Search results for: Thomas Cochrane
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 386

Search results for: Thomas Cochrane

386 The One, the Many, and the Doctrine of Divine Simplicity: Variations on Simplicity in Essentialist and Existentialist Metaphysics

Authors: Mark Wiebe

Abstract:

One of the tasks contemporary analytic philosophers have focused on (e.g., Wolterstorff, Alston, Plantinga, Hasker, and Crisp) is the analysis of certain medieval metaphysical frameworks. This growing body of scholarship has helped clarify and prevent distorted readings of medieval and ancient writers. However, as scholars like Dolezal, Duby, and Brower have pointed out, these analyses have been incomplete or inaccurate in some instances, e.g., with regard to analogical speech or the doctrine of divine simplicity (DDS). Additionally, contributors to this work frequently express opposing claims or fail to note substantial differences between ancient and medieval thinkers. This is the case regarding the comparison between Thomas Aquinas and others. Anton Pegis and Étienne Gilson have argued along this line that Thomas’ metaphysical framework represents a fundamental shift. Gilson describes Thomas’ metaphysics as a turn from a form of “essentialism” to “existentialism.” One should argue that this shift distinguishes Thomas from many Analytic philosophers as well as from other classical defenders of the DDS. Moreover, many of the objections Analytic Philosophers make against Thomas presume the same metaphysical principles undergirding the above-mentioned form of essentialism. This weakens their force against Thomas’ positions. In order to demonstrate these claims, it will be helpful to consider Thomas’ metaphysical outlook alongside that of two other prominent figures: Augustine and Ockham. One area of their thinking which brings their differences to the surface has to do with how each relates to Platonic and Neo-Platonic thought. More specifically, it is illuminating to consider whether and how each distinguishes or conceives essence and existence. It is also useful to see how each approaches the Platonic conflicts between essence and individuality, unity and intelligibility. In both of these areas, Thomas stands out from Augustine and Ockham. Although Augustine and Ockham diverge in many ways, both ultimately identify being with particularity and pit particularity against both unity and intelligibility. Contrastingly, Thomas argues that being is distinct from and prior to essence. Being (i.e., Being in itself) rather than essence or form must therefore serve as the ground and ultimate principle for the existence of everything in which being and essence are distinct. Additionally, since change, movement, and addition improve and give definition to finite being, multitude and distinction are, therefore, principles of being rather than non-being. Consequently, each creature imitates and participates in God’s perfect Being in its own way; the perfection of each genus exists pre-eminently in God without being at odds with God’s simplicity, God has knowledge, power, and will, and these and the many other terms assigned to God refer truly to the being of God without being either meaningless or synonymous. The existentialist outlook at work in these claims distinguishes Thomas in a noteworthy way from his contemporaries and predecessors as much as it does from many of the analytic philosophers who have objected to his thought. This suggests that at least these kinds of objections do not apply to Thomas’ thought.

Keywords: theology, philosophy of religion, metaphysics, philosophy

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385 Controller Design Using GA for SMC Systems

Authors: Susy Thomas, Sajju Thomas, Varghese Vaidyan

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This paper considers SMCs using linear feedback with switched gains and proposes a method which can minimize the pole perturbation. The method is able to enhance the robustness property of the controller. A pre-assigned neighborhood of the ‘nominal’ positions is assigned and the system poles are not allowed to stray out of these bounds even when parameters variations/uncertainties act upon the system. A quasi SMM is maintained within the assigned boundaries of the sliding surface.

Keywords: parameter variations, pole perturbation, sliding mode control, switching surface, robust switching vector

Procedia PDF Downloads 357
384 The Social and Economic Discourse of Roberto Cochrane Simonsen: The Presence of Americanism

Authors: Maxwel F. Silva, José Geraldo Pedrosa

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The issue revolves around the discourse on development that was current in Brazil in the late nineteenth and early twentieth century and its relation to industrialization as idea of civility, modernity and progress. The main objective of this paper is to analyze the workmanship of the visionary entrepreneur and organic intellectual Roberto Cochrane Simonsen (1889-1948). In the set of speeches, lectures and conferences pronounced by Simonsen, the USA constantly appears like model of civilization. The hypothesis is that, as base of the proposals of industrialization defended by him there was an idea of Americanism that would serve of foundation to a way of thinking and acting. For Simonsen, the construction of a nation is directly related to its industrialization. In his thought, develop the Brazil means to structure the country with rational economic mechanisms. This paper investigates the American influences on the discourse of Simonsen about the development of Brazil.

Keywords: Americanism, development of Brazil, Simonsen, social discourse

Procedia PDF Downloads 336
383 Physical Characterization of a Watershed for Correlation with Parameters of Thomas Hydrological Model and Its Application in Iber Hidrodinamic Model

Authors: Carlos Caro, Ernest Blade, Nestor Rojas

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This study determined the relationship between basic geo-technical parameters and parameters of the hydro logical model Thomas for water balance of rural watersheds, as a methodological calibration application, applicable in distributed models as IBER model, which represents a distributed system simulation models for unsteady flow numerical free surface. There was an exploration in 25 points (on 15 sub) basin of Rio Piedras (Boy.) obtaining soil samples, to which geo-technical characterization was performed by laboratory tests. Thomas model has a physical characterization of the input area by only four parameters (a, b, c, d). Achieve measurable relationship between geo technical parameters and 4 values of hydro logical parameters helps to determine subsurface, underground and surface flow more agile manner. It is intended in this way to reach some solutions regarding limits initial model parameters on the basis of Thomas geo-technical characterization. In hydro geological models of rural watersheds, calibration is an important process in the characterization of the study area. This step can require a significant computational cost and time, especially if the initial values or parameters before calibration are outside of the geo-technical reality. A better approach in these initial values means optimization of these process through a geo-technical materials area, where is obtained an important approach to the study as in the starting range of variation for the calibration parameters.

Keywords: distributed hydrology, hydrological and geotechnical characterization, Iber model

Procedia PDF Downloads 517
382 Grief and Repenting: The Engaging Remembrance in Thomas Hardy’s ‘Poems of 1912-13’

Authors: Chih-Chun Tang

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Nostalgia, to some people, may seem foolhardy in a way. However, nostalgia is a completely and intensely private but social, collective emotion. It has continuing consequence and outgrowth for our lives as social actions. It leads people to hunt and explore remembrance of persons and places of our past in an effort to confer meaning of persons and places of present. In the ‘Poems of 1912-13’ Thomas Hardy, a British poet, composed a series of poems after the unexpected death of his long-disaffected wife, Emma. The series interprets the cognitive and emotional concussion of Emma’s death on Hardy, concerning his mind and real visit to the landscape in Cornwall, England. Both spaces perform the author’s innermost in thought to his late wife and to the landscape. They present an apparent counterpart of the poet and his afflicted conscience. After Emma had died, Hardy carried her recollections alive by roaming about in the real visit and whimsical land (space) they once had drifted and meandered. This paper highlights the nostalgias and feds that seem endlessly to crop up.

Keywords: Thomas Hardy, remembrance, psychological, poems 1912-13, Fred Davis, nostalgia

Procedia PDF Downloads 267
381 Does Mirror Therapy Improve Motor Recovery After Stroke? A Meta-Analysis of Randomized Controlled Trials

Authors: Hassan Abo Salem, Guo Feng, Xiaolin Huang

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The objective of this study is to determine the effectiveness of mirror therapy on motor recovery and functional abilities after stroke. The following databases were searched from inception to May 2014: Cochrane Stroke, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, and PEDro. Two reviewers independently screened and selected all randomized controlled trials that evaluate the effect of mirror therapy in stroke rehabilitation.12 randomized controlled trials studies met the inclusion criteria; 10 studies utilized the effect of mirror therapy for the upper limb and 2 studies for the lower limb. Mirror therapy had a positive effect on motor recover and function; however, we found no consistent influence on activity of daily living, Spasticity and balance. This meta-analysis suggests that, Mirror therapy has additional effect on motor recovery but has a small positive effect on functional abilities after stroke. Further high-quality studies with greater statistical power are required in order to accurately determine the effectiveness of mirror therapy following stroke.

Keywords: mirror therapy, motor recovery, stroke, balance

Procedia PDF Downloads 545
380 Shock Compressibility of Iron Alloys Calculated in the Framework of Quantum-Statistical Models

Authors: Maxim A. Kadatskiy, Konstantin V. Khishchenko

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Iron alloys are widespread components in various types of structural materials which are exposed to intensive thermal and mechanical loads. Various quantum-statistical cell models with the approximation of self-consistent field can be used for the prediction of the behavior of these materials under extreme conditions. The application of these models is even more valid, the higher the temperature and the density of matter. Results of Hugoniot calculation for iron alloys in the framework of three quantum-statistical (the Thomas–Fermi, the Thomas–Fermi with quantum and exchange corrections and the Hartree–Fock–Slater) models are presented. Results of quantum-statistical calculations are compared with results from other reliable models and available experimental data. It is revealed a good agreement between results of calculation and experimental data for terra pascal pressures. Advantages and disadvantages of this approach are shown.

Keywords: alloy, Hugoniot, iron, terapascal pressure

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379 A Dynamic Column Adsorption Study of Methyl Blue on Synthesis onto Synthesized Chitosan Immobilized Sawdust Cellulose Nanocrystals

Authors: Opeyemi A. Oyewo, Seshibe Makgato

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This paper presents the synthesis, characterization, and application of pelletized chitosan immobilized sawdust cellulose nanocrystals (PCCN) in a fixed-bed column for the continuous adsorption of methyl blue (MB) from water. The product was characterized using FT-IR, XRD, and SEM analysis. Microstructural examination revealed that the pellets are porous and spherical. XRD examination revealed phases that can be attributed to the presence of chitosan in PCCN. The effects of starting concentration, bed depth, and flow rate on synthetic water were explored. To identify MB breakthrough behaviour, performance indices such as bed volume, adsorbent exhaustion rate, and service time were investigated. Furthermore, the breakthrough data were incorporated into both the Thomas and Bohart-Adams models. The Thomas model was suitable for describing MB breakthrough curves. However, more research with diverse water matrices may be required to assess the resilience of PCCN.

Keywords: adsorption, dynamic, methyl blue, pelletization

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378 Pyridoxine Effectiveness and Safety for Postpartum Lactation Inhibition: A Systematic Review

Authors: Doua AlSaad, Ahmed Awaisu, Samah Elsalem, Palli Valapila Abdulrouf, Binny Thomas, Moza AlHail

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Background: It has been suggested that pyridoxine has an anti-lactogenic effect. Studies of the efficacy of pyridoxine in suppressing lactation have reported conflicting results. The aim of this review is to evaluate the effectiveness and safety of high-dose pyridoxine in postpartum lactation inhibition. Methods: This systematic review included published trials that compared the efficacy and/or safety of pyridoxine to placebo or to other pharmacological agents for the inhibition of postpartum lactation. We searched PubMed, Embase, ScienceDirect, CINAHL, AMED, the Cochrane library, and the clinical trials registry to identify relevant literature. No limit was imposed on the year of publication of the studies, and the review included studies published until 15 January 2016. Two reviewers independently extracted data and assessed the risk of bias. Results: Seven studies were included, with a total of 1155 women, of which 471 women received pyridoxine. Three studies were randomized controlled trials, while the remaining four studies were non-randomized controlled trials. All of the included studies were relatively small (n = 18 – 482). The studies compared pyridoxine with placebo, bromocriptine, and/or stilboestrol. Pyridoxine was given orally, with a total daily dose of 450 – 600 mg for 5 to 7 days. Two trials (n = 349 participants) indicated that pyridoxine was effective in inhibiting lactation in approximately 95% of the enrolled patients. All other studies failed to demonstrate pyridoxine efficacy through either clinical assessment or prolactin level measurements. Pyridoxine safety was assessed by two trials in which no serious untoward side-effects were reported. Overall, the risk of bias for most of the studies was low to moderate. Conclusion: Current evidence supporting the effectiveness of high dose pyridoxine in the inhibition of postpartum lactation is inconsistent and insufficient. Larger randomized trials are needed to confirm the efficacy of pyridoxine in postpartum lactation inhibition. Acknowledgment: This review received a grant from the Medical Research Center of Hamad Medical Corporation in Qatar (grant number: 15100/15).

Keywords: pyridoxine, safety, effectiveness, lactation inhibition

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377 The Effects of Supportive Care Interventions with Psychotherapeutic and Exercise Approaches on Depressive Symptoms Among Patients with Lung Cancer: A Meta-Analysis

Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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376 Structural and Magnetic Properties of Calcium Mixed Ferrites Prepared by Co-Precipitation Method

Authors: Sijo S. Thomas, S. Hridya, Manoj Mohan, Bibin Jacob, Hysen Thomas

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Ferrites are iron based oxides with technologically significant magnetic properties and have widespread applications in medicine, technology, and industry. There has been a growing interest in the study of magnetic, electrical and structural properties of mixed ferrites. In the present work, structural and magnetic properties of Nickel and Calcium substituted Fe₃O₄ nanoparticles were investigated. NiₓCa₁₋ₓFe₂O₄ nanoparticles (x = 0, 0.1, 0.3, 0.5, 0.7, 0.9) were synthesized by chemical co-precipitation method and the samples were subsequently sintered at 900°C. The magnetic and structural properties of NiₓCa₁₋ₓFe₂O₄ were investigated using Vibrating Sample Magnetometer and X-Ray diffraction. The XRD results revealed that the synthesized particles have nanometer size and it varies from 46-72 nm as the calcium concentration diminishes. The variation is explained based on the increase in the reaction rate with Ni concentration which favors the formation of ultrafine particles of mixed ferrites. VSM results show pure CaFe₂O₄ exhibit paramagnetic behavior with low saturation value. As the concentration of Ca decreases, a transition occurs from paramagnetic state to ferromagnetic state. When the concentration of Ni becomes dominant, magnetic saturation, coercivity, and retentivity become high, indicating near ferromagnetic behavior of the compound.

Keywords: co-precipitation, ferrites, magnetic behavior, structure

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375 Systematic Review of the Efficacy of Traditional Chinese Medicine in Parkinson Disease

Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

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Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

Procedia PDF Downloads 137
374 Continuous Fixed Bed Reactor Application for Decolourization of Textile Effluent by Adsorption on NaOH Treated Eggshell

Authors: M. Chafi, S. Akazdam, C. Asrir, L. Sebbahi, B. Gourich, N. Barka, M. Essahli

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Fixed bed adsorption has become a frequently used industrial application in wastewater treatment processes. Various low cost adsorbents have been studied for their applicability in treatment of different types of effluents. In this work, the intention of the study was to explore the efficacy and feasibility for azo dye, Acid Orange 7 (AO7) adsorption onto fixed bed column of NaOH Treated eggshell (TES). The effect of various parameters like flow rate, initial dye concentration, and bed height were exploited in this study. The studies confirmed that the breakthrough curves were dependent on flow rate, initial dye concentration solution of AO7 and bed depth. The Thomas, Yoon–Nelson, and Adams and Bohart models were analysed to evaluate the column adsorption performance. The adsorption capacity, rate constant and correlation coefficient associated to each model for column adsorption was calculated and mentioned. The column experimental data were fitted well with Thomas model with coefficients of correlation R2 ≥0.93 at different conditions but the Yoon–Nelson, BDST and Bohart–Adams model (R2=0.911), predicted poor performance of fixed-bed column. The (TES) was shown to be suitable adsorbent for adsorption of AO7 using fixed-bed adsorption column.

Keywords: adsorption models, acid orange 7, bed depth, breakthrough, dye adsorption, fixed-bed column, treated eggshell

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373 Long-Term Effects of Psychosocial Interventions for Adolescents on Depression and Anxiety: A Systematic Review and Meta-Analysis

Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

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Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

Procedia PDF Downloads 65
372 Expanding the Atelier: Design Lead Academic Project Using Immersive User-Generated Mobile Images and Augmented Reality

Authors: David Sinfield, Thomas Cochrane, Marcos Steagall

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While there is much hype around the potential and development of mobile virtual reality (VR), the two key critical success factors are the ease of user experience and the development of a simple user-generated content ecosystem. Educational technology history is littered with the debris of over-hyped revolutionary new technologies that failed to gain mainstream adoption or were quickly superseded. Examples include 3D television, interactive CDROMs, Second Life, and Google Glasses. However, we argue that this is the result of curriculum design that substitutes new technologies into pre-existing pedagogical strategies that are focused upon teacher-delivered content rather than exploring new pedagogical strategies that enable student-determined learning or heutagogy. Visual Communication design based learning such as Graphic Design, Illustration, Photography and Design process is heavily based on the traditional forms of the classroom environment whereby student interaction takes place both at peer level and indeed teacher based feedback. In doing so, this makes for a healthy creative learning environment, but does raise other issue in terms of student to teacher learning ratios and reduced contact time. Such issues arise when students are away from the classroom and cannot interact with their peers and teachers and thus we see a decline in creative work from the student. Using AR and VR as a means of stimulating the students and to think beyond the limitation of the studio based classroom this paper will discuss the outcomes of a student project considering the virtual classroom and the techniques involved. The Atelier learning environment is especially suited to the Visual Communication model as it deals with the creative processing of ideas that needs to be shared in a collaborative manner. This has proven to have been a successful model over the years, in the traditional form of design education, but has more recently seen a shift in thinking as we move into a more digital model of learning and indeed away from the classical classroom structure. This study focuses on the outcomes of a student design project that employed Augmented Reality and Virtual Reality technologies in order to expand the dimensions of the classroom beyond its physical limits. Augmented Reality when integrated into the learning experience can improve the learning motivation and engagement of students. This paper will outline some of the processes used and the findings from the semester-long project that took place.

Keywords: augmented reality, blogging, design in community, enhanced learning and teaching, graphic design, new technologies, virtual reality, visual communications

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371 Microbial Reduction of Terpenes from Pine Wood Material

Authors: Bernhard Widhalm, Cornelia Rieder-Gradinger, Thomas Ters, Ewald Srebotnik, Thomas Kuncinger

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Terpenes are natural components in softwoods and rank among the most frequently emitted volatile organic compounds (VOC) in the wood-processing industry. In this study, the main focus was on α- and β-pinene as well as Δ3-carene, which are the major terpenes in softwoods. To lower the total emission level of wood composites, defined terpene degrading microorganisms were applied to basic raw materials (e.g. pine wood particles and strands) in an optimised and industry-compatible testing procedure. In preliminary laboratory tests, bacterial species suitable for the utilisation of α-pinene as single carbon source in liquid culture were selected and then subjected to wood material inoculation. The two species Pseudomonas putida and Pseudomonas fluorescens were inoculated onto wood particles and strands and incubated at room temperature. Applying specific pre-cultivation and daily ventilation of the samples enabled a reduction of incubation time from six days to one day. SPME measurements and subsequent GC-MS analysis indicated a complete absence of α- and β-pinene emissions after 24 hours from pine wood particles. When using pine wood strands rather than particles, bacterial treatment resulted in a reduction of α- and β-pinene by 50%, while Δ3-carene emissions were reduced by 30% in comparison to untreated strands. Other terpenes were also reduced in the course of the microbial treatment. The method developed here appears to be feasible for industrial application. However, growth parameters such as time and temperature as well as the technical implementation of the inoculation step will have to be adapted for the production process.

Keywords: GC-MS, pseudomonas, SPME, terpenes

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370 Performance of the Aptima® HIV-1 Quant Dx Assay on the Panther System

Authors: Siobhan O’Shea, Sangeetha Vijaysri Nair, Hee Cheol Kim, Charles Thomas Nugent, Cheuk Yan William Tong, Sam Douthwaite, Andrew Worlock

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The Aptima® HIV-1 Quant Dx Assay is a fully automated assay on the Panther system. It is based on Transcription-Mediated Amplification and real time detection technologies. This assay is intended for monitoring HIV-1 viral load in plasma specimens and for the detection of HIV-1 in plasma and serum specimens. Nine-hundred and seventy nine specimens selected at random from routine testing at St Thomas’ Hospital, London were anonymised and used to compare the performance of the Aptima HIV-1 Quant Dx assay and Roche COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test, v2.0. Two-hundred and thirty four specimens gave quantitative HIV-1 viral load results in both assays. The quantitative results reported by the Aptima Assay were comparable those reported by the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 Test, v2.0 with a linear regression slope of 1.04 and an intercept on -0.097. The Aptima assay detected HIV-1 in more samples than the Roche assay. This was not due to lack of specificity of the Aptima assay because this assay gave 99.83% specificity on testing plasma specimens from 600 HIV-1 negative individuals. To understand the reason for this higher detection rate a side-by-side comparison of low level panels made from the HIV-1 3rd international standard (NIBSC10/152) and clinical samples of various subtypes were tested in both assays. The Aptima assay was more sensitive than the Roche assay. The good sensitivity, specificity and agreement with other commercial assays make the HIV-1 Quant Dx Assay appropriate for both viral load monitoring and detection of HIV-1 infections.

Keywords: HIV viral load, Aptima, Roche, Panther system

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369 Efficacy and Safety of Eucalyptus for Relief Cough Symptom: A Systematic Review and Meta-Analysis

Authors: Ladda Her, Juntip Kanjanasilp, Ratree Sawangjit, Nathorn Chaiyakunapruk

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Cough is the common symptom of the respiratory tract infections or non-infections; the duration of cough indicates a classification and severity of disease. Herbal medicines can be used as the alternative to drugs for relief of cough symptoms from acute and chronic disease. Eucalyptus was used for reducing cough with evidences suggesting it has an active role in reduction of airway inflammation. The present study aims to evaluate efficacy and safety of eucalyptus for relief of cough symptom in respiratory disease. Method: The Cochrane Library, MEDLINE (PubMed), Scopus, CINAHL, Springer, Science direct, ProQuest, and THAILIS databases. From its inception until 01/02/2019 for randomized control trials. We follow for the efficacy and safety of eucalyptus for reducing cough. Methodological quality was evaluated by using the Cochrane risk of bias tool; two reviewers in our team screened eligibility and extracted data. Result: Six studies were included for the review and five studies were included in the meta-analysis, there were 1.911 persons including children (n: 1) and adult (n: 5) studies; for study in children and adult were between 1 and 80 years old, respectively. Eucalyptus was used as mono herb (n: 2) and in combination with other herbs form (n: 4). All of the studies with eucalyptus were compared for efficacy and safety with placebo or standard treatment, Eucalyptus dosage form in studies included capsules, spray, and syrup. Heterogeneity was 32.44 used random effect model (I² = 1.2%, χ² = 1.01; P-value = 0.314). The efficacy of eucalyptus was showed a reduced cough symptom statistically significant (n = 402, RR: 1.40, 95%CI [1.19, 1.65], P-value < 0.0001) when compared with placebo. Adverse events (AEs) were reported mild to moderate intensity with mostly gastrointestinal symptom. The methodological quality of the included trials was overall poor. Conclusion: Eucalyptus appears to be beneficial and safe for relieving in respiratory diseases focus on cough frequency. The evidence was inconclusive due to limited quality trial. Well-designed trials for evaluating the effectiveness in humans, the effectiveness for reducing cough symptom in human is needed. Eucalyptus had safety as monotherapy or in combination with other herbs.

Keywords: cough, eucalyptus, cineole, herbal medicine, systematic review, meta-analysis

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368 Comparison of Adsorbents for Ammonia Removal from Mining Wastewater

Authors: F. Al-Sheikh, C. Moralejo, M. Pritzker, W. A. Anderson, A. Elkamel

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Ammonia in mining wastewater is a significant problem, and treatment can be especially difficult in cold climates where biological treatment is not feasible. An adsorption process is one of the alternative processes that can be used to reduce ammonia concentrations to acceptable limits, and therefore a LEWATIT resin strongly acidic H+ form ion exchange resin and a Bowie Chabazite Na form AZLB-Na zeolite were tested to assess their effectiveness. For these adsorption tests, two packed bed columns (a mini-column constructed from a 32-cm long x 1-cm diameter piece of glass tubing, and a 60-cm long x 2.5-cm diameter Ace Glass chromatography column) were used containing varying quantities of the adsorbents. A mining wastewater with ammonia concentrations of 22.7 mg/L was fed through the columns at controlled flowrates. In the experimental work, maximum capacities of the LEWATIT ion exchange resin were 0.438, 0.448, and 1.472 mg/g for 3, 6, and 9 g respectively in a mini column and 1.739 mg/g for 141.5 g in a larger Ace column while the capacities for the AZLB-Na zeolite were 0.424, and 0.784 mg/g for 3, and 6 g respectively in the mini column and 1.1636 mg/g for 38.5 g in the Ace column. In the theoretical work, Thomas, Adams-Bohart, and Yoon-Nelson models were constructed to describe a breakthrough curve of the adsorption process and find the constants of the above-mentioned models. In the regeneration tests, 5% hydrochloric acid, HCl (v/v) and 10% sodium hydroxide, NaOH (w/v) were used to regenerate the LEWATIT resin and AZLB-Na zeolite with 44 and 63.8% recovery, respectively. In conclusion, continuous flow adsorption using a LEWATIT ion exchange resin and an AZLB-Na zeolite is efficient when using a co-flow technique for removal of the ammonia from wastewater. Thomas, Adams-Bohart, and Yoon-Nelson models satisfactorily fit the data with R2 closer to 1 in all cases.

Keywords: AZLB-Na zeolite, continuous adsorption, Lewatit resin, models, regeneration

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367 Effect of Bonded and Removable Retainers on Occlusal Settling after Orthodontic Treatment: A Systematic Review and Meta-Analysis

Authors: Umair Shoukat Ali, Kamil Zafar, Rashna Hoshang Sukhia, Mubassar Fida, Aqeel Ahmed

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Objective: This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (Hawley and Essix retainer) in terms of improvement in occlusal settling (occlusal contact points/areas) after orthodontic treatment. Search Method: We searched the Cochrane Library, CINAHL Plus, PubMed, Web of Science, Orthodontic journals, and Google scholar for eligible studies. We included randomized control trials (RCT) along with Cohort studies. Studies that reported occlusal contacts/areas during retention with fixed bonded and removable retainers were included. To assess the quality of the RCTs Cochrane risk of bias tool was utilized, whereas Newcastle-Ottawa Scale was used for assessing the quality of cohort studies. Data analysis: The data analysis was limited to reporting mean values of occlusal contact points/areas with different retention methods. By utilizing the RevMan software V.5.3, a meta-analysis was performed for all the studies with the quantitative data. For the computation of the summary effect, a random effect model was utilized in case of high heterogeneity. I2 statistics were utilized to assess the heterogeneity among the selected studies. Results: We included 6 articles in our systematic review after scrutinizing 219 articles and eliminating them based on duplication, titles, and objectives. We found significant differences between fixed and removable retainers in terms of occlusal settling within the included studies. Bonded retainer (BR) allowed faster and better posterior tooth settling as compared to Hawley retainer (HR). However, HR showed good occlusal settling in the anterior dental arch. Essix retainer showed a decrease in occlusal contact during the retention phase. Meta-analysis showed no statistically significant difference between BR and removable retainers. Conclusions: HR allowed better overall occlusal settling as compared to other retainers in comparison. However, BR allowed faster settling in the posterior teeth region. Overall, there are insufficient high-quality RCTs to provide additional evidence, and further high-quality RCTs research is needed.

Keywords: orthodontic retainers, occlusal contact, Hawley, fixed, vacuum-formed

Procedia PDF Downloads 118
366 Compressive Stresses near Crack Tip Induced by Thermo-Electric Field

Authors: Thomas Jin-Chee Liu

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In this paper, the thermo-electro-structural coupled-field in a cracked metal plate is studied using the finite element analysis. From the computational results, the compressive stresses reveal near the crack tip. This conclusion agrees with the past reference. Furthermore, the compressive condition can retard and stop the crack growth during the Joule heating process.

Keywords: compressive stress, crack tip, Joule heating, finite element

Procedia PDF Downloads 399
365 Sustainable Production of Pharmaceutical Compounds Using Plant Cell Culture

Authors: David A. Ullisch, Yantree D. Sankar-Thomas, Stefan Wilke, Thomas Selge, Matthias Pump, Thomas Leibold, Kai Schütte, Gilbert Gorr

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Plants have been considered as a source of natural substances for ages. Secondary metabolites from plants are utilized especially in medical applications but are more and more interesting as cosmetical ingredients and in the field of nutraceuticals. However, supply of compounds from natural harvest can be limited by numerous factors i.e. endangered species, low product content, climate impacts and cost intensive extraction. Especially in the pharmaceutical industry the ability to provide sufficient amounts of product and high quality are additional requirements which in some cases are difficult to fulfill by plant harvest. Whereas in many cases the complexity of secondary metabolites precludes chemical synthesis on a reasonable commercial basis, plant cells contain the biosynthetic pathway – a natural chemical factory – for a given compound. A promising approach for the sustainable production of natural products can be plant cell fermentation (PCF®). A thoroughly accomplished development process comprises the identification of a high producing cell line, optimization of growth and production conditions, the development of a robust and reliable production process and its scale-up. In order to address persistent, long lasting production, development of cryopreservation protocols and generation of working cell banks is another important requirement to be considered. So far the most prominent example using a PCF® process is the production of the anticancer compound paclitaxel. To demonstrate the power of plant suspension cultures here we present three case studies: 1) For more than 17 years Phyton produces paclitaxel at industrial scale i.e. up to 75,000 L in scale. With 60 g/kg dw this fully controlled process which is applied according to GMP results in outstanding high yields. 2) Thapsigargin is another anticancer compound which is currently isolated from seeds of Thapsia garganica. Thapsigargin is a powerful cytotoxin – a SERCA inhibitor – and the precursor for the derivative ADT, the key ingredient of the investigational prodrug Mipsagargin (G-202) which is in several clinical trials. Phyton successfully generated plant cell lines capable to express this compound. Here we present data about the screening for high producing cell lines. 3) The third case study covers ingenol-3-mebutate. This compound is found in the milky sap of the intact plants of the Euphorbiacae family at very low concentrations. Ingenol-3-mebutate is used in Picato® which is approved against actinic keratosis. Generation of cell lines expressing significant amounts of ingenol-3-mebutate is another example underlining the strength of plant cell culture. The authors gratefully acknowledge Inspyr Therapeutics for funding.

Keywords: Ingenol-3-mebutate, plant cell culture, sustainability, thapsigargin

Procedia PDF Downloads 241
364 Autologous Blood for Conjunctival Autograft Fixation in Primary Pterygium Surgery: a Systematic Review and Meta-Analysis

Authors: Mohamed Abdelmongy

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Autologous Blood for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Systematic Review and Meta-analysis Hossam Zein1,2, Ammar Ismail1,3, Mohamed Abdelmongy1,4, Sherif Elsherif1,5,6, Ahmad Hassanen1,4, Basma Muhammad2, Fathy Assaf1,3, Ahmed Elsehili1,7, Ahmed Negida1,7, Shin Yamane9, Mohamed M. Abdel-Daim8,9 and Kazuaki Kadonosono9 https://www.ncbi.nlm.nih.gov/pubmed/30277146 BACKGROUND: Pterygium is a benign ocular lesion characterized by triangular fibrovascular growth of conjunctival tissue over the cornea. Patients complain of the bad cosmetic appearance, ocular surface irritation and decreased visual acuity if the pterygium is large enough to cause astigmatism or encroach on the pupil. The definitive treatment of pterygium is surgical removal. However, outcomes are compromised by recurrence . The aim of the current study is to systematically review the current literature to explore the efficacy and safety of fibrin glue, suture and autologous blood coagulum for conjunctivalautograft fixation in primary pterygium surgery. OBJECTIVES: To assess the effectiveness of fibrin glue compared to sutures and autologous blood coagulum in conjunctival autografting for the surgical treatment of pterygium. METHODS: During preparing this manuscript, we followed the steps adequately illustrated in the Cochrane Handbook for Systematic Reviews of Interventions version 5.3, and reported it according to the preferred reporting of systematic review and meta-analysis (PRISMA) statement guidelines. We searched PubMed, Ovid (both through Medline), ISI Web of Science, and Cochrane Central Register of Controlled Trials (Central) through January 2017, using the following keywords “Pterygium AND (blood OR glue OR suture)” SELECTION CRITERIA: We included all randomized controlled trials (RCTs) that met the following criteria: 1) comparing autologous blood vs fibrin glue for conjunctivalautograft fixation in primary pterygium surgery 2) comparing autologous blood vs sutures for conjunctivalautograft fixation in primary pterygium surgery DATA COLLECTION AND ANALYSIS: Two review authors independently screened the search results, assessed trial quality, and extracted data using standard methodological procedures expected by Cochrane. The extracted data included A) study design, sample size, and main findings, B) Baseline characteristics of patients included in this review including their age, sex, pterygium site and grade, and graft size. C) Study outcomes comprising 1) primary outcomes: recurrence rate 2) secondary outcomes: graft stability outcomes (graft retraction, graft displacement), operation time (min) and postoperative symptoms (pain, discomfort, foreign body sensation, tearing) MAIN RESULTS: We included 7 RCTs and The review included662eyes (Blood: 293; Glue: 198; Suture: 171). we assess the 1) primary outcomes: recurrence rate 2) secondary outcomes: graft stability outcomes (graft retraction, graft displacement), operation time (min) and postoperative symptoms (pain, discomfort, foreign body sensation, tearing) CONCLUSIONS: Autologous blood for conjunctivalautograft fixation in pterygium surgery is associated with lower graft stability than fibrin glue or sutures. It was not inferior to fibrin glue or sutures regarding recurrence rate. The overall quality of evidence is low. Further well designed RCTs are needed to fully explore the efficacy of this new technique.

Keywords: pterygium, autograft, ophthalmology, cornea

Procedia PDF Downloads 154
363 The Efficacy of Preoperative Thermal Pulsation Treatment in Reducing Post Cataract Surgery Dry Eye Disease: A Systematic Review and Meta-analysis

Authors: Lugean K. Alomari, Rahaf K. Sharif, Basil K. Alomari, Hind M. Aljabri, Faisal F. Aljahdali, Amal A. Alomari, Saeed A. Alghamdi

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Background: The thermal pulsation system is a therapy that uses heat and massage to treat dry eye disease; thus, some trials have been published to compare it with the conventional treatment. The aim of this study is to conduct a systematic review and meta-analysis comparing the efficacy of thermal pulsation systems with conventional treatment in patients undergoing cataract surgery. Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for eligible trials. We included three randomized controlled trials (RCTs) that compared the thermal pulsation system with the conventional treatment in patients undergoing cataract surgery. A table of characteristics was plotted, and the Quality of the studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Forest plots were plotted using the Random-effect Inverse Variance method. χ2 test and the Higgins-I-squared (I2) model were used to assess heterogeneity. A total of 201 cataract surgery patients were included, with 105 undergoing preoperative pulsation therapy and 96 receiving conventional treatment. Demographic analysis revealed comparable distributions across groups. Results: All the studies in our analysis are of good quality with a low risk of bias. A total of 201 patients were included in the analysis, out of which 105 underwent pulsation therapy, and 95 were in the control group. Tear Break-up Time (TBUT) analysis revealed no significant baseline differences, except pulsation therapy being better at 1 month. (SMD 0.42 [95%CI 0.14 - 0.70] p=0.004). This positive trend continued at three months (SMD 0.52 [95% CI (0.20 – 0.84)] p=0.002). Corneal fluorescein staining scores and Meibomian gland-yielding secretion scores showed no significant differences at baseline. However, at one month, pulsation therapy significantly improved Meibomian gland function (SMD -0.86 [95% CI (-1.20 - -0.53)] p<0.00001), indicating a reduced risk of dry eye syndrome. Conclusion: Preoperative pulsation therapy appears to enhance post-cataract surgery outcomes, particularly in terms of tear film stability and Meibomian gland secretory function. The sustained positive effects observed at one and three months post-surgery suggest the potential for long-term benefits.

Keywords: lipiflow, cataract, thermal pulsation, dry eye

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362 The Risk of Bleeding in Knee or Shoulder Injections in Patients on Warfarin Treatment

Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

Procedia PDF Downloads 73
361 Approaches to Reduce the Complexity of Mathematical Models for the Operational Optimization of Large-Scale Virtual Power Plants in Public Energy Supply

Authors: Thomas Weber, Nina Strobel, Thomas Kohne, Eberhard Abele

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In context of the energy transition in Germany, the importance of so-called virtual power plants in the energy supply continues to increase. The progressive dismantling of the large power plants and the ongoing construction of many new decentralized plants result in great potential for optimization through synergies between the individual plants. These potentials can be exploited by mathematical optimization algorithms to calculate the optimal application planning of decentralized power and heat generators and storage systems. This also includes linear or linear mixed integer optimization. In this paper, procedures for reducing the number of decision variables to be calculated are explained and validated. On the one hand, this includes combining n similar installation types into one aggregated unit. This aggregated unit is described by the same constraints and target function terms as a single plant. This reduces the number of decision variables per time step and the complexity of the problem to be solved by a factor of n. The exact operating mode of the individual plants can then be calculated in a second optimization in such a way that the output of the individual plants corresponds to the calculated output of the aggregated unit. Another way to reduce the number of decision variables in an optimization problem is to reduce the number of time steps to be calculated. This is useful if a high temporal resolution is not necessary for all time steps. For example, the volatility or the forecast quality of environmental parameters may justify a high or low temporal resolution of the optimization. Both approaches are examined for the resulting calculation time as well as for optimality. Several optimization models for virtual power plants (combined heat and power plants, heat storage, power storage, gas turbine) with different numbers of plants are used as a reference for the investigation of both processes with regard to calculation duration and optimality.

Keywords: CHP, Energy 4.0, energy storage, MILP, optimization, virtual power plant

Procedia PDF Downloads 169
360 Portfolio Risk Management Using Quantum Annealing

Authors: Thomas Doutre, Emmanuel De Meric De Bellefon

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This paper describes the application of local-search metaheuristic quantum annealing to portfolio opti- mization. Heuristic technics are particularly handy when Markowitz’ classical Mean-Variance problem is enriched with additional realistic constraints. Once tailored to the problem, computational experiments on real collected data have shown the superiority of quantum annealing over simulated annealing for this constrained optimization problem, taking advantages of quantum effects such as tunnelling.

Keywords: optimization, portfolio risk management, quantum annealing, metaheuristic

Procedia PDF Downloads 377
359 Macronutrients and the FTO Gene Expression in Hypothalamus: A Systematic Review of Experimental Studies

Authors: Saeid Doaei

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The various studies have examined the relationship between FTO gene expression and macronutrients levels. In order to obtain better viewpoint from this interactions, all of the existing studies were reviewed systematically. All published papers have been obtained and reviewed using standard and sensitive keywords from databases such as CINAHL, Embase, PubMed, PsycInfo, and the Cochrane, from 1990 to 2016. The results indicated that all of 6 studies that met the inclusion criteria (from a total of 428 published article) found FTO gene expression changes at short-term follow-ups. Four of six studies found an increased FTO gene expression after calorie restriction, while two of them indicated decreased FTO gene expression. The effect of protein, carbohydrate and fat were separately assessed and suggested by all of six studies. In conclusion, the level of FTO gene expression in hypothalamus is related to macronutrients levels. Future research should evaluate the long-term impact of dietary interventions.

Keywords: obesity, gene expression, FTO, macronutrients

Procedia PDF Downloads 259
358 The Needs Programme and Poverty Reduction for National Development of Nigeria at 53

Authors: Owulo Thomas

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Despite Nigeria’s ranking as the 6th among oil producing countries, the country faces great challenges. One of such challenges is how to reduce poverty or eradicating it in the land that promises milk and honey to enhance national development. The government of Nigeria initiated various programmes including the NEEDS programme in which it committed her to meeting these challenges. This paper is an attempt to discuss the concept of National Development, the Nigerian poverty profile and its implication for national development, the NEEDS programmes and the extent to which it has addressed the poverty problem in Nigeria at 53.

Keywords: challenges, poverty, national development, NEEDS programme

Procedia PDF Downloads 377
357 Hypoglossal Nerve Stimulation (Baseline vs. 12 months) for Obstructive Sleep Apnea: A Meta-Analysis

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

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Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

Procedia PDF Downloads 109