Search results for: chronic stroke

Authors: Madhujit Deb, G. R. K. Sastry, R. S. Panua, Rahul Banerjee, P. K. Bose

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The present work attempts to investigate the combustion, performance and emission characteristics of an existing single-cylinder four-stroke compression-ignition engine operated in dual-fuel mode with hydrogen as an alternative fuel. Environmental concerns and limited amount of petroleum fuels have caused interests in the development of alternative fuels like hydrogen for internal combustion (IC) engines. In this experimental investigation, a diesel engine is made to run using hydrogen in dual fuel mode with diesel, where hydrogen is introduced into the intake manifold using an LPG-CNG injector and pilot diesel is injected using diesel injectors. A Timed Manifold Injection (TMI) system has been developed to vary the injection strategies. The optimized timing for the injection of hydrogen was 100 CA after top dead center (ATDC). From the study it was observed that with increasing hydrogen rate, enhancement in brake thermal efficiency (BTHE) of the engine has been observed with reduction in brake specific energy consumption (BSEC). Furthermore, Soot contents decrease with an increase in indicated specific NOx emissions with the enhancement of hydrogen flow rate.

Keywords: diesel engine, hydrogen, BTHE, BSEC, soot, NOx

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Authors: Izabella Szollosi, Klara Marton

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Aphasia can be defined as a weakness in accessing linguistic information. Accessing linguistic information is strongly related to information processing, which in turn is associated with the cognitive control system. According to the literature, a deficit in the cognitive control system interferes with language processing and contributes to non-fluent speech performance. The aim of our study was to explore this hypothesis by investigating how cognitive control interacts with language performance in participants with non-fluent aphasia. Cognitive control is a complex construct that includes working memory (WM) and the ability to resist proactive interference (PI). Based on previous research, we hypothesized that impairments in domain-general (DG) cognitive control abilities have negative effects on language processing. In contrast, better DG cognitive control functioning supports goal-directed behavior in language-related processes as well. Since stroke itself might slow down information processing, it is important to examine its negative effects on both cognitive control and language processing. Participants (N=52) in our study were individuals with non-fluent Broca’s aphasia (N = 13), with transcortical motor aphasia (N=13), individuals with stroke damage without aphasia (N=13), and unimpaired speakers (N = 13). All participants performed various computer-based tasks targeting cognitive control functions such as WM and resistance to PI in both linguistic and non-linguistic domains. Non-linguistic tasks targeted primarily DG functions, while linguistic tasks targeted more domain specific (DS) processes. The results showed that participants with Broca’s aphasia differed from the other three groups in the non-linguistic tasks. They performed significantly worse even in the baseline conditions. In contrast, we found a different performance profile in the linguistic domain, where the control group differed from all three stroke-related groups. The three groups with impairment performed more poorly than the controls but similar to each other in the verbal baseline condition. In the more complex verbal PI condition, however, participants with Broca’s aphasia performed significantly worse than all the other groups. Participants with Broca’s aphasia demonstrated the most severe language impairment and the highest vulnerability in tasks measuring DG cognitive control functions. Results support the notion that the more severe the cognitive control impairment, the more severe the aphasia. Thus, our findings suggest a strong interaction between cognitive control and language. Individuals with the most severe and most general cognitive control deficit - participants with Broca’s aphasia - showed the most severe language impairment. Individuals with better DG cognitive control functions demonstrated better language performance. While all participants with stroke damage showed impaired cognitive control functions in the linguistic domain, participants with better language skills performed also better in tasks that measured non-linguistic cognitive control functions. The overall results indicate that the level of cognitive control deficit interacts with the language functions in individuals along with the language spectrum (from severe to no impairment). However, future research is needed to determine any directionality.

Keywords: cognitive control, information processing, language performance, non-fluent aphasia

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Authors: Tytus Tulwin, Rafal Sochaczewski, Ksenia Siadkowska

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Designing a new engine requires a large number of different cases to be considered. Especially different injector parameters and combustion chamber geometries. This is essential when developing an engine with unconventional build – compression ignition, two-stroke operating with direct side injection. Computational Fluid Dynamics modelling allows to test those different conditions and seek for the best conditions with correct combustion. This research presents the combustion results for different injector and combustion chamber cases. The shape of combustion chamber is different than for conventional engines as it requires side injection. This completely changes the optimal shape for the given condition compared to standard automotive heart shaped combustion chamber. Because the injection is not symmetrical there is a strong influence of cylinder swirl and piston motion on the injected fuel stream. The results present the fuel injection phenomena allowing to predict the right injection parameters for a maximum combustion efficiency and minimum piston heat loads. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: CFD, combustion, injection, opposed piston

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Authors: Grygorii Kostromin, Vladyslav Povoroznyuk

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Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: chronic venous disease, risk factors, age, obesity, postmenopausal women

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Authors: Aya Gamal Khattab

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Chronic infection with the hepatitis C virus (HCV) is now the leading cause of liver-related morbidity and mortality; Currently, alanine aminotransferase ALT measurement is not only widely used in detecting the incidence, development, and prognosis of liver disease with obvious clinical symptoms, but also provides reference on screening the overall health status during health check-ups. Exercise is a low-cost, reliable and sustainable therapy for many chronic diseases. Low-volume high intensity interval training HIT is time efficient while also having wider application to different populations including people at risk for chronic inflammatory diseases. Purpose of this study was to investigate the effect of low volume high intensity interval training on ALT, AST in HCV patients. All practical work was done in outpatient physiotherapy clinic of Suez Canal Authority Hospitals. Forty patients both gender (27 male, 13 female), age ranged (40-60) years old submitted to low volume high intensity interval training on treadmill for two months three sessions per week. Each session consisting of five min warming up, two bouts for 10 min each bout consisting of 30 sec - 1 min of high intensity (75%-85%) HRmax then two to four min active recovery at intensity (40%-60%) HRmax, so the sum of high intensity intervals was one to two min for each session and four to eight min active recovery, and ends with five min cooling down. ALT and AST were measured before starting exercise session and 2 months later after finishing the total exercise sessions through blood samples. Results showed significant decrease in ALT, AST with improvement percentage (18.85%), (23.87%) in the study, so the study concluded that low volume high intensity interval training had a significant effect in lowering the level of circulating liver enzymes (ALT, AST) which means protection of hepatic cells and restoration of its function.

Keywords: alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatitis C (HCV), low volume high intensity interval training

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Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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Authors: Amadou Wurry Jallow, Adama N. S. Bah, Karamo Bah, Shih-Ye Wang, Kuo-Chung Chu, Chien-Yeh Hsu

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Chronic kidney disease (CKD) is a major public health challenge with high prevalence, rising incidence, and serious adverse consequences. Developing effective risk prediction models is a cost-effective approach to predicting and preventing complications of chronic kidney disease (CKD). This study aimed to develop an accurate machine learning model that can dynamically identify individuals at risk of CKD using various kinds of diagnostic data, with or without laboratory data, at different follow-up points. Creatinine is a key component used to predict CKD. These models will enable affordable and effective screening for CKD even with incomplete patient data, such as the absence of creatinine testing. This retrospective cohort study included data on 19,429 adults provided by a private research institute and screening laboratory in Taiwan, gathered between 2001 and 2015. Univariate Cox proportional hazard regression analyses were performed to determine the variables with high prognostic values for predicting CKD. We then identified interacting variables and grouped them according to diagnostic data categories. Our models used three types of data gathered at three points in time: non-laboratory, laboratory, and metabolic indices data. Next, we used subgroups of variables within each category to train two machine learning models (Random Forest and XGBoost). Our machine learning models can dynamically discriminate individuals at risk for developing CKD. All the models performed well using all three kinds of data, with or without laboratory data. Using only non-laboratory-based data (such as age, sex, body mass index (BMI), and waist circumference), both models predict chronic kidney disease as accurately as models using laboratory and metabolic indices data. Our machine learning models have demonstrated the use of different categories of diagnostic data for CKD prediction, with or without laboratory data. The machine learning models are simple to use and flexible because they work even with incomplete data and can be applied in any clinical setting, including settings where laboratory data is difficult to obtain.

Keywords: chronic kidney disease, glomerular filtration rate, creatinine, novel metabolic indices, machine learning, risk prediction

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Authors: Natasha Yasmin Felles, Gerard Riley

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Background and Aims: Relationship breakdown is typical when one partner lives with an acquired brain injury caused by issues like a stroke. Research has found that the perception of relationship satisfaction decreases following such an injury among non-injured partners. Non-injured partners also are found to experience caregiver stress/burden as they immediately have to take the role of a caregiver along with being a partner of the injured. Research has also found that the perception of a continuous relationship, i.e. the perception of the relationship to be essentially the same as it was before the injury, also changes among those caregiving partners. However, there is a lack of available intervention strategies that can help those partners with both individual and relationship difficulties. The aim of this case study was to conduct a pilot test of an intervention aimed to explore whether it is possible to support a partner to experience greater continuity within the relationship poststroke, and what benefits such a change might have. Method: A couple, where one partner experienced an acquired brain injury poststroke were provided with Integrated Behavioural Couples Therapy for 3-months. The intervention addressed goals identified as necessary by the couple and by the formulation of their individual and relationship difficulties, alongside the goal of promoting relationship continuity. Before and after measures were taken using a battery of six questionnaires to evaluate changes in perceptions of continuity, stress, and other aspects of the relationship. Results: Both quantitative and qualitative data showed that relationship continuity was improved after the therapy, as were the measures of stress and other aspects of the relationship. The stress felt by the person with the acquired brain injury also showed some evidence of improvement. Conclusion: The study found that perceptions of relationship continuity can be improved by therapy and that improving these might have a beneficial impact on the stress felt by the carer, their satisfaction with the relationship and overall levels of conflict and closeness within the relationship. The study suggested the value of further research on enhancing perceptions of continuity in the relationship after an acquired brain injury. Currently, the findings of the study have been used to develop a pilot feasibility study to collect substantive evidence on the impact of the intervention on the couples and assess its feasibility and acceptability, which will help in further developing a specific generalized relationship continuity intervention, that will be beneficial in preventing relationship breakdown in the future.

Keywords: acquired brain injury, couples therapy, relationship continuity, stroke

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Authors: A. Lubis, L. Setiawati, A. R. Setyoningrum, A. Suryawan, Irwanto

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Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: asthma, chronic health problems, growth, development

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Authors: Stela Papa, Klementina Puto, Migena Pllaha

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HCV is a hepatotropic RNA virus, transmitted primarily via the blood route, which causes progressive disease such as chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma. HCV nowadays is a global healthcare problem. A variety of immunoassays including old and new technologies are being applied to detect HCV in our country. These methods include Immunochromatography assays (ICA), Fluorescence immunoassay (FIA), Enzyme linked fluorescent assay (ELFA), and Enzyme linked immunosorbent assay (ELISA) to detect HCV antibodies in blood serum, which lately is being slowly replaced by more sensitive methods such as rapid automated analyzer chemiluminescence immunoassay (CLIA). The aim of this study is to estimate HCV infection in carriers and chronic acute patients and to evaluate the use of new diagnostic methods. This study was realized from September 2016 to May 2018. During this study period, 2913 patients were analyzed for the presence of HCV by taking samples from their blood serum. The immunoassays performed were ICA, FIA, ELFA, ELISA, and CLIA assays. Concluding, 82% of patients taken in this study, resulted infected with HCV. Diagnostic methods in clinical laboratories are crucial in the early stages of infection, in the management of chronic hepatitis and in the treatment of patients during their disease.

Keywords: CLIA, ELISA, Hepatitis C virus, immunoassay

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Authors: B. V. Lande, Suhas Kongare

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Fuel blend of alcohol and conventional hydrocarbon fuels for a spark ignition engine can increase the fuel octane rating and the power for a given engine displacement and compression ratio. The greatest advantage of ethanol as a fuel in SI Engines is its high octane number. The efficiency of an SI engine that is the ability to convert fuel energy to mechanical energy, mainly depends on the compression ratio. It is, therefore, an advantage to increase this as much as possible. The major restraint is the fuel octane number – high octane fuels can be used with high compression ratios, thus yielding higher energy efficiency. This work investigates to suggest suitable ethanol gasoline blend and compression ratio for single cylinder four strokes SI Engine on the basis of performance and exhaust emissions. A single cylinder four stroke SI Engine was tested with different blend of ethanol – gasoline like E5 (5% ethanol +95% gasoline), E10 (10% ethanol + 90% gasoline) E15 (15% ethanol + 85% petrol) and E20 ( 20% + 80% gasoline) with Variable compression ratio. The performance parameter evaluated BSFC, Brake thermal efficiency and also exhaust emission CO2, Co & HC%. The result showed that higher compression ratio improved engine Performance and reduction in exhaust emission.

Keywords: blend, compression ratio, ethanol, performance, blend

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Authors: Tabassum Yasmin, Hamid Pahlevan

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HIV/Hepatitis C co-infection treatments have evolved substantially and they have similar sustained virologic response rates as those of Hepatitis C monoinfected population. There are a few studies on therapy of patients with dual genotypes, especially in HIV/Hepatic C coinfected group. Most studies portrayed case reports of dual genotype chronic Hepatitis C coinfection treatment with Sofosbuvir/Ledipasvir and Ribavirin. A 79-year-old male with a history of HIV on Truvada and Isentress had chronic Hepatitis C with 1a and 2 genotypes. The patient has a history of alcohol intake for 40 years but recently stopped drinking alcohol. He has a history of intravenous drug use in the past and currently is not using any recreational drugs. Patient has Fibro score of 0.7 with Metavir score F2 to F4. AFP is 3.2. The HCV RNA is 493,034 IU/ML. The HBV viral DNA is < 1.30 (not detected). The CD4 is 687CU/MM. The FIB 4 is 3.34 with APRI index 0.717. The HIV viral load is 101 copies/ML. MRI abdomen did not show any liver abnormality. Fixed dose Sofosbuvir/Ledipasvir was used for therapy without Ribavirin. He tolerated medication except for some minor gastrointestinal side effects like abdominal bloating. He demonstrated 100% adherence rate. Patient completed 12 weeks of therapy. HCV RNA was undetectable at 4 and 12 weeks. He achieved SVR at week 12 and subsequently had undetectable RNA for 2 years. Dual genotype prevalence in chronic hepatitis C population is rare, especially in HIV/hepatic coinfection. Our case demonstrates that dual genotypic cases can still be successfully treated with Direct Acting Antiviral agents. The newer agents for therapy for pan genotypes were not available at the time the patient was being treated. We demonstrated that dual agent therapy was still able to maintain SVR in our patient.

Keywords: HIV/Hepatitis C, SVR (sustained virologic response), DAA (direct active antiviral agents, dual genotype

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Authors: Tassana Boontong, Vilaivan Thongcharoen, Orapan Thosingha, Suphamon Chansakul, Anorut Jenwitheesuk, Chanin Chakkrapopyodhin, Isara Phiwchai, Mattika Chaichan, Rungnapha Khiewchaum

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According to Thailand health policy, subdistrict health promoting hospitals (SHPHs) serve as forefront facilities for inclusive health care service. Those services include health promotion, disease prevention, primary medical care and rehabilitation. However, SHPHs residing in some distant area, such as SHPHs residing on the islands, would deliver different services relevant to health needs of the local people and the tourists. This research aimed to study health care delivery services at SHPHs on the islands in Thailand. Data were collected using questionnaires. The result revealed that in Thailand, there are 58 SHPHs on the islands. During data collection process, the researchers were not allowed to collect data in 5 SHPHs in the southern part due to Covid-19 pandemic. The report is based on 53 SHPHs on the islands. Numbers of health care personnel were 201, 72.14 % were female, with the ages ranged from 22 to 60 years (mean = 35.56 years). About 53% were community health personnel, while 26.08% were professional nurses. In regard to work experiences, the range of year varied from less than 1 year to 30 years, with the mean of 8.36 years. The majority of their responsibilities focused on providing primary medical care (86.34%), caring of people with chronic illnesses (85.30%) and providing medical care procedures for patients with chronic illnesses at home (84.36%). Nurses were main health care personnel in performing primary medical care. Due to difficulty transportation from the islands to the mainland, nurses had to provide prompt emergency medical care while the patients arrived with emergency and critical illnesses such as severe head trauma, stroke or coronary artery disease. Although some medical procedures were complex and not covered by nursing and midwifery license, they decided to protect patients from life- threatening conditions and make them stable before transportation. In SHPHs, the workload exceeded manpower, health care personnel had to work overtime almost every day. In the famous tourist islands, health care personnel had to carry 3-4 folds of their workload during the holidays because of the large crowds of foreign and Thai tourists. It is recommended that SHPHs on the islands should scale up the level of services to cover advanced medical care. Health care personnel, in particular, professional nurses, should be equipped with emergency and critical care skills. The expected outcomes of the services should emphasize on rescuing patients with emergency and life-threatening illnesses and providing comprehensive care for people living on or visiting the islands.

Keywords: distant area, islands, sub district health promoting hospital, heath care services, Thailand

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Authors: Mohammad Reza Dawoudi

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With the increasing rate of patients suffering from chronic pain, several methods for evaluating of chronic pain are suggested. Motion of morbid has been defined as the rate of pine and it is linked with various co-morbid conditions. This study provides a summary of procedure useful to statistics performing direct behavioral observation in hospital settings. We describe the need for and usefulness of comprehensive “morbid motions” observations; provide a primer on the identification, definition, and assessment of morbid behaviors; and outline and discuss specific statistical procedures, including formulating referral motions, describing and conducting the observation. We also provide practical devices for observing and analyzing the obtained information into a report that guides clinical intervention.

Keywords: assessing pain, DNA modeling, image matching technique, pain scale

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Authors: Benghezel Hichem

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Thyroid dysfunction in hemodialysis subjects is represented mainly by hypothyroidism. The objective of our work is to determine the thyroid profile of our hemodialysis patients and to highlight the prevalence of different thyroid disorders. Methods: This is a retrospective study performed on a mono centric 2 months (February and March 2013) on 42 hemodialysis patients (11 male and 31 female). We made the dosage of thyroid hormones Thyrotropin (TSH) ((free thyroxin ) FT4 and free Triodothyronin ) FT3) by chemiluminescence immunoassay method on cobas 6000 Roche Diagnostics. The results: The prevalence of biological hypothyroidism was 18% (7% with a high TSH isolated and a mean +/- SD 9.44 +/- 6.29, 5% with high TSH, and with low FT4 a mean +/- SD is 8.18 +/- 0.53 for TSH and 9.69 +/- 0.22 for FT4, One patient with a high TSH, and low FT4, FT3. 4% of patients with a low T3 syndrome with a mean +/- SD of 3.93 +/- 0,3 for FT3), we notice that 5% of patients with hyperthyroidism TSH collapsed and mean +/- SD of TSH is 0.017 +/- 0,001. Conclusion: The biological Hypothyroidism is a common endocrine disorder in chronic hemodialysis.

Keywords: hypothyroidism, hemodialysis, thyréostimulin, free thyroxin, triodothyronin

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Authors: Kuni Vergauwen, Ivan P. J. Huijnen, Astrid Depuydt, Jasmine Van Regenmortel, Mira Meeus

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A lower activity level and imbalanced activity pattern are frequently observed in persons with chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (ME) due to debilitating fatigue and post-exertional malaise (PEM). Identification of measurement instruments to evaluate the activity level and pattern is therefore important. The objective is to identify measurement instruments suited to evaluate the activity level and/or pattern in patients with CFS/ME and review their psychometric properties. A systematic literature search was performed in the electronic databases PubMed and Web of Science until 12 October 2016. Articles including relevant measurement instruments were identified and included for further analysis. The psychometric properties of relevant measurement instruments were extracted from the included articles and rated based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 49 articles and 15 unique measurement instruments were found, but only three instruments were evaluated in patients with CFS/ME: the Chronic Fatigue Syndrome-Activity Questionnaire (CFS-AQ), Activity Pattern Interview (API) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), three self-report instruments measuring the physical activity level. The IPAQ-SF, CFS-AQ and API are all equally capable of evaluating the physical activity level, but none of the three measurement instruments are optimal to use. No studies about the psychometric properties of activity monitors in patients with CFS/ME were found, although they are often used as the gold standard to measure the physical activity pattern. More research is needed to evaluate the psychometric properties of existing instruments, including the use of activity monitors.

Keywords: chronic fatigue syndrome, data collection, physical activity, psychometrics

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Authors: Muhammad Wahb

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Physical activity is increasingly recognized as a significant factor in maintaining optimal health and preventing chronic diseases. This research scrutinizes the long-term health benefits of sustained physical activity, employing a systematic review of epidemiological studies and randomized control trials conducted over the past decade. The study illuminates the protective effects of regular physical activity against cardiovascular disease, obesity, diabetes, and mental health disorders, with a special focus on the mechanisms involved. Furthermore, the paper provides insights into how public health initiatives can effectively promote physical activity among diverse populations, contributing to improved community health outcomes.

Keywords: physical activity, long-term health benefits, chronic disease prevention, public health

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Authors: Rafal Sochaczewski, Marcin Szlachetka, Miroslaw Wendeker

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Increasing requirements to reduce exhaust emissions and fuel consumption while increasing the power factor is increasingly becoming applicable to internal combustion engines intended for aircraft applications. As a result, intensive research work is underway to develop a diesel-powered unit for aircraft propulsion. Due to a number of advantages, such as lack of the head (lower heat loss) and timing system, opposite movement of pistons conducive to balancing the engine, the two-stroke compression-ignition engine with the opposite pistons has been developed and upgraded. Of course, such construction also has drawbacks. The main one is the necessity of using a gear connecting two crankshafts or a complicated crank system with one shaft. The peculiarity of the arrangement of pistons with sleeves, as well as the fulfillment of rigorous requirements, makes it necessary to apply the most modern technologies and constructional solutions. In the case of the fuel supply system, it was decided to use common rail system elements. The paper presents an analysis of the possibility of using a common rail pump to supply an aircraft compression-ignition engine. It is an engine with a two-stroke cycle, three cylinders, opposing pistons, and 100 kW power. Each combustion chamber is powered by two injectors controlled by electromagnetic valves. In order to assess the possibility of using a common rail pump, four high-pressure pumps were tested on a bench. They are piston pumps differing in the number and geometry of the pumping sections. The analysis included the torque on the pump drive shaft and the power needed to drive the pump depending on the rotational speed, pumping pressure and fuel dispenser settings. The research allowed to optimize the engine power supply system depending on the fuel demand and the way the pump is mounted on the engine. Acknowledgment: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A.’ and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish Nation-al Centre for Research and Development.

Keywords: diesel engine, fuel pump, opposing pistons, two-stroke

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Authors: Mohua Chatterjee, Rajib De

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Introduction: Bone Marrow Transplant (BMT) is often performed to treat patients with various types of leukemia. A majority of these patients develop complications like chronic musculoskeletal GVHD post-BMT where patients get scleroderma, pain and restricted range of motion of joints of hand. If not treated early, it may cause permanent deformity of hand. This study was done to find the effectiveness of physiotherapy in hand dysfunction caused due to chronic musculoskeletal GVHD of leukemia patients after BMT. Methodology: 23 patients diagnosed with leukemia and having musculoskeletal GVHD were treated with a set of exercises including active exercises and stretching. The outcome was measured by Cochin Hand Function Scale (CHFS) at baseline and after four weeks of intervention. Results: Two patients were not able to carry out exercises beyond two weeks due to relapse of disease and one patient defaulted. It was found that all the patients who received physiotherapy had significant improvement in hand function. Mean CHFS decreased from 63.67 to 27.43 (P value < 0.001) indicating improvement in hand function after four weeks of physiotherapy. Conclusion: Early intervention of physiotherapy is effective in reducing hand dysfunction of leukemia patients with musculoskeletal GVHD post-BMT.

Keywords: bone marrow transplant, hand dysfunction, leukemia, musculoskeletal graft versus host disease, physiotherapy

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Authors: Amulya Srivatsa, Gayatri Prakash, Deeksha Sarda, Varshni Nandakumar, Duncan Salmon

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Delivery of Patient-Directed Wound Care Via Mobile Application-Based Qualitative Analysis Chronic wounds are difficult for patients to manage at-home due to their unpredictable healing process. These wounds are associated with increased morbidity and negatively affect physical and mental health. The solution is a mobile application that will have an algorithm-based checklist to determine the state of the wound based on different factors that vary from person to person. Once this information is gathered, the application will recommend a plan of care to the user and subsequent steps to be taken. The mobile application will allow users to perform a digital scan of the wound to extract quantitative information regarding wound width, length, and depth, which will then be uploaded to the EHR to notify the patient’s provider. This scan utilizes a photo taken by the user, who is prompted appropriately. Furthermore, users will enter demographic information and answer multiple choice and drop-down menus describing the wound state. The proposed solution can save patients from unnecessary trips to the hospital for chronic wound care. The next iteration of the application can incorporate AI to allow users to perform a digital scan of the wound to extract quantitative information regarding wound width, length, and depth, which can be shared with the patient’s provider to allow for more efficient treatment. Ultimately, this product can provide immediate and economical medical advice for patients that suffer from chronic wounds. Research Objectives: The application should be capable of qualitative analysis of a wound and recommend a plan of care to the user. Additionally, the results of the wound analysis should automatically upload to the patient’s EMR. Research Methodologies: The app has two components: the first is a checklist with tabs for varying factors that assists users in the assessment of their skin. Subsequently, the algorithm will create an at-home regimen for patients to follow to manage their wounds. Research Contributions: The app aims to return autonomy back to the patient and reduce the number of visits to a physician for chronic wound care. The app also serves to educate the patient on how best to care for their wounds.

Keywords: wound, app, qualitative, analysis, home, chronic

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Authors: Roop Kiran, Muhammad Shoaib Zafar, Nazish Idrees Chaudhary

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Depression is known to be the second most frequently occurring comorbid mental illness among patients suffering from chronic physical conditions. Around the world, depression is associated with chronic liver diseases as one of the dominant symptoms. This evidence brings attention to the research about various predictors for short life expectancy and poor quality of life in patients suffering from comorbid depression and CLD. Following are the objectives of this study i) measure the occurrence rate of comorbid depression among patients with CLD and ii) find the frequency of risk factors between patients with and without depression comorbid with CLD. This is a quantitative study with a cross-sectional design. The research data was collected through a measure called Hamilton Depression Rating Scale (HDRS) with a demographic Performa from 100 patients who visited the Department of Psychiatry for consultation at Mayo Hospital Lahore with a diagnosed CLD from the last four years. There were (42%) patients with CLD who had comorbid depression. Among depressed and non-depressed patients, significant differences were found (p<0.05) for unemployment in 25 (59.5%) males and 20 (34.5%) female patients, for co-morbidity in 25 (59.5%) males and 18 (31.0%) female patients, for illiteracy in 18 (42.9%) males and 13 (22.4%) female patients, for the history of CLD for more than the last 2years in 41 (97.6%) males and 47 (81.0%) female patients, for severity of CLD in 26 (61.9%) males and 20 (34.5%) female patients. This concludes that depression frequently occurs among patients with CLD. This study recommends considerable attention to plan preventative measures in the future and develop such intervention protocols that consider the management of risk factors that significantly influence comorbid depression with CLD.

Keywords: psychiatry, comorbid, health, quality of life

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Authors: Rachid Kacem

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Excessive recruitment of Neutrophils into the lungs is a hallmark of several chronic inflammatory disorders such as emphysema and COPD. The resulting of this recruitment is the pathogenesis of lungs which is characterized by an imbalance between leukocyte serine proteinases mainly neutrophil elastase and the physiological inhibitors. The development of emphysema and remodeling of airway tissue occurred when neutrophil migrate into the lungs with more release of elastase and other proteolytic enzymes. Many reports have demonstrated that the extracts from medicinal plants such as Nigella sativa (L.) seeds extracts have anti-elastase activity; this is mainly due to the enrichment of the extracts with many bioactive molecules mainly phenolic compounds. Neutrophil serine proteases including human neutrophil elastase are involved in many inflammatory diseases, such as chronic obstructive pulmonary disease and emphysema. Since the current therapies for these diseases are inadequate and have numerous adverse effects, there is an acute need of potential alternative therapies. The natural protease inhibitors have received increasing attention as useful tools for potential utilization in pharmacology. This work is elucidating the most important natural phenolic substances that have been reported recently for their effectiveness as natural anti-elastase molecules, and hence, to the possibility of their use in the field of pharmaceuticals.

Keywords: medicinal plants, phenols, elastase, anti-elastase, chronic obstructive pulmonary disease, COPD, emphysema

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Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

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The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL) , its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know that any patient will need to take the time to know that his new physical limitations do not limit him as a person, as soul, no matter what other people are thinking as a positive hopeful attitude is essential for combating HCV.

Keywords: hepatitis C virus chronic infection - physical health component and mental health component of QoL– total quality of life

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Authors: G. Dadashova, A. Bakhshaliyev

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Aim: Determine gender differences in the etiology and clinical outcomes, as well as in the remodeling of the left ventricle (LV) in patients with chronic heart failure (CHF), suffering from arterial hypertension (AH) and coronary heart disease (CHD). Material and methods: The study included 112 patients of both sexes; aged 45 to 60 years with postinfarction cardiosclerosis had functional class (FC) heart failure II-IV of NYHA which were examined on the basis of Azerbaijan Scientific Research Institute of Cardiology. The patients were divided into 2 groups: 1st c. 60 males, mean age 54,8 ± 3,3 years, and 2nd gr 52 women, mean age 55,8 ± 3,1 years. To assess cardiac hemodynamic all patients underwent echocardiography (B-M-modes) using ‘Vivid 3’. Thus on the basis of indicators such as the index of the relative thickness of the left ventricle wall and the index of left ventricular mass (LVMI) was identified the architectonic model of the left ventricle. Results: According to our research leading cause of heart failure in women is 50.5% of cases of hypertension, ischemic heart disease 23.7% (with 79.5% of the cases developed in patients with chronic heart failure who did not have a history of myocardial infarction). While in men is the undisputed leader of CHD, forming 78.3% of CHF (80.3% in men with CHF occurred after myocardial infarction). According to our research in women more often than men CHF develops a type of diastolic dysfunction (DD, and left ventricular ejection fraction remained unchanged. Since DD occurs in men at 65,8% vs. 76,4% of women when p < 0,05. In the group of women was more common prognostic neblagopryatnye remodeling - eccentric hypertrophy of the left ventricle: 68% vs. 54.5% among men (p < 0,05), concentric left ventricular hypertrophy: 21% in women vs 19,1% (p > 0,05 ). Conclusions: Patients with heart failure are a number of gender-specific: the prevalence of hypertension in women, and coronary heart disease in men. While in women with heart failure often recorded diastolic dysfunction and characterized by the development of prognostically unfavorable remodeling types: eccentric and concentric LV hypertrophy.

Keywords: chronic heart failure, arterial hypertension, remodeling, diastolic dysfunction, men, women, ischemic heart disease

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Authors: Sahil Kapahi

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A Formula SAE competition is characterized by typical track layouts having slaloms, tight corners and short straights, which favor a particular range of engine speed for a given set of gear ratios. Therefore, it is imperative that the power-train is optimized for the corresponding engine rpm band. This paper describes the process of designing, simulating and validating an air intake manifold for an inline four cylinder four-stroke internal combustion gasoline engine based on analysis of required vehicle performance. The requirements for the design of subject intake were set considering the rules of FSAE competitions and analysis of engine performance patterns for typical competition scenarios, carried out using OPTIMUMLAP software. Manifold geometry was optimized using results of air flow simulations performed on ANSYS CFX, and subsequent effect of this geometry on the engine was modeled using 1D simulation on Ricardo WAVE. A design was developed to meet the targeted performance standards in terms of engine torque output and volumetric efficiency. Finally, the intake manifold was manufactured and assembled onto the vehicle, and the engine output of the vehicle with the designed intake was studied using a dynamometer. The results of the dynamometer testing were then validated against predicted values derived from the Ricardo WAVE modeling and benefits to performance of the vehicle were established.

Keywords: 1 D Simulation, air flow simulation, ANSYS CFX, four-stroke engine, OPTIMUM LAP, Ricardo WAVE

Procedia PDF Downloads 217

Authors: Fagner Luiz P. Salles, Janaina C. Oliveira, Ivair P. Cesar

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Statement of the Problem: Auriculotherapy (AT) is a TCM technique, which uses seeds instead of needles, based physiologically on the mechanical stimulation of the cranial nerves. In the context of understanding the new concept of health of the WHO, the AT is an integrative approach for achieving Global Health Care so as to achieve the global health care concerns. This study aimed to evaluate the effect of auriculotherapy on pain and sleep quality in patients with chronic pain. Methodology and Theoretical Orientation: This study was performed between February and March 2017 at the Faculdade Estácio de Sá de Vitória, Brazil. The pain evaluation was through VAS in 4 periods: maximum, minimum, average and at the time of evaluation; the evaluation of sleep quality was used the Pittsburgh Sleep Quality Index. Socio-demographic data included: gender, age, use of medication and BMI. All data are presented as mean (standard deviation), Teste Mann-Whitney and T-student with P-values < 0.05 were regarded as significant. Findings: Participated in this study thirty-two individuals with age (M = 43.18, SD = 17.86), the time with pain in years (M = 3.67, SD = 3.68), 81.7% were female, 75% of the individuals used medication and BMI (M = 26.67; SD = 6.20). The pain presented improvement in the maximum level and the average of the pain and sleep quality before did not have statistically significant results. Conclusion and Significance: This study showed that TA is efficacy for reduction levels of pain. However, AT was not effective in improving sleep quality.

Keywords: auriculotherapy, chronic pain, sleep quality, integrative approach

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Authors: Brahmi Brahim, Mohammad Habibur Rahman, Maarouf Saad, Cristóbal Ochoa Luna

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A repetitive training movement is an efficient method to improve the ability and movement performance of stroke survivors and help them to recover their lost motor function and acquire new skills. The ETS-MARSE is seven degrees of freedom (DOF) exoskeleton robot developed to be worn on the lateral side of the right upper-extremity to assist and rehabilitate the patients with upper-extremity dysfunction resulting from stroke. Practically, rehabilitation activities are repetitive tasks, which make the assistive/robotic systems to suffer from repetitive/periodic uncertainties and external perturbations induced by the high-order dynamic model (seven DOF) and interaction with human muscle which impact on the tracking performance and even on the stability of the exoskeleton. To ensure the robustness and the stability of the robot, a new nonlinear backstepping control was implemented with designed tests performed by healthy subjects. In order to limit and to reject the periodic/repetitive disturbances, an iterative estimator was integrated into the control of the system. The estimator does not need the precise dynamic model of the exoskeleton. Experimental results confirm the robustness and accuracy of the controller performance to deal with the external perturbation, and the effectiveness of the iterative estimator to reject the repetitive/periodic disturbances.

Keywords: backstepping control, iterative control, Rehabilitation, ETS-MARSE

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Authors: Elsayed A. M. Shokr, A. Alhazemi, T. Naser, Talal A. Zuhair, Adel A. Zuhair, Ahmed N. Alshamary, Thamer A. Alanazi, Hosam A. Alanazi

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The main threats to human health from heavy metals are associated with exposure to Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. is mainly via intake of drinking water being the most important source in most populations. These metals have been extensively studied and their effects on human health regularly reviewed by international bodies such as the WHO. Heavy metals have been used by humans for thousands of years. Although several adverse health effects of heavy metals have been known for a long time, exposure to heavy metals continues, and is even increasing in some parts of the world, in particular in less developed countries, though emissions have declined in most developed countries over the last 100 years. A strong relationship between contaminated drinking water with heavy metals from some of the stations of water shopping in Hail, KSA and chronic diseases such as renal failure, liver cirrhosis, and chronic anemia has been identified in this study. These diseases are apparently related to contaminant drinking water with heavy metals such as Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. Renal failure is related to contaminate drinking water with lead and cadmium, liver cirrhosis to copper and molybdenum, and chronic anemia to copper and cadmium. Recent data indicate that adverse health effects of cadmium exposure may occur at lower exposure levels than previously anticipated, primarily in the form of kidney damage but possibly also bone effects and fractures. The general population is primarily exposed to mercury via drinking water being a major source of methyl mercury exposure, and dental amalgam. During the last century lead, cadmium, zinc, iron and arsenic is mainly via intake of drinking water being the most important source in most populations. Long-term exposure to lead, cadmium, zinc, iron and arsenic in drinking-water is mainly related to primarily in the form of kidney damage. Studies of these diseases suggest that abnormal incidence in specific areas is related to toxic materials in the groundwater and thereby led to the contamination of drinking water in these areas.

Keywords: heavy metals, liver functions, kidney functions and chronic renal failure, hail, renal, water

Procedia PDF Downloads 295

Authors: Michael Stevens

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David Hunter, a musicologist, has suggested that both Beethoven and Handel had chronic lead poisoning from the wine that they drank. These two eminent musical composers had some striking similarities. Beethoven had alcohol dependency and preferred wine, to which lead had been added to improve the taste. Handel was obese due to an eating disorder that included drinking tainted wine after large meals. They both had paresthesia of their extremities that they interpreted as rheumatism. This is a common sensory symptom from chronic lead poisoning. Their differences are marked in that Beethoven was profoundly deaf by the end of his life, whereas Handel had remarkably good hearing. Handel had paresis of three fingers of his right hand, whereas Beethoven lacked any motor symptoms. Beethoven reported recurrent abdominal pain suggestive of lead colic, whereas it can only be inferred that this symptom was present in Handel. Lead poisoning is likely in Handel because his paralysis was consistent with radial nerve involvement in the dominant hand. In addition, it was cured by hot baths, which have been shown to reduce total body lead content by exchanging with iron and calcium ions in water. Although lead produces predominantly motor symptoms in classic or subacute lead poisoning, and sensory symptoms in chronic lead poisoning, lead poisoning causes a variety of symptoms that depending on duration and level of exposure, are extremely variable from person to person. It therefore seems likely that Handel had lead poisoning, but extremely likely that Beethoven did because of the confirmatory finding of high levels of lead deep in his skull bone, which is a good measure of total body burden.

Keywords: beethoven, handel, lead, poisoning

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Authors: Mahsa Hadipour Jahromy, Sara Rezaii

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Parkinson’s disease (PD) results primarily from the death of dopaminergic neurons in the substantia nigra. Soon after the discovery of levodopa and its beneficial effects in chronic administration, debilitating involuntary movements observed, termed levodopa-induced dyskinesia (LID) with poorly understood pathogenesis. Polyphenol-rich compounds, like pomegranate, provided neuroprotection in several animal models of brain diseases. In the present work, we investigated whether pomegranate has preventive effects following 4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced dopaminergic degenerations and the potential to diminish LID in mice. Mice model of PD was induced by MPTP (30 mg/kg daily for five consecutive days). To induce a mice model of LID, valid PD mice were treated with levodopa (50 mg/kg, i.p) for 15 days. Then the effects of chronic co-administration of pomegranate juice (20 ml/kg) with levodopa and continuing for 10 days, evaluated. Behavioural tests were performed in all groups, every other day including: Abnormal involuntary movements (AIMS), forelimb adjusting steps, cylinder, and catatonia tests. Finally, brain tissue sections were prepared to study substantia nigra changes and dopamine neuron density after treatments. With this MPTP regimen, significant movement disorders revealed in AIMS tests and there was a reduction in dopamine striatal density. Levodopa attenuates their loss caused by MPTP, however, in chronic administration, dyskinesia observed in forelimb adjusting step and cylinder tests. Besides, catatonia observed in some cases. Chronic pomegranate co-administration significantly improved LID in both tests and reduced dopaminergic loss in substantia nigra. These data indicate that pomegranate might be a good adjunct for preserving dopaminergic neurons in the substantia nigra and reducing LID in mice.

Keywords: levodopa-induced dyskinesia, MPTP, Parkinson’s disease, pomegranate

Procedia PDF Downloads 467