Search results for: fluid therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3966

Search results for: fluid therapy

3726 Two Cases of VACTERL Association in Pregnancy with Lymphocyte Therapy

Authors: Seyed Mazyar Mortazavi, Masod Memari, Hasan Ali Ahmadi, Zhaleh Abed

Abstract:

Introduction: VACTERL association is a rare disorder with various congenital malformations. The aetiology remains unknown. Combination of at least three congenital anomalies of the following criteria is required for diagnosis: vertebral defects, anal atresia, cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and limb defects. Case presentation: The first case was 1-day old male neonate with multiple congenital anomalies was bore from 28 years old mother. The mother had history of pregnancy with lymphocyte therapy. His anomalies included: defects in thoracic and lumbar vertebral, anal atresia, bilateral hydronephrosis, atrial septal defect, and lower limb abnormality. Other anomalies were cryptorchidism and nasal canal narrowing. The second case was born with 32 weeks gestational age from mother with history of pregnancy with lymphocyte therapy. He had thoracic vertebral defect, cardiac anomalies and renal defect. Conclusion: diagnosis based on clinical finding is VACTERL association. Early diagnosis is very important to investigation and treatment of other coexistence anomalies. VACTERL association in mothers with history of pregnancy with lymphocyte therapy has suggested possibly of relationship between VACTERL association and this method of pregnancy.

Keywords: anal atresia, tracheo-esophageal fistula, atrial septal defect, lymphocyte therapy

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3725 The Empowerment of Reminiscence Group Play Therapy for Older People in Taiwan

Authors: Jiun-De Lin

Abstract:

The main purpose of this study was to investigate the empowerment effect of the older people through a structured reminiscence play therapeutic group program in Changhua county of Taiwan. This program was used Taiwanese traditional culture as the main concept based on the topic of reminiscence. In order to assimilate into the process for older people, thematic group activities were easy to operate. During the reminiscence play activities, they would improve their personal control and competence, the same as empowerment. A counselor who acted as a group leader led 10 elderly people participated in this reminiscence group play therapy. The participants of the study were 10 older people consisting of 7 males and 3 females who lived in a rehabilitation center in Changhua county of Taiwan. The participants’ average age was 72.5 years old. The study adopted the methods of survey research and the instruments in this study included subjects’ demographic information and the empowerment inventory for adults. A one-group pretest-posttest design was adopted by researchers to test the study hypothesis. The collected data were analyzed by descriptive statistics, and Wilcoxon matched paired signed-ranks test. The main finding of this study was that the reminiscence group play therapy had a significant effect (Z= 2.382, p < .05) to promote the state of empowerment of older people participated in this group play therapy. Based on the conclusion of this study, the suggestions and implications were proposed for the practices and future research.

Keywords: empowerment, group play therapy, older people, reminiscence

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3724 Treatment of Papillary Thyroid Carcinoma Metastasis to the Sternum: A Case Report

Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

Abstract:

Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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3723 Effect of Radiation on Magnetohydrodynamic Two Phase Stenosed Arterial Blood Flow with Heat and Mass Transfer

Authors: Bhavya Tripathi, Bhupendra Kumar Sharma

Abstract:

In blood, the concentration of red blood cell varies with the arterial diameter. In the case of narrow arteries, red blood cells concentrate around the center of the artery and there exists a cell-free plasma layer near the arterial wall due to Fahraeus-Lindqvist effect. Due to non- uniformity of the fluid in the narrow arteries, it is preferable to consider the two-phase model of the blood flow. In the present article, coupled nonlinear differential equations have been developed for momentum, energy and concentration of two phase model of the blood flow assuming the Newtonian fluid in both central core and cell free plasma layer and the exact solutions have been found for the problem. For having an adequate insight into the stenosed arterial two-phase blood flow, major components of the flow as flow resistance, total flow rate, and wall shear stress have been estimated for different values of magnetic and radiation parameter. Results show that the increase in the effects of magnetic field decreases the velocity of both cores as well as plasma regions. This result can be helpful to control the blood flow in narrow arteries during surgical process. Temperature of core as well plasma regions decrease as value of radiation parameter increases. The present result is implemented in the form of radiation therapy which is very helpful for cancer patients.

Keywords: two phase blood flow, radiation, magnetohydrodynamics (MHD), stenosis

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3722 The Superhydrophobic Surface Effect on Laminar Boundary Layer Flows

Authors: Chia-Yung Chou, Che-Chuan Cheng, Chin Chi Hsu, Chun-Hui Wu

Abstract:

This study investigates the fluid of boundary layer flow as it flows through the superhydrophobic surface. The superhydrophobic surface will be assembled into an observation channel for fluid experiments. The fluid in the channel will be doped with visual flow field particles, which will then be pumped by the syringe pump and introduced into the experimentally observed channel through the pipeline. Through the polarized light irradiation, the movement of the particles in the channel is captured by a high-speed camera, and the velocity of the particles is analyzed by MATLAB to find out the particle velocity field changes caused on the fluid boundary layer. This study found that the superhydrophobic surface can effectively increase the velocity near the wall surface, and the faster with the flow rate increases. The superhydrophobic surface also had longer the slip length compared with the plan surface. In the calculation of the drag coefficient, the superhydrophobic surface produces a lower drag coefficient, and there is a more significant difference when the Re reduced in the flow field.

Keywords: hydrophobic, boundary layer, slip length, friction

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3721 Contributions at the Define of the Vortex Plane Cyclic Motion

Authors: Petre Stan, Marinica Stan

Abstract:

In this paper, a new way to define the vortex plane cyclic motion is exposed, starting from the physical cause of reacting the vortex. The Navier-Stokes equations are used in cylindrical coordinates for viscous fluids in laminar motion, and are integrated in case of a infinite long revolving cylinder which rotates around a pintle in a viscous fluid that occupies the entire space up to infinite. In this way, a revolving field of velocities in fluid is obtained, having the shape of a vortex in which the intensity is obtained objectively, being given by the physical phenomenon that generates this vortex.

Keywords: cylindrical coordinates, Navier-Stokes equations, viscous fluid, vortex plane

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3720 Investigation on Porcine Follicular Fluid Protein Pattern of Medium and Large Follicles

Authors: Hatairuk Tungkasen, Somrudee Phetchrid, Suwapat Jaidee, Supinya Yoomak, Chantana Kankamol, Mayuree Pumipaiboon, Mayuva Areekijseree

Abstract:

Ovaries of reproductive female pigs were obtained from local slaughterhouses in Nakorn Pathom Province, Thailand. Follicular fluid of medium follicle (5-6 diameters) and large follicles (7-8 mm and 10 mm in diameter) were aspirated and collected by sterile technique and analyzed protein pattern. The follicular fluid protein bands were found by SDS-PAGE which has no protein band in difference compared to standard protein band. So we chose protein band molecular weight 50, 62-65, 75-80, 90, 120-160, and >220 kDa were analyzed by LC/MS/MS. The result was found immunoglobulin gamma chain, keratin, transferrin, heat shock protein, and plasminogen precursor, ceruloplasmin, and hemopexin, and protease, respectively. All proteins play important roles in promotion and regulation on growth and development of reproductive cells. The result of this study found many proteins which were useful and important for in vitro oocyte maturation and embryonic development of cell technology in animals. The further study will be use porcine follicular fluid protein of medium and large follicles as feeder cells in in vitro condition to promote oocyte and embryo maturation.

Keywords: follicular fluid protein, LC/MS/MS, porcine oocyte, SDS-PAGE

Procedia PDF Downloads 558
3719 Simulation of Nano Drilling Fluid in an Extended Reach Well

Authors: Lina Jassim, Robiah Yunus, , Amran Salleh

Abstract:

Since nano particles have been assessed as thermo stabilizer, rheology enhancer, and ecology safer, nano drilling fluid can be utilized to overcome the complexity of hole cleaning in highly deviated interval of an extended reach wells. The eccentric annular flow is a flow with special considerations; it forms a vital part of drilling fluid flow analysis in an extended reach wells. In this work eccentric, dual phase flow (different types of rock cuttings with different size were blended with nano fluid) through horizontal well (an extended reach well) are simulated with the help of CFD, Fluent package. In horizontal wells flow occurs in an adverse pressure gradient condition, that makes the particle inside it susceptible to reversed flow. Thus the flow has to be analyzed in a three dimensional manner. Moreover the non-Newtonian behavior of the nano fluid makes the problem really challenging in numerical and physical aspects. The primary objective of the work is to establish a relationship between different flow characteristics with the speed of inner wall rotation. The nano fluid flow characteristics include swirl of flow and its effect on wellbore cleaning ability , wall shear stress and its effect on fluid viscosity to suspend and carry the rock cuttings, axial velocity and its effect on transportation of rock cuttings to the wellbore surface, finally pressure drop and its effect on managed of drilling pressure. The importance of eccentricity of the inner cylinder has to be analyzed as a part of it. Practical horizontal well flows contain a good amount of particles (rock cuttings) with moderate axial velocity, which verified nano drilling fluid ability of carrying and transferring cuttings particles in the highly deviated eccentric annular flow is also of utmost importance.

Keywords: Non-Newtonian, dual phase, eccentric annular, CFD

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3718 Large Eddy Simulations for Flow Blurring Twin-Fluid Atomization Concept Using Volume of Fluid Method

Authors: Raju Murugan, Pankaj S. Kolhe

Abstract:

The present study is mainly focusing on the numerical simulation of Flow Blurring (FB) twin fluid injection concept was proposed by Ganan-Calvo, which involves back flow atomization based on global bifurcation of liquid and gas streams, thus creating two-phase flow near the injector exit. The interesting feature of FB injector spray is an insignificant effect of variation in atomizing air to liquid ratio (ALR) on a spray cone angle. Besides, FB injectors produce a nearly uniform spatial distribution of mean droplet diameter and are least susceptible to variation in thermo-physical properties of fuels, making it a perfect candidate for fuel flexible combustor development. The FB injector working principle has been realized through experimental flow visualization techniques only. The present study explores potential of ANSYS Fluent based Large Eddy Simulation(LES) with volume of fluid (VOF) method to investigate two-phase flow just upstream of injector dump plane and spray quality immediate downstream of injector dump plane. Note that, water and air represent liquid and gas phase in all simulations and ALR is varied by changing the air mass flow rate alone. Preliminary results capture two phase flow just upstream of injector dump plane and qualitative agreement is observed with the available experimental literature.

Keywords: flow blurring twin fluid atomization, large eddy simulation, volume of fluid, air to liquid ratio

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3717 Transient Response of Rheological Properties of a CI-Water Based Magnetorheological Fluid under Different Operating Modes

Authors: Chandra Shekhar Maurya, Chiranjit Sarkar

Abstract:

The transient response of rheological properties of a carbonyl iron (CI)-water-based magnetorheological fluid (MRF) was studied under shear rate, shear stress, and shear strain working mode subjected to step-change in an applied magnetic field. MR fluid is a kind of smart material whose rheological properties change under an applied magnetic field. We prepared an MR fluid comprising of CI 65 weight %, water 35 weight %, and OPTIGEL WX used as an additive by changing the weight %. It was found that the MR effect of the CI/water suspension was enhanced by using an additive. A transient shear stress response was observed by switched on and switched off of the magnetic field to see the stability, relaxation behavior, and resulting change in rheological properties. When the magnetic field is on, a sudden increase in the shear stress was observed due to the fast motion of magnetic structures that describe the transition from the liquidlike state to the solid-like state due to an increase in dipole-dipole interaction of magnetic particles. Simultaneously, the complete reverse transition occurs due to instantaneous breakage of the chain structure once the magnetic field is switched off.

Keywords: magnetorheological fluid, rheological properties, shears stress, shears strain, viscosity

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3716 Omalizumab Therapy Experience for Asthma, at Zayed Military Hospital (ZMH) in United Arab Emirates

Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

Abstract:

Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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3715 Effect of Viscous Dissipation on 3-D MHD Casson Flow in Presence of Chemical Reaction: A Numerical Study

Authors: Bandari Shanker, Alfunsa Prathiba

Abstract:

The influence of viscous dissipation on MHD Casson 3-D fluid flow in two perpendicular directions past a linearly stretching sheet in the presence of a chemical reaction is explored in this work. For exceptional circumstances, self-similar solutions are obtained and compared to the given data. The enhancement in the values Ecert number the temperature boundary layer increases. Further, the current findings are observed to be in great accord with the existing data. In both directions, non - dimensional velocities and stress distribution are achieved. The relevant data are graphed and explained quantitatively in relation to changes in the Casson fluid parameter as well as other fluid flow parameters.

Keywords: viscous dissipation, 3-D Casson flow, chemical reaction, Ecert number

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3714 Analytical Investigation of Viscous and Non-Viscous Fluid Particles in a Restricted Region Using Diffusion Magnetic Resonance Imaging Equation

Authors: Yusuf, S. I., Saba, A., Olaoye, D. O., Ibrahim J. A., Yahaya H. M., Jatto A. O

Abstract:

Nuclear Magnetic Resonance (NMR) technology has been applied in several ways to provide vital information about petro-physical properties of reservoirs. However, due to the need to study the molecular behaviours of particles of the fluids in different restricted media, diffusion magnetic resonance equation is hereby applied in spherical coordinates and solved analytically using the method of separation of variables and solution of Legendre equation by Frobenius method. The viscous fluid considered in this research work is unused oil while the non-viscous fluid is water. The results obtained show that water begins to manifest appreciable change at radial adjustment value of 10 and Magnetization of 2.31191995400015x1014 and relaxes finally at 2.30x1014 at radial adjustment value of 1. On the other hand, unused engine oil begins to manifest its changes at radial adjustment value of 40 and Magnetization of 1.466557018x1014and relaxes finally at 1.48x1014 at radial adjustment value of 5.

Keywords: viscous and non-viscous fluid, restricted medium, relaxation times, coefficient of diffusion

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3713 Narrative Family Therapy and the Treatment of Perinatal Mood and Anxiety Disorders

Authors: Jamie E. Banker

Abstract:

For many families, pregnancy and the postpartum time are filled with both anticipation and change. For some pregnant or postpartum women, this time is marked by the onset of a mood or anxiety disorder. Experiencing a mood or anxiety disorders during this time of life differs from depression or anxiety at other times of life. Not only because of the physical changes occurring in the mother’s body but also the mental and physical preparation necessary to redefine family roles, responsibilities, and develop new identities in the life transition. The presence of a mood or anxiety disorder can influence the way in which a mother defines herself and can complicate her understanding of her abilities and competencies as a mother. The complexity of experiencing a mood or anxiety disorder in the midst of these changes necessitates specific treatment interventions to match both the symptomatology and psychological adjustments. This study explores the use of narrative family therapy techniques when treating a mother who is experiencing postpartum depression. Externalization is a common technique used in narrative family therapy and can help client’s separate their identity from the problems they are experiencing. This is crucial to a new mom who is in the middle of defining her identity during her transition to parenthood. The goal of this study is to examine how the use of externalization techniques help postpartum women separate their mood and anxiety symptoms from their identity as a mother. An exploratory case study design was conducted in a single setting, private practice therapy office, and explored how a narrative family therapy approach can be used to treat perinatal mood and anxiety disorders. The therapy sessions were audio recorded and transcribed. Constructivism and narrative theory are used as theoretical frameworks and data from the therapy sessions, and a follow-up survey was triangulated and analyzed. During the course of the treatment, the participant reports using the new externalizing labels for her symptoms. Within one month of treatment, the participant reports that she could stop herself from thinking the harmful thoughts faster, and within three months, the harmful thoughts went away. The main themes in this study were building courage and less self-blame. This case highlights the role narrative family therapy can play in the treatment of perinatal mood and anxiety disorders and the importance of separating a women’s mood from her identity as a mother. This conceptual framework was beneficial to the postpartum mother when treating perinatal mood and anxiety disorder symptoms.

Keywords: externalizing techniques, narrative family therapy, perinatal mood and anxiety disorders, postpartum depression

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3712 Numerical Study of a Butterfly Valve for Vibration Analysis and Reduction

Authors: Malik I. Al-Amayreh, Mohammad I. Kilani, Ahmed S. Al-Salaymeh

Abstract:

This works presents a Computational Fluid Dynamics (CFD) simulation of a butterfly valve used to control the flow of combustible gas mixture in an industrial process setting. The work uses CFD simulation to analyze the flow characteristics in the vicinity of the valve, including the velocity distributions, streamlines and path lines. Frequency spectrum of the pressure pulsations downstream the valves, and the vortex shedding allow predicting the torque fluctuations acting on the valve shaft and the possibility of generating mechanical vibration and resonance. These fluctuations are due to aerodynamic torque resulting from fluid turbulence and vortex shedding in the valve vicinity. The valve analyzed is located in a pipeline between two opposing 90o elbows, which exposes the valve and the surrounding structure to the turbulence generated upstream and downstream the elbows at either end of the pipe. CFD simulations show that the best location for the valve from a vibration point of view is in the middle of the pipe joining the elbows.

Keywords: butterfly valve vibration analysis, computational fluid dynamics, fluid flow circuit design, fluctuation

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3711 MONDO Neutron Tracker Characterisation by Means of Proton Therapeutical Beams and MonteCarlo Simulation Studies

Authors: G. Traini, V. Giacometti, R. Mirabelli, V. Patera, D. Pinci, A. Sarti, A. Sciubba, M. Marafini

Abstract:

The MONDO (MOnitor for Neutron Dose in hadrOntherapy) project aims a precise characterisation of the secondary fast and ultrafast neutrons produced in particle therapy treatments. The detector is composed of a matrix of scintillating fibres (250 um) readout by CMOS Digital-SPAD based sensors. Recoil protons from n-p elastic scattering are detected and used to track neutrons. A prototype was tested with proton beams (Trento Proton Therapy Centre): efficiency, light yield, and track-reconstruction capability were studied. The results of a MonteCarlo FLUKA simulation used to evaluated double scattering efficiency and expected backgrounds will be presented.

Keywords: secondary neutrons, particle therapy, tracking, elastic scattering

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3710 The Effect of Supercritical Fluid on the Extraction Efficiency of Heavy Metal from Soil

Authors: Haifa El-Sadi, Maria Elektorowicz, Reed Rushing, Ammar Badawieh, Asif Chaudry

Abstract:

Clay soils have particular properties that affect the assessment and remediation of contaminated sites. In clay soils, electro-kinetic transport of heavy metals has been carried out. The transport of these metals is predicated on maintaining a low pH throughout the cell, which, in turn, keeps the metals in the pore water phase where they are accessible to electro-kinetic transport. Supercritical fluid extraction and acid digestion were used for the analysis of heavy metals concentrations after the completion of electro-kinetic experimentation. Supercritical fluid (carbon dioxide) extraction is a new technique used to extract the heavy metal (lead, nickel, calcium and potassium) from clayey soil. The comparison between supercritical extraction and acid digestion of different metals was carried out. Supercritical fluid extraction, using ethylenediaminetetraacetic acid (EDTA) as a modifier, proved to be efficient and a safer technique than acid digestion technique in extracting metals from clayey soil. Mixing time of soil with EDTA before extracting heavy metals from clayey soil was investigated. The optimum and most practical shaking time for the extraction of lead, nickel, calcium and potassium was two hours.

Keywords: clay soil, heavy metals, supercritical fluid extraction, acid digestion

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3709 I Can’t Escape the Scars, Even If I Do Get Better”: A Discourse Analysis of Adolescent Talk About Their Self-Harm During Cognitive-Behavioural Therapy Sessions for Major Depressive Disorder

Authors: Anna Kristen

Abstract:

There has been a pronounced increase in societal discourses around adolescent self-harm, yet there is a paucity of literature examining adolescent talk about self-harm that accounts for the sociocultural context. The objective of this study was to explore how adolescents with Depression talk about their self-harm engagement in consideration of both socio-cultural discourses and the therapy context during Cognitive-Behavioural Therapy (CBT) sessions. Utilizing a sample from the Improving Mood with Psychoanalytic and Cognitive Therapies study, discourse analysis was carried out on audio-recorded CBT sessions. The study established three groupings of results: (a) adolescent positioning as stuck in self-harm engagement; (b) adolescent positioning as ambivalent in the talk about ceasing self-harm; and (c) adolescent use of stigma discourses in self-harm talk & constructions of self-harm scars. These findings indicate that clinician awareness of adolescent use of language and discourse may inform interventions beyond Manualized CBT strategies. These findings are highly relevant in light of research that demonstrates CBT treatment for adolescent depression does not effectively address concurring self-harm and given that self-harm is the most significant risk factor predictive of subsequent suicidal behaviours.

Keywords: adolescence, cognitive-behavioral therapy, discourse, self-harm, stigma

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3708 Identifying the Source of Stress and Coping Strategies of Undergraduate Occupational Therapy Students' of BHPI in Bangladesh

Authors: Md. Toufiq Hasan

Abstract:

This research set out to explore the source of stress and coping strategies of undergraduate Occupational Therapy students’ of Bangladesh Health Professions Institute (BHPI) in Bangladesh. For that reason, a quantitative and prospective type survey has been conducted by the researcher with 27 student participants of BHPI Occupational Therapy department whose stress scores were ≥40 according to Zung’s self-rating depression scale. Data was collected by using Bengali and English joined questionnaire of Inventory of College Students’ Recent Life Experience and Ways of Coping Scale. The researcher followed ‘Comprehensive sampling’ procedure to study the entire group of population. From the in-depth analysis to data found some source of stress and coping strategies of the students’. Stress was found significantly more in 2nd year students rather than other years. Female students were more vulnerable for stress rather than male. The age ranges 18-20 years of students are more vulnerable for stress. The main sources of stresses are found that, a lot of responsibilities and too many things to do at once and not enough time to meet their obligation or duties. The important coping strategies are found that, they criticized or lectured their selves, tried not to burn their bridges, but leave things open somewhat and inspired to do something creative. Findings of the study highlighted the need for teachers-students interactive relationship for better academic performance. The study also discloses some important recommendations for the students and teachers. At last the findings of the study will help the Occupational Therapy students and teachers of BHPI.

Keywords: BHPI undergraduate occupational therapy students, stress, source of stress, coping strategies

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3707 Experimental Squeeze Flow of Bitumen: Rheological Properties

Authors: A. Kraiem, A. Ayadi

Abstract:

The squeeze flow tests were studied by many authors to measure the rheological properties of fluid. Experimental squeezing flow test with constant area between two parallel disks of bitumen is investigated in the present work. The effect of the temperature, the process of preparing the sample and the gap between the discs were discussed. The obtained results were compared with the theoretical models. The behavior of bitumen depends on the viscosity and the yield stress. Thus, the bitumen was presented as a power law for a small power law exponent and as a biviscous fluid when the viscosity ratio was smaller than one. Also, the influence of the ambient temperature is required for the compression test. Therefore, for a high temperature the yield stress decrease.

Keywords: bitumen, biviscous fluid, squeeze flow, viscosity, yield stress

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3706 Prevalence of Rituximab Efficacy Over Immunosuppressants in Therapy of Systemic Sclerosis

Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

Abstract:

Abstract Objectives. Rituximab (RTX) shown a positive effect in the treatment of systemic sclerosis (SSc). But there is still not enough data on comparing the effectiveness of RTX with immunosuppressants (IS). The aim of our study was to compare changes of lung function and skin score in SSc between two groups of patients (pts) - on RXT therapy (prescribed after ineffectiveness of previous therapy with IS) and on therapy with IS only. Methods. This study included 103 pts received RTX as an addition to previous therapy (group 1) and 65 pts received therapy with IS and prednisolone (group 2). The mean follow-up period was 12.6±10.7months. In group 1 the mean age was 47±12.9 years, female – 88 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. 82% pts had interstitial lung disease (ILD) and 92% were positive for ANA, 67% of them were positive for antitopoisomerase-1. All pts received prednisolone at a dose of 11.3±4.5 mg/day, IS at inclusion received 47% of them. The cumulative mean dose of RTX was 1.7±0.6 g. In group 2 the mean age was 50.8±13.8 years, female-53 pts (82%), the diffuse cutaneous subset of the disease had 44 pts (68%). The mean disease duration was 8.8±7.7 years. 81% pts had ILD and 88% were positive for ANA, 58% of them were positive for antitopoisomerase-1. All pts received prednisolone at a dose of 8.69±4.28 mg/day, IS received 57% of them. Cyclophosphamide (CP) received 45% of pts. The cumulative mean dose of CP was 10.2±15.1g. D-penicillamine received 30% of pts. Other pts was on mycophenolate mofetil or methotrexate therapy in single cases. The pts of the compared groups did not differ in the main demographic and clinical parameters. The results are presented as delta (Δ) - difference between the baseline parameter and follow up point. Results. In group 1 there was an improvement of all outcome parameters: increased of forced vital capacity, % predicted - ΔFVC=4% (p=0.0004); Diffusing capacity for carbon monoxide, % predicted remained stable (ΔDLCO=0.1%); improvement of the Rodnan skin score-ΔmRss=3.4 (p=0.001); decrease of Activity index (EScSG-AI) - ΔActivity index=1.7 (p=0.001). In group 2 the changes was insignificant: ΔFVC=-2.3%, ΔmRss=0.87, ΔActivity index=0.3. But there was a significant decrease of DLCO: ΔDLCO=-5.1% (p=0.001). Conclusion. The results of our study confirm the data on the positive effect of RTX in complex therapy in pts with SSc (decrease of skin induration, increase of FVC, stabilization of DLCO). Meantime, pts on IS and prednisolone therapy shown the worsening of lung function and insignificant changes of other clinical parameters. RTX could be considered as a more effective option in complex treatment of SSc in comparison with IS therapy

Keywords: immunosuppressants, interstitial lung disease, systemic sclerosis, rituximab

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3705 Development and in vitro Evaluation of Polymer-Drug Conjugates Containing Potentiating Agents for Combination Therapy

Authors: Blessing A. Aderibigbe

Abstract:

Combination therapy is a treatment approach that is used to prevent the emergence of drug resistance. This approach is used for the treatment of many chronic and infectious diseases. Potentiating agents are currently explored in combination therapy, resulting in excellent therapeutic outcomes. Breast cancer and malaria are two chronic conditions responsible globally for high death rates. In this research, a class of polymer-drug conjugates containing potentiating agents with either antimalarial or anticancer drugs were prepared by Michael Addition Polymerization reaction and ring-opening polymerization reaction. Conjugation of potentiating agents with bioactive compounds into the polymers resulted in conjugates with good water solubility, highly selective and non-toxic. In vitro cytotoxicity and in vitro antiplasmodial evaluation on the conjugates revealed that the conjugates were more effective when compared to the free drugs. The drug release studies further showed that the release profile of the drugs from the conjugates was sustained. The findings revealed the potential of polymer-drug conjugates to overcome drug toxicity and drug resistance, which is common with the currently used antimalarial and anticancer drugs.

Keywords: anticancer, antimalarials, combination therapy, polymer-drug conjugates

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3704 Assessment of Barriers to the Clinical Adoption of Cell-Based Therapeutics

Authors: David Pettitt, Benjamin Davies, Georg Holländer, David Brindley

Abstract:

Cellular based therapies, whose origins can be traced from the intertwined concepts of tissue engineering and regenerative medicine, have the potential to transform the current medical landscape and offer an approach to managing what were once considered untreatable diseases. However, despite a large increase in basic science activity in the cell therapy arena alongside a growing portfolio of cell therapy trials, the number of industry products available for widespread clinical use correlates poorly with such a magnitude of activity, with the number of cell-based therapeutics in mainstream use remaining comparatively low. This research serves to quantitatively assess the barriers to the clinical adoption of cell-based therapeutics through identification of unique barriers, specific challenges and opportunities facing the development and adoption of such therapies.

Keywords: cell therapy, clinical adoption, commercialization, translation

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3703 Transient/Steady Natural Convective Flow of Reactive Viscous Fluid in Vertical Porous Pipe

Authors: Ahmad K. Samaila, Basant K. Jha

Abstract:

This paper presents the effects of suction/injection of transient/steady natural convection flow of reactive viscous fluid in a vertical porous pipe. The mathematical model capturing the time dependent flow of viscous reactive fluid is solved using implicit finite difference method while the corresponding steady state model is solved using regular perturbation technique. Results of analytical and numerical solutions are reported for various parametric conditions to illustrate special features of the solutions. The coefficient of skin friction and rate of heat transfer are obtained and illustrated graphically. The numerical solution is shown to be in excellent agreement with the closed form analytical solution. It is interesting to note that time required to reach steady state is higher in case of injection in comparison to suction.

Keywords: porous pipe, reactive viscous fluid, transient natural-convective flow, analytical solution

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3702 Effects of Variable Properties and Double Dispersion on Magnetohydrodynamic (MHD) Mixed Convection in a Power-Law Fluid Saturated Non-Darcy Porous Medium

Authors: Pranitha Janapatla, Venkata Suman Gontla

Abstract:

The present paper investigates the effects of MHD, double dispersion and variable properties on mixed convection flow from a vertical surface in a power-law fluid saturated non-Darcy porous medium. The governing non-linear partial differential equations are reduced to a system of ordinary differential equations by using a special form of Lie group transformations viz. scaling group of transformations. These ordinary differential equations are solved numerically by using Shooting technique. The influence of relevant parameters on the non-dimensional velocity, temperature, concentration for pseudo-plastic fluid, Newtonian and dilatant fluid are discussed and displayed graphically. The behavior of heat and mass transfer coefficients are shown in tabular form. Comparisons with the published works are performed and are found to be in very good agreement. From this analysis, it is observed that an increase in variable viscosity causes to decrease in velocity profile and increase the temperature and concentration distributions. It is also concluded that increase in the solutal dispersion decreases the velocity and concentration but raises the temperature profile.

Keywords: power-law fluid, thermal conductivity, thermal dispersion, solutal dispersion, variable viscosity

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3701 Responsive Integrative Therapeutic Method: Paradigm for Addressing Core Deficits in Autism by Balkibekova

Authors: Balkibekova Venera Serikpaevna

Abstract:

Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.

Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications

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3700 Fluid Structure Interaction of Flow and Heat Transfer around a Microcantilever

Authors: Khalil Khanafer

Abstract:

This study emphasizes on analyzing the effect of flow conditions and the geometric variation of the microcantilever’s bluff body on the microcantilever detection capabilities within a fluidic device using a finite element fluid-structure interaction model. Such parameters include inlet velocity, flow direction, and height of the microcantilever’s supporting system within the fluidic cell. The transport equations are solved using a finite element formulation based on the Galerkin method of weighted residuals. For a flexible microcantilever, a fully coupled fluid-structure interaction (FSI) analysis is utilized and the fluid domain is described by an Arbitrary-Lagrangian–Eulerian (ALE) formulation that is fully coupled to the structure domain. The results of this study showed a profound effect on the magnitude and direction of the inlet velocity and the height of the bluff body on the deflection of the microcantilever. The vibration characteristics were also investigated in this study. This work paves the road for researchers to design efficient microcantilevers that display least errors in the measurements.

Keywords: fluidic cell, FSI, microcantilever, flow direction

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3699 Study of the Effect of Rotation on the Deformation of a Flexible Blade Rotor

Authors: Aref Maalej, Marwa Fakhfakh, Wael Ben Amira

Abstract:

We present in this work a numerical investigation of fluid-structure interaction to study the elastic behavior of flexible rotors. The principal aim is to provide the effect of the aero/hydrodynamic parameters on the bending deformation of flexible rotors. This study is accomplished using the strong two-way fluid-structure interaction (FSI) developed by the ANSYS Workbench software. This method is used for coupling the fluid solver to the transient structural solver to study the elastic behavior of flexible rotors in water. In this study, we use a moderately flexible rotor modeled by a single blade with simplified rectangular geometry. In this work, we focus on the effect of the rotational frequency on the flapwise bending deformation. It is demonstrated that the blade deforms in the downstream direction, and the amplitude of these deformations increases with the rotational frequencies. Also, from a critical frequency, the blade begins to deform in the upstream direction.

Keywords: numerical simulation, flexible blade, fluid-structure interaction, ANSYS workbench, flapwise deformation

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3698 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai

Abstract:

Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.

Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis

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3697 Drug Therapy Problems and Associated Factors among Patients with Heart Failure in the Medical Ward of Arba Minch General Hospital, Ethiopia

Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

Abstract:

Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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