Search results for: music therapy intervention

Authors: Virginia Maskill, Philippa Seaton, Marie Crowe, Maree Inder

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A diagnosis of a chronic condition, including Type 2 diabetes can significantly impact an individual’s self-identity which in turn can have considerable implications on how they adapt to, and self-manage their condition. This paper reports on the findings from a qualitative PhD study of forty participants diagnosed with Type 2 diabetes mellitus and comorbid conditions. The primary objective of the study explored the impact conditions had on self-identity and the relationship with self-management practices. Participants were recruited from a larger study which explored the effectiveness of a therapeutic intervention on glycemic control. Interviews were audio-recorded, transcribed verbatim and analysed utilising a narrative thematic analysis methodological approach including a transitional conceptual framework. The majority of participants experienced a loss of their normal self and struggled to integrate diabetes and comorbid conditions into their self-identity. Acceptance, knowledge and integration of conditions were often found to directly influence self-management practices with individuals commonly experiencing four transitional phases from the onset of diagnosis. Successful negotiation of these four phases was influenced by a range of variables which also impacted on an individual’s self-identity and in turn their self-management practices.

Keywords: comorbidity, type two diabetes, self-identity, self-management

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Authors: Rachita Lal

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Solar energy is a clean energy source. Because it is readily available in India and has many potential decentralized uses, urban local authorities may use it in various ways to manage the energy needs in the territory under their control. Apart from these and other services for which people pay a substantial number of money, urban local councils play a crucial role in administering essential services like water supply, street lighting, and health care. ULBs may contribute considerably to the transition to solar energy, both for their benefit and simultaneously for several additional direct and indirect advantages at multiple levels. The research primarily focuses on using clean energy management to reduce urban areas' reliance on traditional (electricity) energy. A technique for estimating the rooftop solar power potential using GIS (Geographical Information System) is described. Given that the combustion of fossil fuels produces 75% of India's power, meeting the country's energy needs through renewable energy sources is a step toward sustainable development and combating climate change. The study will further help in categorization, phasing, and understanding the demand and supply and thus calculating the cumulative benefits. The main objectives are to study the consumption of conventional energy in the study area and to identify the potential areas where solar photovoltaic intervention can be installed.

Keywords: solar energy, GIS, clean energy management, sustainable development

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Authors: Robert L. Williamson

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A 'token economy' refers to a method of positive behaviour support whereby ‘tokens’ are delivered to students as a reward for exhibiting specific behaviours. Students later exchange tokens to ‘purchase’ items of interest. Unfortunately, implementation fidelity can be problematic as some find physical delivery of tokens while teaching difficult. This project developed and tested a prototype, iPad-based tool that enabled teachers to deliver and track tokens electronically. Using an alternating treatment design, any differences in on-task individual and/or group behaviours between the virtual versus physical token delivery systems were examined. Results indicated that while students and teachers preferred iPad-based implementation, no significant difference was found concerning on-task behaviours of students between the two methodologies. Perhaps more interesting was that the teacher found implementation of both methods problematic and suggested a second person was most effective in implementing a token economy method. This would represent a significant cost to the effective use of such a method. Further research should focus on the use of a lay volunteer regarding method implementation fidelity and associated outcomes of the method.

Keywords: positive behaviour support, inclusion, token economy, applied behaviour analysis

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Authors: Khairy M. A. Zoheir

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One of the most severe complications of Rheumatoid arthritis is delayed recovery. lipoic acid possesses antioxidant, hypoglycemic, and anti-inflammatory activity. In the present study, the effects of lipoic acid was investigated on the key mediators of Rheumatoid arthritis, namely, CD4+CD25+ T cell subsets, GITR expressing cells, CD4+CD25+Foxp3+ regulatory T (Treg) cells, T-helper-17 (Th17) cells, and pro-inflammatory cytokines Interleukin-1β (IL-1β), Interleukin-6 (IL-6) and Tumor Necrosis Factor- α (TNF-α)] through flow-cytometry and qPCR analyses. Lipoic acid treated mice showed a significant decrease in the Rheumatoid arthritis, the frequency of GITR-expressing cells, and Th1 cytokines (IL-17A, TNF-αand Interferon- γ (IFN-γ) compared with positive and negative controlled mice. Lipoic acid treatment also down regulated the mRNA expression of the inflammatory mediators compared with the Rheumatoid arthritis mouse model and untreated mice. The number of Tregs also found to be significantly upregulated in lipoic acid treated mice. Our results were confirmed by the histopathological examination. This study showed the beneficial role of lipoic acid in promoting a well-balanced tool for therapy Rheumatoid arthritis.

Keywords: lipoic acid, chemokines, inflammatory, rheumatoid arthritis

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Authors: Alisher Agzamov, Hanan Al Harbi

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BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists. We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 220 +/- 80 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 150 +/- 55 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for patients with AML (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 20 % compared with the prerobot era, and there was an ICU cost savings of KD2.5 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, rp - 7 in icu management, cost and icu occupancy

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Authors: Fayzan Ahmed, Saad Bin Saeed, Abdul Qadir Jangda

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Gafchromic™ sheet are extensively used for the QA of intensity modulated radiation therapy and other in-vivo dosimetry. Intra-sheet Non-uniformity of scanner as well as film causes undesirable fluctuations which are reflected in dosimetry The aim of this study is to define a systematic and robust method to investigate the intra-sheet uniformity of the unexposed Gafchromic Sheets and the region of interest (ROI) of the scanner. Sheets of lot No#: A05151201 were scanned before and after the expiry period with the EPSON™ XL10000 scanner in the transmission mode, landscape orientation and 72 dpi resolution. ROI of (8’x 10’ inches) equal to the sheet dimension in the center of the scanner is used to acquire images with full transmission, block transmission and with sheets in place. 500 virtual grids, created in MATALB® are imported as a macros in ImageJ (1.49m Wayne Rasband) to analyze the images. In order to remove the edge effects, the outer 86 grids are excluded from the analysis. The standard deviation of the block transmission and full transmission are 0.38% and 0.66% confirming a higher uniformity of the scanner. Expired and non-expired sheets have standard deviations of 2.18% and 1.29%, show that uniformity decreases after expiry. The results are promising and indicates a good potential of this method to be used as a uniformity check for scanner and unexposed Gafchromic sheets.

Keywords: IMRT, film dosimetry, virtual grids, uniformity

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Authors: Stella O. Olubodun, George E. Eriyamremu

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The study assessed the effect of crude oil applied at rates, 0, 2, 5, and 10% on the fractional chemical forms and availability of some metals in soils from Usen, Edo State, with no known crude oil contamination and soil from a crude oil spill site in Ubeji, Delta State, Nigeria. Three methods were used to determine the bioavailability of metals in the soils: maize (Zea mays) plant, EDTA and BCR sequential extraction. The sequential extract acid soluble fraction of the BCR extraction (most labile fraction of the soils, normally associated with bioavailability) were compared with total metal concentration in maize seedlings as a means to compare the chemical and biological measures of bioavailability. Total Fe was higher in comparison to other metals for the crude oil contaminated soils. The metal concentrations were below the limits of 4.7% Fe, 190mg/kg Cu and 720mg/kg Zn intervention values and 36mg/kg Cu and 140mg/kg Zn target values for soils provided by the Department of Petroleum Resources (DPR) guidelines. The concentration of the metals in maize seedlings increased with increasing rates of crude oil contamination. Comparison of the metal concentrations in maize seedlings with EDTA extractable concentrations showed that EDTA extracted more metals than maize plant.

Keywords: availability, crude oil contamination, EDTA, maize, metals

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Authors: Wendy I. E. Wesseling

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The unemployment rate has been on the rise since the outbreak of the global financial crisis in 2008. Especially labor market entrants suffer from economic downfall. Despite the abundance of programs and agencies that help to reintegrate unemployed youth, considerable less research attention has been paid to 'fit' between these programs and its participants that ensure a durable labor market transition. According to Self-Determination Theory, need satisfaction is associated with better (mental) adjustment. As such, three hypothesis were formulated: when workers’ needs for competence (H1), relatedness (H2), and autonomy (H3) are satisfied in the workplace, they are more likely to remain employed at the same employer. To test these assumptions, a sample of approximately 800 young people enrolled in a youth unemployment policy participated in a longitudinal study. The unemployment policy was aimed at the development of generic and vocational competences, and had a maximum duration of six months. Need satisfaction during the program was measured, as well as their employment outcomes up to 12 months after completion of the policy. All hypotheses were (partly) supported. Some limitations should be noted. First, since our sample consisted primarily of highly educated white graduates, it remains to be tested whether our results generalize to other groups of unemployed youth. Moreover, we are unable to conclude whether the results are due to the intervention, participants (selection effect), or both, because of the lack of a control group.

Keywords: need satisfaction, person-job fit, self-determination theory, youth unemployment policy

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Authors: Sarantos Psycharis

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Physical Computing, as an instructional model, is applied in the framework of the Engineering Pedagogy to teach “transversal/cross-cutting ideas” in a STEM content approach. Labview and Arduino were used in order to connect the physical world with real data in the framework of the so called Computational Experiment. Tertiary prospective engineering educators were engaged during their course and Computational Thinking (CT) concepts were registered before and after the intervention across didactic activities using validated questionnaires for the relationship between self-efficacy, computer programming, and CT concepts when STEM content epistemology is implemented in alignment with the Computational Pedagogy model. Results show a significant change in students’ responses for self-efficacy for CT before and after the instruction. Results also indicate a significant relation between the responses in the different CT concepts/practices. According to the findings, STEM content epistemology combined with Physical Computing should be a good candidate as a learning and teaching approach in university settings that enhances students’ engagement in CT concepts/practices.

Keywords: arduino, computational thinking, computer programming, Labview, self-efficacy, STEM

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Authors: Boran Cui, Zhenxiong Wen, Yuhan Zhang, Weibo Zhang

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The Gut-Brain Axis (GBA) is a bidirectional communication system between the central nervous system (CNS) and the enteric nervous system (ENS), with gut microbiota playing a crucial role in regulating its functions. This study investigates probiotics’ effects on adolescents’ cognition, memory, and emotions. A double-blind, randomized controlled trial involved 15 healthy adolescents aged 15–18, divided into a treatment group receiving probiotics and a control group given a placebo. Assessments included baseline and post-intervention evaluations after a fourweek period using the Positive and Negative Affect Schedule (PANAS) and the Montreal Cognitive Assessment (MoCA). Results showed significant cognitive improvement and increased positive emotions in the treatment group, while the control group exhibited no notable changes. These findings suggest probiotics positively influence cognitive function and emotional state by modulating gut microbiota. Despite the small sample size, this study provides preliminary evidence for probiotics’ therapeutic potential in adolescents. Larger, longer-term studies are needed to confirm these results.

Keywords: gut-brain axis, probiotics, cognitive function, emotional state, adolescents, Lp-G18

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Authors: Achraf Al Faraj, Asma Sultana Shaik, Baraa Al Sayed

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Specific and effective targeting of drug delivery systems (DDS) to cancerous sites remains a major challenge for a better diagnostic and therapy. Recently, SWCNTs with their unique physicochemical properties and the ability to cross the cell membrane show promising in the biomedical field. The purpose of this study was first to develop a biocompatible iron oxide tagged SWCNTs as diagnostic nanoprobes to allow their noninvasive detection using MRI and their preferential targeting in a breast cancer murine model by placing an optimized flexible magnet over the tumor site. Magnetic targeting was associated to specific antibody-conjugated SWCNTs active targeting. The therapeutic efficacy of doxorubicin-conjugated SWCNTs was assessed, and the superiority of diffusion-weighted (DW-) MRI as sensitive imaging biomarker was investigated. Short Polyvinylpyrrolidone (PVP) stabilized water soluble SWCNTs were first developed, tagged with iron oxide nanoparticles and conjugated with Endoglin/CD105 monoclonal antibodies. They were then conjugated with doxorubicin drugs. SWCNTs conjugates were extensively characterized using TEM, UV-Vis spectrophotometer, dynamic light scattering (DLS) zeta potential analysis and electron spin resonance (ESR) spectroscopy. Their MR relaxivities (i.e. r1 and r2*) were measured at 4.7T and their iron content and metal impurities quantified using ICP-MS. SWCNTs biocompatibility and drug efficacy were then evaluated both in vitro and in vivo using a set of immunological assays. Luciferase enhanced bioluminescence 4T1 mouse mammary tumor cells (4T1-Luc2) were injected into the right inguinal mammary fat pad of Balb/c mice. Tumor bearing mice received either free doxorubicin (DOX) drug or SWCNTs with or without either DOX or iron oxide nanoparticles. A multi-pole 10x10mm high-energy flexible magnet was maintained over the tumor site during 2 hours post-injections and their properties and polarity were optimized to allow enhanced magnetic targeting of SWCNTs toward the primary tumor site. Tumor volume was quantified during the follow-up investigation study using a fast spin echo MRI sequence. In order to detect the homing of SWCNTs to the main tumor site, susceptibility-weighted multi-gradient echo (MGE) sequence was used to generate T2* maps. Apparent diffusion coefficient (ADC) measurements were also performed as a sensitive imaging biomarker providing early and better assessment of disease treatment. At several times post-SWCNT injection, histological analysis were performed on tumor extracts and iron-loaded SWCNT were quantified using ICP-MS in tumor sites, liver, spleen, kidneys, and lung. The optimized multi-poles magnet revealed an enhanced targeting of magnetic SWCNTs to the primary tumor site, which was found to be much higher than the active targeting achieved using antibody-conjugated SWCNTs. Iron-loading allowed their sensitive noninvasive tracking after intravenous administration using MRI. The active targeting of doxorubicin through magnetic antibody-conjugated SWCNTs nanoprobes was found to considerably decrease the primary tumor site and may have inhibited the development of metastasis in the tumor-bearing mice lung. ADC measurements in DW-MRI were found to significantly increase in a time-dependent manner after the injection of DOX-conjugated SWCNTs complexes.

Keywords: single-walled carbon nanotubes, nanomedicine, magnetic resonance imaging, cancer diagnosis and therapy

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Authors: Shreyansh Jain Jeetmal, Shobith P. Chadaga, Shreyas H. Srinivas

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Internet of Things (IoT) is seen as the next major step in the ongoing revolution in the Information Age. It is predicted that in the near future billions of embedded devices will be communicating with each other to perform a plethora of tasks with or without human intervention. One of the major ongoing hotbed of research activity in IoT is Human Computer Interaction (HCI). HCI is used to facilitate communication between an intelligent system and a user. An intelligent system typically comprises of a system consisting of various sensors, actuators and embedded controllers which communicate with each other to monitor data collected from the environment. Communication by the user to the system is typically done using voice. One of the major ongoing applications of HCI is in home automation as a personal assistant. The prime objective of our project is to implement a use case of HCI for home automation. Our system is designed to detect and recognize the users and personalize the appliances in the house according to their individual preferences. Our HCI system is also capable of speaking with the user when certain commands are spoken such as searching on the web for information and controlling appliances. Our system can also monitor the environment in the house such as air quality and gas leakages for added safety.

Keywords: human computer interaction, internet of things, computer vision, sensor networks, speech to text, text to speech, android

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Authors: Abdelmenen Abobghala, Mahmud Ahmed, Mohamed Alwaheshi, Anwar Fanan, Meftah Mehdawi, Ahmed Abuhatira

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This research aims to predict academic performance and identify weak points in students to aid teachers in understanding their learning needs. Both quantitative and qualitative methods are used to identify difficult test items and the factors causing difficulties. The study uses interventions like focus group discussions, interviews, and action plans developed by the students themselves. The research questions explore the predictability of final grades based on mock exams and assignments, the student's response to action plans, and the impact on learning performance. Ethical considerations are followed, respecting student privacy and maintaining anonymity. The research aims to enhance student engagement, motivation, and responsibility for learning.

Keywords: prediction, academic performance, weak points, understanding, learning, quantitative methods, qualitative methods, formative assessments, feedback, emotional responses, intervention, focus group discussion, interview, action plan, student engagement, motivation, responsibility, ethical considerations

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Authors: Ratri A. Benedictus, Felicia M. Yolanda

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Public transport is a crucial issue for capital city in developing country, such as Jakarta. Inadequate number and low quality of public transport services resulting personal vehicles as the main option. As a result, traffic jams are getting worse in Jakarta. The low quality of public transport, particularly buses, compounded by the risk behavior of the driver. Traffic accidents involving public bus in Jakarta were often the case, even result in fatality. The purpose of this study is to get a description of risk behavior among the public bus drivers in Jakarta. 132 bus drivers become respondent of this study. Risky Driving Behavior scale of Dorn were used. Data were analyzed using descriptive statistics. 51.5% of respondents felt often showing risky behavior while on driving. The highest type of risky driving behavior is still using the unsafe bus (62%). Followed by trespass the bus line (30%), over speed (21%), violate the road signs (15%) and driving with unhealthy physical condition (4%). Results of this study suggested that high understanding of the bus drivers on their risk behaviors have not lead to the emergence of safe driving behavior. Therefore, together with technical engineering and instrumentation work intervention over this issue, psychological aspects also need to be considered, such as: risk perception, safety attitude,safety culture, locus of control and Fatalism.

Keywords: bus driver, psychological factors, public transportation, risky driving behavior

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Authors: Cassandra Springate, Alexandra Furber, Jack E. Hines

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Objectives: To create an evidence map of the cost-utility studies available with non-small cell lung cancer patients, and identify the geographical settings and interventions used. Methods: Using the Disease, Study Type, and Model Type filters in heoro.com we identified all cost-utility studies published between 1960 and 2017 with patients with non-small cell lung cancer. These papers were then indexed according to pre-specified categories. Results: Heoro.com identified 89 independent publications, published between 1995 and 2017. Of the 89 papers, 74 were published since 2010, 28 were from the USA, and 35 were from Europe, 16 of which were from the UK. Other publications were from China and Japan (13), Canada (9), Australia and New Zealand (4), and other countries (8). Fifty-nine studies included a chemotherapy intervention, of which 23 included erlotinib or gefitinib, 21 included pemetrexed or docetaxel, others included nivolumab (3), pembrolizumab (2), crizotinib (2), denosumab (2), necitumumab (1), and bevacizumab (1). Also, 19 studies modeled screening, staging, or surveillance strategies. Conclusions: The cost-utility studies found for NSCLC most commonly looked at the effectiveness of different chemotherapy treatments, with some also evaluating the addition of screening strategies. Most were also conducted with patient data from the USA and Europe.

Keywords: cancer, cost-utility, economic model, non-small cell lung cancer

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Authors: E. Verduci, I. Aguglia, A. Filocamo, I. Macrì, R. Scala, A. Vinci

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One of the first indicator of autism spectrum disorder (ASD) is a decreasing tendency or failure to respond to name (RTN) call. Despite RTN is important for social and language developmentand it’s a common target for early interventions for children with ASD, research on specific treatments is insufficient and does not consider the importance of the discrimination between the own name and other names. The purpose of the current study was to replicate an assessment and treatment model proposed by Conine et al. (2020) to teach children with ASD to respond to their own name and to not respond to other names (RTO). The model includes three different phases (baseline/screening, treatment, and generalization), and itgradually introduces the different treatment components, starting with the most naturalistic ones (such as social interaction) and adding more intrusive components (such as tangible reinforcements, prompt and fading procedures) if necessary. The participants of this study were three children with ASD diagnosis: D. (5 years old) with a low frequency of RTN, M. (7 years old) with a RTN unstable and no ability of discrimination between his name and other names, S. (3 years old) with a strong RTN but a constant response to other names. Moreover, the treatment for D. and M. consisted of social and tangible reinforcements (treatment T1), for S. the purpose of the treatment was to teach the discrimination between his name and the others. For all participants, results suggest the efficacy of the model to acquire the ability to selectively respond to the own name and the generalization of the behavior with other people and settings.

Keywords: response to name, autism spectrum disorder, progressive training, ABA

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Authors: Huang Wei-Yi

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Purpose: Oral cancer patients undergoing skin flap reconstruction may have wounds in the oral cavity, leading to accumulation of blood, clots, and secretions. Inadequate oral care by nursing staff can result in oral infections and pain. Methods: An investigation revealed that ICU nurses' knowledge and adherence to oral care standards were below acceptable levels. Key issues identified included lack of hands-on training opportunities, insufficient experience, absence of oral care standards and regular audits, no in-service education programs, and a lack of oral care educational materials. Interventions: The following measures were implemented: 1) in-service education programs, 2) development of care standards, 3) creation of a monitoring plan, 4) bedside demonstration teaching, and 5) revision of educational materials. Results: The intervention demonstrated that ICU nurses' knowledge and adherence to oral care standards improved, leading to better quality oral care and reduced pain for patients. Conclusion: Through in-service education, bedside demonstrations, establishment of oral care standards, and regular audits, the oral care skills of ICU nurses were significantly enhanced, resulting in improved oral care quality and decreased patient pain.

Keywords: oral care, ICU, improving, oral cancer

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Authors: Elham Ghandali, Saeed Talebian Moghadam, Mohammad Reza Hadian, Gholamreza Olyaei, Shohreh Jalaie, Elaheh Sajjadi

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Purpose: A few studies have examined the effect of Tai Chi on balance in elderly patients with knee osteoarthritis (OA). The aim of this study was to determine the balance measures in elderly patients with knee OA after Tai Chi exercises. For this purpose, 14 females and 6 males with knee OA were chosen. The area and mean velocity of the center of pressure movements (CoP) were measured by force plate in standing positions (on foam and rigid surfaces). The measurements of area and mean velocity of CoP were performed before and after 60 min of Tai Chi sessions (twice a week for 8 weeks). Results: The results showed that the area of CoP in a standing position on a rigid surface was significantly decreased (P < 0.01) after Tai Chi exercises. Furthermore, the mean velocity of CoP was significantly decreased after Tai Chi exercises on both rigid and foam surfaces (P < 0.001). Our study also indicated that changes in surfaces (rigid and foam) would cause significant differences regarding the area of CoP in standing positions. How- ever, similar findings were not found regarding the mean velocity of CoP. Considering the effects of Tai Chi on the mean velocity of CoP, it might be concluded that motor control and Postural stability improvements have occurred. Conclusions: Therefore, based on these results, Tai Chi exercises could be recommended for elderly patients with knee OA as part of their rehabilitation and physical therapy protocols.

Keywords: Tai Chi, balance, knee osteoarthritis, elderly patients, different surfaces

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Authors: M. Chaichanyut, S. Tungjitkusolmun

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This research is presented with microwave (MW) ablation by using the T-Prong monopole antennas. In the study, three-dimensional (3D) finite-element methods (FEM) were utilized to analyse: the tissue heat flux, temperature distributions (heating pattern) and volume destruction during MW ablation in liver cancer tissue. The configurations of T-Prong monopole antennas were considered: Three T-prong antenna, Expand T-Prong antenna and Arrow T-Prong antenna. The 3D FEMs solutions were based on Maxwell and bio-heat equations. The microwave power deliveries were 10 W; the duration of ablation in all cases was 300s. Our numerical result, heat flux and the hotspot occurred at the tip of the T-prong antenna for all cases. The temperature distribution pattern of all antennas was teardrop. The Arrow T-Prong antenna can induce the highest temperature within cancer tissue. The microwave ablation was successful when the region where the temperatures exceed 50°C (i.e. complete destruction). The Expand T-Prong antenna could complete destruction the liver cancer tissue was maximized (6.05 cm³). The ablation pattern or axial ratio (Widest/length) of Expand T-Prong antenna and Arrow T-Prong antenna was 1, but the axial ratio of Three T-prong antenna of about 1.15.

Keywords: liver cancer, T-Prong antenna, finite element, microwave ablation

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Authors: Khairy Mohamed Abdalla Zoheir

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One of the most severe complications of Rheumatoid arthritis is delayed recovery. lipoic acid possesses antioxidant, hypoglycemic, and anti-inflammatory activity. In the present study, the effects of lipoic acid were investigated on the key mediators of Rheumatoid arthritis, namely, CD4+CD25+ T cell subsets, GITR expressing cells, CD4+CD25+Foxp3+ regulatory T (Treg) cells, T-helper-17 (Th17) cells and pro-inflammatory cytokines Interleukin-1β (IL-1β), Interleukin-6 (IL-6) and Tumor Necrosis Factor- α (TNF-α)] through flow-cytometry and qPCR analyses. Lipoic acid-treated mice showed a significant decrease in Rheumatoid arthritis, the frequency of GITR-expressing cells, and Th1 cytokines (IL-17A, TNF-αand Interferon- γ (IFN-γ) compared with positive and negative controlled mice. Lipoic acid treatment also downregulated the mRNA expression of the inflammatory mediators compared with the Rheumatoid arthritis mouse model and untreated mice. The number of Tregs was also found to be significantly upregulated in lipoic acid-treated mice. Our results were confirmed by the histopathological examination. This study showed the beneficial role of lipoic acid in promoting a well-balanced tool for the therapy of Rheumatoid arthritis.

Keywords: lipoic acid, inflammatory markers, rheumatoid arthritis, qPCR

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Authors: Yanuarti Retnaningrum, Cendrawasih A. Farmasyanti, Kuswahyuning

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Orthodontists find challenges in treating patients who have cases of macroglossia and multiple tooth agenesis because difficulties in determining the causes, formulating a diagnosis and the potential for relapse after treatment. Definition of macroglossia is a tongue enlargement due to muscle hypertrophy, tumor or an endocrine disturbance. Macroglossia may cause many problems such as anterior proclination of upper and lower incisors, development of general diastema and anterior and/ or posterior open bite. Treatment for such patients with multiple tooth agenesis and macroglossia can be complex and must consider orthodontic and/or surgical interventions. This article discusses an orthodontic non surgical approach to a patient with a general diastema in both maxilla and mandible associated with multiple tooth agenesis and macroglossia. Fixed orthodontic therapy with straightwire appliance was used for space closure in anterior region of maxilla and mandible, also to create a space suitable for future prosthetic restoration. After 12 months treatment, stable and functional occlusal relationships was achieved, although still have edentulous area in both maxilla and mandible. At the end of the orthodontic treatment was obtained with correct overbite and overjet values. After removal of the brackets, a maxillary and mandibular removable retainer combine with artificial tooth were placed for retention.

Keywords: general diastema, macroglossia, space closure, tooth agenesis

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Authors: Hadach Mohamed

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Tourism becomes more and more a source of added value for developing countries. In Morocco, the sector contributes at 20% of national GDP, or the effects of this activity become increasingly harmful. The methodology we followed is qualitative, we analyzed the data according to a process-based approach in two longitudinal period from 2001 to 2009 and a period of real time from 2010 to 2014.Through a process-based longitudinal study we analyzed the effects of tourism on the three components of sustainability: economic, environmental and socio-cultural in Essaouira destination in the south west of Morocco. The objective of this paper is to identify among others, harmful effects of mass tourism on fragile destination in terms of load capacity, promotion of youth employment and respect for indigenous traditions. This study also aims to analyze the impact of tourism on the fragile destination, which depends heavily on this activity; it also seeks to test a series of indicators for sustainable development of sensitive areas. Within results, we found that tourism as an activity is very linked to the international situation, tested sustainable development indicators showed us that tourism is environmentally destructive, job creator and changer modes and lives of indigenous. Between the two periods analyzed, the situation becomes more and more vulnerable and the state intervention is becoming more indispensable.

Keywords: Sustainable tourism; Essaouira; destination, environmental and socio-cultural

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Authors: Negar Miri-Lavasani

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Background: Children with Attention-deficit/hyperactivity disorder (ADHD) show fine motor skills difficulties, and it is controversial whether this difficulty is based on problems in their fine motor skills or their executive function impairments. Objectives of Study: The Fine Motor and Executive Function assessment tool (FiM&EF) was developed to answer the question, ‘Do the fine motor skill deficits in children with ADHD come from their fine motor problems or is it caused by their executive function problems?’. This paper describes the development of a new assessment of Fine Motor and Executive Function (FiM &EF) needed by primary school students with ADHD aged 6-12 years with ADHD. Methods: A study on the content validity established through a survey of a panel of nine experts is explained in detail. Findings: Most the experts agreed such an assessment was needed and two items were deleted as a result of experts’ feedback. Relevance to Clinical Practice: Distinguishing the main reason of fine motor problem in these children could help the clinician for their therapy plans. Knowledge on the influence of executive functioning on fine motor ability in selected age children with ADHD would provide a clearer clinical picture of the fine motor capabilities and executive function for these children.

Keywords: children with ADHD, executive function, fine motor, test

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Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla

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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.

Keywords: AKI, dialysis, hypertension, sepsis, renal parameters

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Authors: Eunhwa Jun

Abstract:

This case report describes the misdiagnosis of a patient who presented with right arm pain as cervical disc herniation. The patient had several underlying conditions, including hypertension, diabetes mellitus, liver cirrhosis, a history of lung cancer with left lower lobe lobectomy, and adjuvant chemoradiotherapy. An external cervical spine MRI revealed central protruding discs at the C4-5-6-7 levels. Despite treatment with medication and epidural blocks, the patient's pain persisted. A C-RACZ procedure was planned, but the patient's pain had worsened before admission. Using ultrasound, a brachial plexus block was attempted, but the brachial plexus eluded clear visualization, hinting at underlying neurological complexities. Chest CT revealed a new, large soft tissue mass in the right supraclavicular region with adjacent right axillary lymphadenopathy, leading to the diagnosis of metastatic squamous cell carcinoma. Palliative radiation therapy and chemotherapy were initiated as part of the treatment plan, and the patient's pain score decreased to 3 out of 10 on the Numeric Rating Scale (NRS), revealing the pain was due to metastatic lung cancer.

Keywords: supraclavicula brachial plexus metastasis, cervical disc herniation, brachial plexus block, metastatic lung cancer

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Authors: Mary-Ann N. Jallad, Dalal F. Jaber, Alexander M. Abdelnoor

Abstract:

Introduction: Current evidence confirms that both innate and adaptive immune systems are capable of recognizing and abolishing malignant cells. The emergence of cancerous tumors in patients is, therefore, an indication that certain cancer cells can resist elimination by the immune system through a process known as “immune evasion”. In fact, cancer cells often exploit regulatory mechanisms to escape immunity. Such mechanisms normally exist to control the immune responses and prohibit exaggerated or autoimmune reactions. Recently, immunotherapies have shown promising yet limited results. Therefore this study investigates several immunotherapeutic combinations and devises a triple immunotherapy which harnesses the innate and acquired immune responses towards the annihilation of malignant cells through overcoming their ability of immune evasion, consequently hampering malignant progression and eliminating established tumors. The aims of the study are to rule out acute/chronic toxic effects of the proposed treatment combinations, to assess the effect of these combinations on tumor growth and survival rates, and to investigate potential mechanisms underlying the phenotypic results through analyzing serum levels of anti-tumor cytokines, angiogenic factors and tumor progression indicator, and the tumor-infiltrating immune-cells populations. Methodology: For toxicity analysis, cancer-free C57BL/6 mice are randomized into 9 groups: Group 1 untreated, group 2 treated with sterile saline (solvent of used treatments), group 3 treated with Monophosphoryl-lipid-A, group 4 with anti-CTLA4-antibodies, group 5 with 1-Methyl-Tryptophan (Indolamine-Dioxygenase-1 inhibitor), group 6 with both MPLA and anti-CTLA4-antibodies, group 7 with both MPLA and 1-MT, group 8 with both anti-CTLA4-antibodies and 1-MT, and group 9 with all three: MPLA, anti-CTLA4-antibodies and 1-MT. Mice are monitored throughout the treatment period and for three following months. At that point, histological sections from their main organs are assessed. For tumor progression and survival analysis, a murine melanoma model is generated by injecting analogous mice with B16F10 melanoma cells. These mice are segregated into the listed nine groups. Their tumor size and survival are monitored. For a depiction of underlying mechanisms, melanoma-bearing mice from each group are sacrificed at several time-points. Sera are tested to assess the levels of Interleukin-12 (IL-12), Vascular-Endothelial-Growth Factor (VEGF), and S100B. Furthermore, tumors are excised for analysis of infiltrated immune cell populations including T-cells, macrophages, natural killer cells and immune-regulatory cells. Results: Toxicity analysis shows that all treated groups present no signs of neither acute nor chronic toxicity. Their appearance and weights were comparable to those of control groups throughout the treatment period and for the following 3 months. Moreover, histological sections from their hearts, kidneys, lungs, and livers were normal. Work is ongoing for completion of the remaining study aims. Conclusion: Toxicity was the major concern for the success of the proposed comprehensive combinational therapy. Data generated so far ruled out any acute or chronic toxic effects. Consequently, ongoing work is quite promising and may significantly contribute to the development of more effective immunotherapeutic strategies for the treatment of cancer patients.

Keywords: cancer immunotherapy, check-point blockade, combination therapy, melanoma

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Authors: Zahra Salehi Shahrbabaki, Zahra Chavoshzadeh, Fahimeh Abdollahimajd, Samin Sharafian, Tolue Mahdavi, Mahnaz Jamee

Abstract:

Background: Inborn errors of immunity (IEIs) are monogenic diseases of the immune the system with broad clinical manifestations. Despite the increasing genetic advancements, the diagnosis of IEIs still leans on clinical diagnosis. Dermatologic manifestations are observed in a large number of IEI patients and can lead to proper approach, prompt intervention and improved prognosis. Methods: This cross-sectional study was carried out between 2018 and 2020 on IEIs at a Children's tertiary care center in Tehran, Iran. Demographic details (including age, sex, and parental consanguinity), age at onset of symptoms and family history of IEI with were recorded. Results :212 patients were included. Cutaneous findings were reported in (95 ,44.8%) patients. and 61 of 95 (64.2%) reported skin lesions as the first clinical presentation. Skin infection (69, 72.6%) was the most frequent cutaneous manifestation, followed by an eczematous rash (24, 25 %). Conclusions: Skin manifestations are common feature in IEI patients and can be readily recognizable by healthcare providers. This study tried to provide information on prognostic consequences.

Keywords: primary immuno deficiency, inborn errror of metabolism, skin manifestation, skin infection

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Authors: Hamidreza Jahani, Zahra Salehzadeh, Ehsan Amini, Mohsen Tohidifar

Abstract:

Calvarial Hyperostosis Syndrome (CHS) is a benign bone disease of the skull. It is a non-neoplastic and proliferative bone disease, and the main feature of the disease is progressive and asymmetrical bone involvement. CHS is mostly reported in young male and female bullmastiff dogs and less frequently in other breeds. The etiology of CHS is unknown. This is the first case report of CHS in Iran. A 3-month-old male Persian Mastiff was presented with chief complaints of multiple episodes of seizure, pacing, bizarre behavior, delayed growth, head pressing, and difficulty in opening the mouth. Central blindness and open fontanelles were observed in clinical examination. No abnormality was found in the complete blood count and routine blood biochemical tests. CT scan findings include cortical thickening of frontal and parietal bones and enlargement of the left retropharyngeal lymph node. For treatment, oral clindamycin for two weeks, prednisolone and phenobarbital for one month, respectively, were administrated, and the case showed improvement after a week and recovered after one month.

Keywords: calvarial hyperostosis, Persian Mastiff, frontal bone, seizure

Procedia PDF Downloads 142

Authors: Fayzan Ahmed, Saad Bin Saeed, Abdul Qadir Jangda

Abstract:

Gafchromic™ sheet are extensively used for the QA of intensity modulated radiation therapy and other in-vivo dosimetry. Intra-sheet Non-uniformity of scanner as well as film causes undesirable fluctuations which are reflected in dosimetry The aim of this study is to define a systematic and robust method to investigate the intra-sheet uniformity of the unexposed Gafchromic Sheets and the region of interest (ROI) of the scanner. Sheets of lot No#: A05151201 were scanned before and after the expiry period with the EPSON™ XL10000 scanner in the transmission mode, landscape orientation, and 72 dpi resolution. ROI of (8’x 10’ inches) equal to the sheet dimension in the center of the scanner is used to acquire images with full transmission, block transmission and with sheets in place. 500 virtual grids, created in MATALB® are imported as a macros in ImageJ (1.49m Wayne Rasband) to analyze the images. In order to remove the edge effects, the outer 86 grids are excluded from the analysis. The standard deviation of the block transmission and full transmission are 0.38% and 0.66% confirming a higher uniformity of the scanner. Expired and non-expired sheets have standard deviations of 2.18% and 1.29%, show that uniformity decreases after expiry. The results are promising and indicate a good potential of this method to be used as a uniformity check for scanner and unexposed Gafchromic sheets.

Keywords: IMRT, film dosimetry, virtual grids, uniformity

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Authors: Ben Clapperton, Daniel Stahl, Kimberley Goldsmith, Trudie Chalder

Abstract:

Chronic fatigue syndrome (CFS) is a condition characterised by chronic disabling fatigue and other symptoms that currently can't be explained by any underlying medical condition. Although clinical trials support the effectiveness of cognitive behaviour therapy (CBT), the success rate for individual patients is modest. Patients vary in their response and little is known which factors predict or moderate treatment outcomes. The aim of the project is to develop a prediction model from baseline characteristics of patients, such as demographics, clinical and psychological variables, which may predict likely treatment outcome and provide guidance for clinical decision making and help clinicians to recommend the best treatment. The project is aimed at identifying subgroups of patients with similar baseline characteristics that are predictive of treatment effects using modern cluster analyses and data mining machine learning algorithms. The characteristics of these groups will then be used to inform the types of individuals who benefit from a specific treatment. In addition, results will provide a better understanding of for whom the treatment works. The suitability of different clustering methods to identify subgroups and their response to different treatments of CFS patients is compared.

Keywords: chronic fatigue syndrome, latent class analysis, prediction modelling, self-organizing maps

Procedia PDF Downloads 229