generated in the factory. Based on the preliminary results the main water sources that can be considered for reuse in the processes were determined as painting and styrofoam processes.

Keywords: enamel coating, painting, reuse, wastewater

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18363 The Influence of Teachers Anxiety-Reducing Strategies on Learners Foreign Language Anxiety

Authors: Fakieh Alrabai

Abstract:

This study investigated the effects on learner anxiety of anxiety-reducing strategies utilized by English as foreign language teachers in Saudi Arabia. The study was conducted in two stages. In the first stage, sources of foreign language anxiety for Saudi learners of English (N = 596) were identified using The Foreign Language Classroom Anxiety Scale (FLCAS). In the second stage, 465 learners who were divided almost equally into two groups (experimental vs. control) and 12 teachers were recruited. Anxiety-reducing strategies were implemented exclusively in the treatment group for approximately eight weeks. FLCAS was used to assess learners’ FL anxiety levels before and after treatment. Statistical analyses (e.g. ANOVA and ANCOVA) were used to evaluate the study findings. These findings revealed that the intervention led to significantly decreased levels of FL anxiety for learners in the experimental group compared with increased levels of anxiety for those in the control group.

Keywords: communication apprehension, EFL teaching/learning, fear of negative evaluation, foreign language anxiety

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18362 Posterior Acetabular Fractures-Optimizing the Treatment by Enhancing Practical Skills

Authors: Olivera Lupescu, Taina Elena Avramescu, Mihail Nagea, Alexandru Dimitriu

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Acetabular fractures represent a real challenge due to their impact upon the long term function of the hip joint, and due to the risk of intra- and peri-operative complications especially that they affect young, active people. That is why treating these fractures require certain skills which must be exercised, regarding the pre-operative planning, as well as the execution of surgery.The authors retrospectively analyse 38 cases with acetabular fractures operated using the posterior approach in our hospital between 01.01.2013- 01.01.2015 for which complete medical records ensure a follow-up of 24 months, in order to establish the main causes of potential errors and to underline the methods for preventing them. This target is included in the Erasmus + project ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery COR-skills’. This paper analyses the pitfalls revealed by these cases, as well as the measures necessary to enhance the practical skills of the surgeons who perform acetabular surgery. Pre-op planning matched the intra and post-operative outcome in 88% of the analyzed points, from 72% at the beginning to 94% in the last case, meaning that experience is very important in treating this injury. The main problems detected for the posterior approach were: nervous complications - 3 cases, 1 of them a complete paralysis of the sciatic nerve, which recovered 6 months after surgery, and in other 2 cases intra-articular position of the screws was demonstrated by post-operative CT scans, so secondary screw removal was necessary in these cases. We analysed this incident, too, due to lack of information about the relationship between the screws and the joint secondary to this approach. Septic complications appeared in 3 cases, 2 superficial and 1 profound (requiring implant removal). The most important problems were the reduction of the fractures and the positioning of the screws so as not to interfere with the the articular space. In posterior acetabular fractures, pre-op complex planning is important in order to achieve maximum treatment efficacy with minimum of risk; an optimal training of the surgeons insisting on the main points of potential mistakes ensure the success of the procedure, as well as a favorable outcome for the patient.

Keywords: acetabular fractures, articular congruency, surgical skills, vocational training

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18361 Effects of Pulsed Electromagnetic and Static Magnetic Fields on Musculoskeletal Low Back Pain: A Systematic Review Approach

Authors: Mohammad Javaherian, Siamak Bashardoust Tajali, Monavvar Hadizadeh

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Objective: This systematic review study was conducted to evaluate the effects of Pulsed Electromagnetic (PEMF) and Static Magnetic Fields (SMG) on pain relief and functional improvement in patients with musculoskeletal Low Back Pain (LBP). Methods: Seven electronic databases were searched by two researchers independently to identify the published Randomized Controlled Trials (RCTs) on the efficacy of pulsed electromagnetic, static magnetic, and therapeutic nuclear magnetic fields. The identified databases for systematic search were Ovid Medline®, Ovid Cochrane RCTs and Reviews, PubMed, Web of Science, Cochrane Library, CINAHL, and EMBASE from 1968 to February 2016. The relevant keywords were selected by Mesh. After initial search and finding relevant manuscripts, all references in selected studies were searched to identify second hand possible manuscripts. The published RCTs in English would be included to the study if they reported changes on pain and/or functional disability following application of magnetic fields on chronic musculoskeletal low back pain. All studies with surgical patients, patients with pelvic pain, and combination of other treatment techniques such as acupuncture or diathermy were excluded. The identified studies were critically appraised and the data were extracted independently by two raters (M.J and S.B.T). Probable disagreements were resolved through discussion between raters. Results: In total, 1505 abstracts were found following the initial electronic search. The abstracts were reviewed to identify potentially relevant manuscripts. Seventeen possibly appropriate studies were retrieved in full-text of which 48 were excluded after reviewing their full-texts. Ten selected articles were categorized into three subgroups: PEMF (6 articles), SMF (3 articles), and therapeutic nuclear magnetic fields (tNMF) (1 article). Since one study evaluated tNMF, we had to exclude it. In the PEMF group, one study of acute LBP did not show significant positive results and the majority of the other five studies on Chronic Low Back Pain (CLBP) indicated its efficacy on pain relief and functional improvement, but one study with the lowest sessions (6 sessions during 2 weeks) did not report a significant difference between treatment and control groups. In the SMF subgroup, two articles reported near significant pain reduction without any functional improvement although more studies are needed. Conclusion: The PEMFs with a strength of 5 to 150 G or 0.1 to 0.3 G and a frequency of 5 to 64 Hz or sweep 7 to 7KHz can be considered as an effective modality in pain relief and functional improvement in patients with chronic low back pain, but there is not enough evidence to confirm their effectiveness in acute low back pain. To achieve the appropriate effectiveness, it is suggested to perform this treatment modality 20 minutes per day for at least 9 sessions. SMFs have not been reported to be substantially effective in decreasing pain or improving the function in chronic low back pain. More studies are necessary to achieve more reliable results.

Keywords: pulsed electromagnetic field, static magnetic field, magnetotherapy, low back pain

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18360 The Use of Semantic Mapping Technique When Teaching English Vocabulary at Saudi Schools

Authors: Mohammed Hassan Alshaikhi

Abstract:

Vocabulary is essential factor of learning and mastering any languages, and it helps learners to communicate with others and to be understood. The aim of this study was to examine whether semantic mapping technique was helpful in terms of improving student's English vocabulary learning comparing to the traditional technique. The students’ age was between 11 and 13 years old. There were 60 students in total who participated in this study. 30 students were in the treatment group (target vocabulary items were taught with semantic mapping). The other 30 students were in the control group (the target vocabulary items were taught by a traditional technique). A t-test was used with the results of pre-test and post-test in order to examine the outcomes of using semantic mapping when teaching vocabulary. The results showed that the vocabulary mastery in the treatment group was increased more than the control group.

Keywords: English language, learning vocabulary, Saudi teachers, semantic mapping, teaching vocabulary strategies

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18359 The Application of Transcranial Direct Current Stimulation (tDCS) Combined with Traditional Physical Therapy to Address Upper Limb Function in Chronic Stroke: A Case Study

Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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18358 Time Estimation of Return to Sports Based on Classification of Health Levels of Anterior Cruciate Ligament Using a Convolutional Neural Network after Reconstruction Surgery

Authors: Zeinab Jafari A., Ali Sharifnezhad B., Mohammad Razi C., Mohammad Haghpanahi D., Arash Maghsoudi

Abstract:

Background and Objective: Sports-related rupture of the anterior cruciate ligament (ACL) and following injuries have been associated with various disorders, such as long-lasting changes in muscle activation patterns in athletes, which might last after ACL reconstruction (ACLR). The rupture of the ACL might result in abnormal patterns of movement execution, extending the treatment period and delaying athletes’ return to sports (RTS). As ACL injury is especially prevalent among athletes, the lengthy treatment process and athletes’ absence from sports are of great concern to athletes and coaches. Thus, estimating safe time of RTS is of crucial importance. Therefore, using a deep neural network (DNN) to classify the health levels of ACL in injured athletes, this study aimed to estimate the safe time for athletes to return to competitions. Methods: Ten athletes with ACLR and fourteen healthy controls participated in this study. Three health levels of ACL were defined: healthy, six-month post-ACLR surgery and nine-month post-ACLR surgery. Athletes with ACLR were tested six and nine months after the ACLR surgery. During the course of this study, surface electromyography (sEMG) signals were recorded from five knee muscles, namely Rectus Femoris (RF), Vastus Lateralis (VL), Vastus Medialis (VM), Biceps Femoris (BF), Semitendinosus (ST), during single-leg drop landing (SLDL) and forward hopping (SLFH) tasks. The Pseudo-Wigner-Ville distribution (PWVD) was used to produce three-dimensional (3-D) images of the energy distribution patterns of sEMG signals. Then, these 3-D images were converted to two-dimensional (2-D) images implementing the heat mapping technique, which were then fed to a deep convolutional neural network (DCNN). Results: In this study, we estimated the safe time of RTS by designing a DCNN classifier with an accuracy of 90 %, which could classify ACL into three health levels. Discussion: The findings of this study demonstrate the potential of the DCNN classification technique using sEMG signals in estimating RTS time, which will assist in evaluating the recovery process of ACLR in athletes.

Keywords: anterior cruciate ligament reconstruction, return to sports, surface electromyography, deep convolutional neural network

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18357 Shared Decision-Making in Holistic Healthcare: Integrating Evidence-Based Medicine and Values-Based Medicine

Authors: Ling-Lang Huang

Abstract:

Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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18356 Possible Role of Fenofibrate and Clofibrate in Attenuated Cardioprotective Effect of Ischemic Preconditioning in Hyperlipidemic Rat Hearts

Authors: Gurfateh Singh, Mu Khan, Razia Khanam, Govind Mohan

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Objective: The present study has been designed to investigate the beneficial role of Fenofibrate & Clofibrate in attenuated the cardioprotective effect of ischemic preconditioning (IPC) in hyperlipidemic rat hearts. Materials & Methods: Experimental hyperlipidemia was produced by feeding high fat diet to rats for a period of 28 days. Isolated langendorff’s perfused normal and hyperlipidemic rat hearts were subjected to global ischemia for 30 min followed by reperfusion for 120 min. The myocardial infarct size was assessed macroscopically using triphenyltetrazolium chloride staining. Coronary effluent was analyzed for lactate dehydrogenase (LDH) and creatine kinase-MB release to assess the extent of cardiac injury. Moreover, the oxidative stress in heart was assessed by measuring thiobarbituric acid reactive substance, superoxide anion generation and reduced form of glutathione. Results: The ischemia-reperfusion (I/R) has been noted to induce oxidative stress by increasing TBARS, superoxide anion generation and decreasing reduced form of glutathione in normal and hyperlipidemic rat hearts. Moreover, I/R produced myocardial injury, which was assessed in terms of increase in myocardial infarct size, LDH and CK-MB release in coronary effluent and decrease in coronary flow rate in normal and hyperlipidemic rat hearts. In addition, the hyperlipidemic rat hearts showed enhanced I/R-induced myocardial injury with high degree of oxidative stress as compared with normal rat hearts subjected to I/R. Four episodes of IPC (5 min each) afforded cardioprotection against I/R-induced myocardial injury in normal rat hearts as assessed in terms of improvement in coronary flow rate and reduction in myocardial infarct size, LDH, CK-MB and oxidative stress. On the other hand, IPC mediated myocardial protection against I/R-injury was abolished in hyperlipidemic rat hearts. However, Treatment with Fenofibrate (100 mg/kg/day, i.p.), Clofibrate (300mg/kg/day, i.p.) as a agonists of PPAR-α have not affected the cardioprotective effect of IPC in normal rat hearts, but its treatment markedly restored the cardioprotective potentials of IPC in hyperlipidemic rat hearts. Conclusion: It is noted that the high degree of oxidative stress produced in hyperlipidemic rat heart during reperfusion and consequent down regulation of PPAR-α may be responsible to abolish the cardioprotective potentials of IPC.

Keywords: Hyperlipidemia, ischemia-reperfusion injury, ischemic preconditioning, PPAR-α

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18355 Direct Displacement-Based Design Procedure for Performance-Based Seismic Design of Structures

Authors: Haleh Hamidpour

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Since the seismic damageability of structures is controlled by the inelastic deformation capacities of structural elements, seismic design of structure based on force analogy methods is not appropriate. In recent year, the basic approach of design codes have been changed from force-based approach to displacement-based. In this regard, a Direct Displacement-Based Design (DDBD) and a Performance-Based Plastic Design (PBPD) method are proposed. In this study, the efficiency of these two methods on seismic performance of structures is evaluated through a sample 12-story reinforced concrete moment frame. The building is designed separately based on the DDBD and the PBPD methods. Once again the structure is designed by the traditional force analogy method according to the FEMA P695 regulation. Different design method results in different structural elements. Seismic performance of these three structures is evaluated through nonlinear static and nonlinear dynamic analysis. The results show that the displacement-based design methods accommodate the intended performance objectives better than the traditional force analogy method.

Keywords: direct performance-based design, ductility demands, inelastic seismic performance, yield mechanism

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18354 Disability, Stigma and In-Group Identification: An Exploration across Different Disability Subgroups

Authors: Sharmila Rathee

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Individuals with disability/ies often face negative attitudes, discrimination, exclusion, and inequality of treatment due to stigmatization and stigmatized treatment. While a significant number of studies in field of stigma suggest that group-identification has positive consequences for stigmatized individuals, ironically very miniscule empirical work in sight has attempted to investigate in-group identification as a coping measure against stigma, humiliation and related experiences among disability group. In view of death of empirical research on in-group identification among disability group, through present work, an attempt has been made to examine the experiences of stigma, humiliation, and in-group identification among disability group. Results of the study suggest that use of in-group identification as a coping strategy is not uniform across members of disability group and degree of in-group identification differs across different sub-groups of disability groups. Further, in-group identification among members of disability group depends on variables like degree and impact of disability, factors like onset of disability, nature, and visibility of disability, educational experiences and resources available to deal with disabling conditions.

Keywords: disability, stigma, in-group identification, social identity

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18353 Corrosion of Concrete Reinforcing Steel Bars Tested and Compared Between Various Protection Methods

Authors: P. van Tonder, U. Bagdadi, B. M. D. Lario, Z. Masina, T. R. Motshwari

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This paper analyses how concrete reinforcing steel bars corrode and how it can be minimised through the use of various protection methods against corrosion, such as metal-based paint, alloying, cathodic protection and electroplating. Samples of carbon steel bars were protected, using these four methods. Tests performed on the samples included durability, electrical resistivity and bond strength. Durability results indicated relatively low corrosion rates for alloying, cathodic protection, electroplating and metal-based paint. The resistivity results indicate all samples experienced a downward trend, despite erratic fluctuations in the data, indicating an inverse relationship between electrical resistivity and corrosion rate. The results indicated lowered bond strengths when the reinforced concrete was cured in seawater compared to being cured in normal water. It also showed that higher design compressive strengths lead to higher bond strengths which can be used to compensate for the loss of bond strength due to corrosion in a real-world application. In terms of implications, all protection methods have the potential to be effective at resisting corrosion in real-world applications, especially the alloying, cathodic protection and electroplating methods. The metal-based paint underperformed by comparison, most likely due to the nature of paint in general which can fade and chip away, revealing the steel samples and exposing them to corrosion. For alloying, stainless steel is the suggested material of choice, where Y-bars are highly recommended as smooth bars have a much-lowered bond strength. Cathodic protection performed the best of all in protecting the sample from corrosion, however, its real-world application would require significant evaluation into the feasibility of such a method.

Keywords: protection methods, corrosion, concrete, reinforcing steel bars

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18352 Mentor and Mentee Based Learning

Authors: Erhan Eroğlu

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This paper presents a new method called Mentor and Mentee Based Learning. This new method is becoming more and more common especially at workplaces. This study is significant as it clearly underlines how it works well. Education has always aimed at equipping people with the necessary knowledge and information. For many decades it went on teachers’ talk and chalk methods. In the second half of the nineteenth century educators felt the need for some changes in delivery systems. Some new terms like self- discovery, learner engagement, student centered learning, hands on learning have become more and more popular for such a long time. However, some educators believe that there is much room for better learning methods in many fields as they think the learners still cannot fulfill their potential capacities. Thus, new systems and methods are still being developed and applied at education centers and work places. One of the latest methods is assigning some mentors for the newly recruited employees and training them within a mentor and mentee program which allows both parties to see their strengths and weaknesses and the areas which can be improved. This paper aims at finding out the perceptions of the mentors and mentees on the programs they are offered at their workplaces and suggests some betterment alternatives. The study has been conducted via a qualitative method whereby some interviews have been done with both mentors and mentees separately and together. Results show that it is a great way to train inexperienced one and also to refresh the older ones. Some points to be improved have also been underlined. The paper shows that education is not a one way path to follow.

Keywords: learning, mentor, mentee, training

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18351 Biological Treatment of a Mixture of Iodine-Containing Aromatic Compounds from Industrial Wastewaster

Authors: A. Elain, M. Le Fellic, A. Le Pemp, N. Hachet

Abstract:

Iodinated Compounds (IC) are widely detected contaminants in most aquatic environments including sewage treatment plant, surface water, ground water and even drinking water, up to the µg.L-1 range. As IC contribute in the adsorbable organic halides (AOX) level, their removal or dehalogenation is expected. We report here on the biodegradability of a mixture of IC from an industrial effluent using a microbial consortium adapted to grow on IC as well as the native microorganisms. Both aerobic and anaerobic treatments were studied during batch experiments in 500-mL flasks. The degree of mineralization and recovery of iodide were monitored by HPLC-UV, TOC analysis and potentiometric titration. Providing ethanol as an electron acceptor was found to stimulate anaerobic reductive deiodination of IC while sodium chloride even at high concentration (22 g.l-1) had no influence on the degradation rates nor on the microbial viability. Phylogenetic analysis of 16S RNA gene sequence (MicroSeq®) was applied to provide a better understanding of the degradative microbial community.

Keywords: iodinated compounds, biodegradability, deiodination, electron-accepting conditions, microbial consortium

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18350 The Rupture Potential of Nerve Tissue Constrained Intracranial Saccular Aneurysm

Authors: M. Alam, P. Seshaiyer

Abstract:

The rupture predictability of intracranial aneurysm is one of the most important parameters for physicians in surgical treatment. As most of the intracranial aneurysms are asymptomatic, still the rupture potential of both symptomatic and asymptomatic lesions is relatively unknown. Moreover, an intracranial aneurysm constrained by a nerve tissue might be a common scenario for a physician to deal with during the treatment process. Here, we perform a computational modeling of nerve tissue constrained intracranial saccular aneurysm to show a protective role of constrained tissue on the aneurysm. A comparative parametric study of the model also performs taking long constraint, medium constraint, short constraint, point contact, narrow neck aneurysm, wide neck aneurysm as parameters for the analysis. Results show that contact constraint aneurysm generates less stress near the fundus compared to no constraint aneurysm, hence works as a protective wall for the aneurysm not to be ruptured.

Keywords: rupture potential, intracranial saccular aneurysm, anisotropic hyper-elastic material, finite element analysis

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18349 Effect of Silver Diamine Fluoride on Reducing Fungal Adhesion on Dentin

Authors: Rima Zakzouk, Noriko Hiraishi, Mohamed Mahdi Alshahni, Koichi Makimura, Junji Tagami

Abstract:

Background and Purpose: Silver diamine fluoride (SDF) is used to prevent and arrest dental caries. The aim of this study is to evaluate the effect of SDF on reducing Candida albicans adhesion on dentin. Materials and Methods: Bovine dentin disks (6×6 mm) were cut by Isomet and polished using grit silicon carbide papers down to 2000 in order to obtain flat dentin surfaces. Samples were divided into two groups. The first group (SDF group) was treated with 38% SDF for 3 min, while the other group (control group) did not undergo SDF treatment. All samples were exposed to C. albicans suspension, washed after 6 hours incubation at 30 °C before to be tested using XTT (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) and real time PCR approaches. Statistical analyses of the results were performed at the significance level α = 0.05. Results: SDF inhibited C. albicans adhesion onto dentin. A significant difference was found between the SDF and control groups in both XTT and real time PCR tests. Conclusion: Using SDF to arrest the caries, could inhibit the Candida growth on dentin.

Keywords: silver diamine fluoride, dentin, real time PCR, XTT

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18348 Review of Research on Effectiveness Evaluation of Technology Innovation Policy

Authors: Xue Wang, Li-Wei Fan

Abstract:

The technology innovation has become the driving force of social and economic development and transformation. The guidance and support of public policies is an important condition to promote the realization of technology innovation goals. Policy effectiveness evaluation is instructive in policy learning and adjustment. This paper reviews existing studies and systematically evaluates the effectiveness of policy-driven technological innovation. We used 167 articles from WOS and CNKI databases as samples to clarify the measurement of technological innovation indicators and analyze the classification and application of policy evaluation methods. In general, technology innovation input and technological output are the two main aspects of technological innovation index design, among which technological patents are the focus of research, the number of patents reflects the scale of technological innovation, and the quality of patents reflects the value of innovation from multiple aspects. As for policy evaluation methods, statistical analysis methods are applied to the formulation, selection and evaluation of the after-effect of policies to analyze the effect of policy implementation qualitatively and quantitatively. The bibliometric methods are mainly based on the public policy texts, discriminating the inter-government relationship and the multi-dimensional value of the policy. Decision analysis focuses on the establishment and measurement of the comprehensive evaluation index system of public policy. The economic analysis methods focus on the performance and output of technological innovation to test the policy effect. Finally, this paper puts forward the prospect of the future research direction.

Keywords: technology innovation, index, policy effectiveness, evaluation of policy, bibliometric analysis

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18347 Effect of a Single Injection of hCG on Testosterone Concentration in Male Alpacas

Authors: A. ElZawam, D. McLean, A. Tibary

Abstract:

In alpaca, age at puberty is variable and the factors regulating the pattern of puberty and sexual maturation are a subject of controversy. Plasma testosterone level is often used as an indicator of sexual maturity. Our hypothesis is that hCG treatment will cause an increase in testosterone level that is correlated with animal age. The specific aim was to investigate the testicular tissue response to a single hCG injection by monitoring the serum testosterone concentration. Eighty four (n=84) males ranging in age from 6 to 60 months were used. Alpacas were grouped based on their ages into 15 groups. Each group had three to five male animals. Blood samples were collected from the jugular vein before treatment with hCG and 2 hours after intravenous administration of 3000 IU of hCG (Chorulon®). The serum was harvested and stored at -20ºC until the analysis. The effect of age on basal testosterone level and response to hCG treatment was evaluated by Analysis of Variance. As a result, basal serum testosterone concentrations were very low (<0.1ng/ml) until 9 months of age. Although basal serum testosterone concentrations increased steadily with age there was a significant variation amongst males within the same age group. Administration of 3000 IU of hCG, resulted in an average increase of 50% (P<0.05) in serum testosterone concentration after 2 hours. The percentage increase in serum testosterone in response to hCG stimulation varied from 51 to 81%. There was no correlation between the degree of response and age. However, the response to hCG injection presented two modes of increase depending on the age of animals. The first mode occurred at ages 9 to 14 months and the second mode was observed between 22 and 36 months. In conclusion, our results suggest that testicular growth and sensitivity to LH stimulation may be bimodal in the male alpaca with a rapid increase in growth and sensitivity between 9 and 14 months of age and a second phase of increased responsiveness after 21 months of ages.

Keywords: alpaca, testosterone, hCG, animal science

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18346 Organic Matter Removal in Urban and Agroindustry Wastewater by Chemical Precipitation Process

Authors: Karina Santos Silvério, Fátima Carvalho, Maria Adelaide Almeida

Abstract:

The impacts caused by anthropogenic actions on the water environment have been one of the main challenges of modern society. Population growth, added to water scarcity and climate change, points to a need to increase the resilience of production systems to increase efficiency regarding the management of wastewater generated in the different processes. Based on this context, the study developed under the NETA project (New Strategies in Wastewater Treatment) aimed to evaluate the efficiency of the Chemical Precipitation Process (CPP), using the hydrated lime (Ca(OH )₂) as a reagent in wastewater from the agroindustry sector, namely swine wastewater, slaughterhouse and urban wastewater, in order to make the productive means 100% circular, causing a direct positive impact on the environment. The purpose of CPP is to innovate in the field of effluent treatment technologies, as it allows rapid application and is economically profitable. In summary, the study was divided into four main stages: 1) Application of the reagent in a single step, raising the pH to 12.5 2) Obtaining sludge and treated effluent. 3) Natural neutralization of the effluent through Carbonation using atmospheric CO₂. 4) Characterization and evaluation of the feasibility of the chemical precipitation technique in the treatment of different wastewaters through the technique of determining the chemical oxygen demand (COD) and other supporting physical-chemical parameters. The results showed an approximate average removal efficiency above 80% for all effluents, highlighting the swine effluent with 90% removal, followed by urban effluent with 88% and slaughterhouse with 81% on average. Significant improvement was also obtained with regard to color and odor removal after Carbonation to pH 8.00.

Keywords: agroindustry wastewater, urban wastewater, natural carbonatation, chemical precipitation technique

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18345 Improvement in Properties of Ni-Cr-Mo-V Steel through Process Control

Authors: Arnab Majumdar, Sanjoy Sadhukhan

Abstract:

Although gun barrel steels are an important variety from defense view point, available literatures are very limited. In the present work, an IF grade Ni-Cr-Mo-V high strength low alloy steel is produced in Electric Earth Furnace-ESR Route. Ingot was hot forged to desired dimension with a reduction ratio of 70-75% followed by homogenization, hardening and tempering treatment. Sample chemistry, NMIR, macro and micro structural analyses were done. Mechanical properties which include tensile, impact, and fracture toughness were studied. Ultrasonic testing was done to identify internal flaws. The existing high strength low alloy Ni-Cr-Mo-V steel shows improved properties in modified processing route and heat treatment schedule in comparison to properties noted earlier for manufacturing of gun barrels. The improvement in properties seems to withstand higher explosive loads with the same amount of steel in gun barrel application.

Keywords: gun barrel steels, IF grade, chemistry, physical properties, thermal and mechanical processing, mechanical properties, ultrasonic testing

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18344 Effect of Unilateral Unoperated Ovarian Endometrioma on Responsiveness to Hyperstimulation

Authors: Abdelmaguid Ramzy, Mohamed Bahaa

Abstract:

Introduction: The effects of ovarian endometrioma on fertility outcomes with IVF have been always related to poor outcomes. Objective: To evaluate the effect of unilateral unoperated ovarian endometrioma < 2cm on the number of developing follicles and compare them with the contralateral ovary as a control. Design: Retrospective case control study. Setting: KasrEl-Aini IVF center. Patient(s): We studied 32 women with unilateral endometrioma who underwent their first IVF cycle. Methods: 32 Patients aged between 20-35 years selected for IVF who were diagnosed with one unilateral endometrioma (diameter <2 cm) and who did not undergo previous ovarian surgery were retrospectively identified. The number of follicles > 17 mm during folliculometry on the day of HCG trigger in the ovary that contained endometrioma were compared with those from the contralateral ovary. They were all hyperstimulated using long protocol with (225-300 IU) gonadotrophins. Primary outcome: The number of follicles > 17 mm during folliculometry on the day of HCG trigger. Result(s): The mean ± SD age, Day 3 serum FSH and LH were 27± 3.7 years, 5.8 ± 1.6 IU/ml and 4.5 ± 1.7 IU/ml respectively. There was no significant difference in the number of follicles > 17 mm on the day of HCG trigger in the ovary that contained endometrioma (4.4 ±2.5) and in the opposite ovary (4.5 ± 2.8) (P= 0.48). Conclusion: The presence of ovarian endometrioma in a controlled ovarian hyperstimulation cycle for IVF treatment is not associated with a reduced number of follicles > 17 mm during folliculometry on the day of HCG trigger.

Keywords: endometrioma, folliculometry, hyperstimulation, fertility

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18343 Bioremediation of PAHs-Contaminated Soil Using Land Treatment Processes

Authors: Somaye Eskandary

Abstract:

Polycyclic aromatic hydrocarbons (PAHs) are present in crude oil and its derivatives contaminate soil and also increase carcinogen and mutagen contamination, which is a concern for researchers. Land farming is one of the methods that remove pollutants from the soil by native microorganisms. It seems that this technology is cost-effective, environmentally friendly and causes less debris problem to be disposed. This study aimed to refine the polycyclic aromatic hydrocarbons from oil-contaminated soil using the land farming method. In addition to examine the concentration of polycyclic aromatic hydrocarbons by GC-FID, some characteristics such as soil microbial respiration and dehydrogenase, peroxidase, urease, acid and alkaline phosphatase enzyme concentration were also measured. The results showed that after land farming process the concentrations of some polycyclic aromatic hydrocarbons dropped to 50 percent. The results showed that the enzyme concentration is reduced by reducing the concentration of hydrocarbons and microbial respiration. These results emphasize the process of land farming for removal of polycyclic aromatic hydrocarbons from soil by indigenous microorganisms.

Keywords: soil contamination, gas chromatography, native microorganisms, soil enzymes, microbial respiration, carcinogen

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18342 Effects of X and + Tail-Body Configurations on Hydrodynamic Performance and Stability of an Underwater Vehicle

Authors: Kadri Koçer, Sezer Kefeli

Abstract:

This paper proposes a comparison of hydrodynamic performance and stability characteristic for an underwater vehicle which has two type of tail design, namely X and +tail-body configurations. The effects of these configurations on the underwater vehicle’s hydrodynamic performance and maneuvering characteristic will be investigated comprehensively. Hydrodynamic damping coefficients for modeling the motion of the underwater vehicles will be predicted. Additionally, forces and moments due to control surfaces will be compared using computational fluid dynamics methods. In the aviation, the X tail-body configuration is widely used for high maneuverability requirements. However, in the underwater, the + tail-body configuration is more commonly used than the X tail-body configuration for its stability characteristics. Thus it is important to see the effect and differences of the tail designs in the underwater world. For CFD analysis, the incompressible, three-dimensional, and steady Navier-Stokes equations will be used to simulate the flows. Also, k-ε Realizable turbulence model with enhanced wall treatment will be taken. Numerical results is verified with experimental results for verification. The overall goal of this study is to present the advantages and disadvantages of hydrodynamic performance and stability characteristic for X and + tail-body configurations of the underwater vehicle.

Keywords: maneuverability, stability, CFD, tail configuration, hydrodynamic design

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18341 Impact of Prolonged Sodium Hypochlorite Cleaning on Silicon Carbide Ultrafiltration Membranes Prepared via Low-Pressure Chemical Vapor Deposition

Authors: Asif Jan

Abstract:

Sodium hypochlorite (NaClO) is a common cleaning agent for ultrafiltration (UF) membranes. While its detrimental effects on polymeric membranes are well-documented, its impact on ceramic membranes remains less explored. This study investigates the chemical stability of silicon carbide (SiC) UF membranes prepared using low-pressure chemical vapor deposition (LP-CVD) during prolonged NaClO exposure. SiC UF membranes were fabricated via LP-CVD at two different temperature and pressure conditions. LP-CVD offers the advantage of SiC membrane fabrication at significantly lower temperatures (700-900°C) compared to conventional methods. The membranes were subjected to 200 hours of NaClO aging to assess their resilience. Before and after aging, we evaluated the properties and performance of the SiC UF membranes to identify optimal LP-CVD conditions. Our findings show that SiC UF membranes produced at 860°C via LP-CVD exhibit exceptional resistance to NaClO aging, whereas those prepared at 750°C experience significant deterioration. This highlights the crucial role of precise LP-CVD parameters in ensuring the robustness and long-term performance of SiC membranes in harsh chemical cleaning environments.

Keywords: ceramic membranes, ultrafiltration membranes, wastewater treatment, chemical vapor deposition

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18340 The Role Support Groups Play in Decreasing Depression and PTSD in Cancer Survivors: A Literature Review

Authors: Julianne Macmullen

Abstract:

Due to advances in technology and early detection and treatment of cancer, many cancer patients are surviving longer than five years post-diagnosis. Most cancer patients suffer from depression, anxiety, and post-traumatic stress disorder (PTSD) at some point during diagnosis, treatment, and survivorship. A subgroup of patients will continue to suffer from depression and PTSD and require early intervention. Support groups provide patients with the emotional and informational support they require while also giving survivors a sense of community, friendship, and purpose. This type of support is recognized by researchers to improve the quality of life while also decreasing depression and PTSD symptoms. The gaps in the literature include cultural diversity, minorities, and support groups involving cancer types other than breast cancer. Another gap in the literature includes the perceptions of cancer patients as well as longitudinal studies to determine the relationships between support groups and decreased depression and PTSD rates over time. Future research is required to fill the gaps in the literature mentioned previously. Future research is also needed to analyze the difference in age groups and different types of support groups such as professionally-led, peer-led, and online. Implications for practice involve providers assessing for the symptoms of depression and PTSD in order to offer prompt treatment and support services to those patients. In conclusion, social support by way of support groups improves the quality of life, gives survivors a sense of purpose to help others while also gaining the support they need, and reduces the rate of depressive episodes related to PTSD.

Keywords: cancer survivor, survivorship, post-traumatic stress disorder (PTSD), depression, support groups

Procedia PDF Downloads 161
18339 Comparing the Gap Formation around Composite Restorations in Three Regions of Tooth Using Optical Coherence Tomography (OCT)

Authors: Rima Zakzouk, Yasushi Shimada, Yuan Zhou, Yasunori Sumi, Junji Tagami

Abstract:

Background and Purpose: Swept source optical coherence tomography (OCT) is an interferometric imaging technique that has been recently used in cariology. In spite of progress made in adhesive dentistry, the composite restoration has been failing due to secondary caries which occur due to environmental factors in oral cavities. Therefore, a precise assessment to effective marginal sealing of restoration is highly required. The aim of this study was evaluating gap formation at composite/cavity walls interface with or without phosphoric acid etching using SS-OCT. Materials and Methods: Round tapered cavities (2×2 mm) were prepared in three locations, mid-coronal, cervical, and root of bovine incisors teeth in two groups (SE and PA Groups). While self-etching adhesive (Clearfil SE Bond) was applied for the both groups, Group PA had been already pretreated with phosphoric acid etching (K-Etchant gel). Subsequently, both groups were restored by Estelite Flow Quick Flowable Composite Resin. Following 5000 thermal cycles, three cross-sectionals were obtained from each cavity using OCT at 1310-nm wavelength at 0°, 60°, 120° degrees. Scanning was repeated after two months to monitor the gap progress. Then the average percentage of gap length was calculated using image analysis software, and the difference of mean between both groups was statistically analyzed by t-test. Subsequently, the results were confirmed by sectioning and observing representative specimens under Confocal Laser Scanning Microscope (CLSM). Results: The results showed that pretreatment with phosphoric acid etching, Group PA, led to significantly bigger gaps in mid-coronal and cervical compared to SE group, while in the root cavity no significant difference was observed between both groups. On the other hand, the gaps formed in root’s cavities were significantly bigger than those in mid-coronal and cervical within the same group. This study investigated the effect of phosphoric acid on gap length progress on the composite restorations. In conclusions, phosphoric acid etching treatment did not reduce the gap formation even in different regions of the tooth. Significance: The cervical region of tooth was more exposing to gap formation than mid-coronal region, especially when we added pre-etching treatment.

Keywords: image analysis, optical coherence tomography, phosphoric acid etching, self-etch adhesives

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