Search results for: lower limb exoskeleton

Authors: M. Akhlaque Ahmed, Sidra A. Shaikh, Maliha A. Siddiqui

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Global and diffuse solar radiation on horizontal surface of Lower Sindh, namely Karachi, Hyderabad, Nawabshah were carried out using sunshine hour data of the area to assess the feasibility of solar energy utilization for power generation in Sindh province. The results obtained show a large variation in the direct and diffuse component of solar radiation in summer and winter months in Lower Sindh (50% direct and 50% diffuse for Karachi and Hyderabad). In Nawabshah area, the contribution of diffuse solar radiation is low during the monsoon months, July and August. The K_T value of Nawabshah indicates a clear sky throughout almost the entire year. The percentage of diffuse radiation does not exceed more than 20%. In Nawabshah, the appearance of cloud is rare even during the monsoon months. The estimated values indicate that Nawabshah has high solar potential, whereas Karachi and Hyderabad have low solar potential. During the monsoon months the Lower part of Sindh can utilize the hybrid system with wind power. Near Karachi and Hyderabad, the wind speed ranges between 6.2 m/sec to 6.9 m/sec. A wind corridor exists near Karachi, Hyderabad, Gharo, Keti Bander and Shah Bander. The short fall of solar can be compensated by wind because in the monsoon months of July and August, wind speeds are higher in the Lower region of Sindh.

Keywords: hybrid power system, lower Sindh, power generation, solar and wind energy potential

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Authors: Tea Poklepović, Zdravka Aljinović, Mario Matković

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Modern Portfolio Theory (MPT) according to Markowitz states that investors form mean-variance efficient portfolios which maximizes their utility. Markowitz proposed the standard deviation as a simple measure for portfolio risk and the lower semi-variance as the only risk measure of interest to rational investors. This paper uses a third volatility estimator based on intraday data and compares three efficient frontiers on the Croatian Stock Market. The results show that range-based volatility estimator outperforms both mean-variance and lower semi-variance model.

Keywords: variance, lower semi-variance, range-based volatility, MPT

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Authors: Bert H. Jacobson, Taylor Monaghan, John Sellers

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Intense resistance-type activity generally elicits delayed onset muscle soreness (DOMS) in individuals unaccustomed to such action. DOMS is a combination of contractile tissue microtrauma, osmotic pressure changes, alteration calcium regulation, and inflammation. Elevated muscle-specific enzyme creatine kinase (CK) is a marker of striated muscle damage. Avian immunoglobulin (IgY) mediates inflammation and may thereby reduce post-exercise DOMS. Purpose: The aim of this study was to compare the effect of oral IgY and placebo (Pl) on CK, serum relevels, and perceived pain following induced DOMS. Methods: Healthy college-aged females (N=16) were randomly divided into an experimental group (IgY) and a control group (PL). CK serum levels were recorded followed by 14 days of supplementation of either IgY or Pl at the following doses: days 1-2 =4.5 g, days 3-5 =9.0 g, and days 6-14 =13.5 g. Following the 14 d, lower limb DOMS was induced using two methods of resistance training. After 48 hours, subjects reported for a second blood draw. Results: One-way ANOVA resulted in the IgY group posting significantly less (p < 0.05) serum CK than the PL group. Furthermore, the IgY group experienced significantly less post-test perceived soreness than the Pl group. Conclusion: IgY supplementation lessens muscle CK levels and perceived muscle soreness following exercise, possibly due to an anti-inflammatory effect. It was suggested that IgY may serve as a buffer for DOMS thereby allowing the participant to continue vigorous exercise without discomfort.

Keywords: muscle, soreness, damage, serum

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Authors: Amal Raqib Shameran, Ghanim Aboud Al-Mola

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Respiratory syncytial virus (hRSV) is the major pathogens of respiratory tract infections (RTI) among infants and children in the world. They are classified in family Paramyxoviridae and sub-family Pneumovirinae. The current work aimed to detect the role of RSV in the lower respiratory tract infection (LRTI) in Hilla, Iraq. The samples were collected from 50 children who were admitted to hospital suffering from lower respiratory tract infections (LRTI). 50 nasal and pharyngeal swabs were taken from patients at the period from January 2010 till April 2011, hospitalized in Hilla Maternity and Children Hospital. The results showed that the proportion of children infected with hRSV accounted for 24% 12/50 with lower respiratory tract infections (LRTI) when they tested by polymerase chain reaction (RT-PCR).

Keywords: respiratory syncytial virus, respiratory tract infections, infants, polymerase chain reaction (PCR)

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Authors: Radwa El Shorbagy, Alaa El Din Balbaa, Khaled Ayad, Waleed Reda

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Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated.Objective: to determine the contribution of proximal hip strategy to dynamic posture control in patients with recurrent ankle sprain. Methods:Fifteen subjects with recurrent ankle sprain (Group A) and fifteen healthy control subjects (Group B) participated in this study. Abductor-adductor as well as flexor-extensor hip musculature control was abolished by fatigue using the Biodex Isokinatic System. Dynamic posture control was measured before and after fatigue by the Biodex Balance System. Results: Repeated measures MANOVA was used to compare within group differences. In group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) lowered overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p=0.00) whereas; in group B fatiguing of hip flexors-extensors lowered significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Conclusion: fatiguing of hip muscles has a significant deleterious effect on dynamic posture control in patient with recurrent ankle sprain indicating their increased dependence on hip strategy.

Keywords: ankle sprain, fatigue hip muscles, dynamic balance, ankle sprain

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Authors: G. Espriú-Pérez, F. A. Vargas-Oviedo, I. Zenteno-Aguirrezábal, M. D. Moya-Bencomo

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One of the injuries with a higher incidence among university-level athletes in the North of Mexico is presented in the knee. This injury generates absenteeism in training and competitions for at least 8 weeks. There is no active quantitative methodology, or protocol, that directly contributes to the clinical evaluation performed by the medical personnel at the prevalence of knee injuries. The main objective is to contribute with a quantitative tool that allows further development of preventive and corrective measures to these injuries. The study analyzed 55 athletes for 6 weeks, belonging to the disciplines of basketball, volleyball, soccer and swimming. Using a motion capture system (Nexus®, Vicon®), a three-dimensional analysis was developed that allows the measurement of the range of movement of the joint. To focus on the performance of the lower limb, eleven different movements were chosen from the Functional Performance Test, Functional Movement Screen, and the Cincinnati Jump Test. The research identifies the profile of the natural movement of a healthy knee, with the use of medical guidance, and its differences between each sport. The data recovered by the single-leg crossover hop managed to differentiate the type of knee movement among athletes. A maximum difference of 60° of offset was found in the adduction movement between male and female athletes of the same discipline. The research also seeks to serve as a guideline for the implementation of protocols that help identify the recovery level of such injuries.

Keywords: Cincinnati jump test, functional movement screen, functional performance test, knee, motion capture system

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Authors: Rohin Rameswarapu, Sameer Valsangkar

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Background: Globally, musculoskeletal disorders are the largest single cause of work-related illnesses accounting for over 33% of all newly reported occupational illnesses. Risk factors for MSD need to be delineated to suggest means for amelioration. Material and methods: In this current cross-sectional study, the prevalence of MSDs among workers in an electrical company assembly line, the socio-demographic and job characteristics associated with MSD were obtained through a semi-structured questionnaire. A quantitative assessment of the physical risk factors through the Rapid Upper Limb Assessment (RULA) tool, and measurement of psychosocial risk factors through a Likert scale was obtained. Statistical analysis was conducted using Epi-info software and descriptive and inferential statistics including chi-square and unpaired t test were obtained. Results: A total of 263 workers consented and participated in the study. Among these workers, 200 (76%) suffered from MSD. Most of the workers were aged between 18–27 years and majority of the workers were women with 198 (75.2%) of the 263 workers being women. A chi square test was significant for association between male gender and MSD with a P value of 0.007. Among the MSD positive group, 4 (2%) had a grand score of 5, 10 (5%) had a grand score of 6 and 186 (93%) had a grand score of 7 on RULA. There were significant differences between the non-MSD and MSD group on five out of the seven psychosocial domains, namely job demand, job monotony, co-worker support, decision control and family and environment domains. Discussion: The current cross-sectional study demonstrates a high prevalence of MSD among assembly line works with inherent physical and psychosocial risk factors and recommends that not only physical risk factors, addressing psychosocial risk factors through proper ergonomic means is also essential to the well-being of the employee.

Keywords: musculoskeletal disorders, India, occupational health, Rapid Upper Limb Assessment (RULA)

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Authors: S. S. Dol, M. S. Chan, S. F. Wong, J. S. Lim

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Emulsion formation is unavoidable and can be detrimental to an oil field production. The presence of stable emulsions also reduces the quality of crude oil and causes more problems in the downstream refinery operations, such as corrosion and pipeline pressure drop. Hence, it is important to know the effects of emulsions in the pipeline. Light crude oil was used for the continuous phase in the W/O emulsions where the emulsions pass through a flow loop to test the pressure drop across the pipeline. The results obtained shows that pressure drop increases as water cut is increased until it peaks at the phase inversion of the W/O emulsion between 30% to 40% water cut. Emulsions produced by gradual constrictions show a lower stability as compared to sudden constrictions. Lower stability of emulsions in gradual constriction has the higher influence of pressure drop compared to a sudden sharp decrease in diameter in sudden constriction. Generally, sudden constriction experiences pressure drop of 0.013% to 0.067% higher than gradual constriction of the same ratio. Lower constriction ratio cases cause larger pressure drop ranging from 0.061% to 0.241%. Considering the higher profitability in lower emulsion stability and lower pressure drop at the developed flow region of different constrictions, an optimum design of constriction is found to be gradual constriction with a ratio of 0.5.

Keywords: constriction, pressure drop, turbulence, water-in-oil emulsions

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Authors: Rohit Gupta, Ravinder Agarwal

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Surface electromyographic (sEMG) signal has the potential to identify the human activities and intention. This potential is further exploited to control the artificial limbs using the sEMG signal from residual limbs of amputees. The paper deals with the development of multichannel cost efficient sEMG signal interface for research application, along with evaluation of proposed class dependent statistical approach of the feature selection method. The sEMG signal acquisition interface was developed using ADS1298 of Texas Instruments, which is a front-end interface integrated circuit for ECG application. Further, the sEMG signal is recorded from two lower limb muscles for three locomotions namely: Plane Walk (PW), Stair Ascending (SA), Stair Descending (SD). A class dependent statistical approach is proposed for feature selection and also its performance is compared with 12 preexisting feature vectors. To make the study more extensive, performance of five different types of classifiers are compared. The outcome of the current piece of work proves the suitability of the proposed feature selection algorithm for locomotion recognition, as compared to other existing feature vectors. The SVM Classifier is found as the outperformed classifier among compared classifiers with an average recognition accuracy of 97.40%. Feature vector selection emerges as the most dominant factor affecting the classification performance as it holds 51.51% of the total variance in classification accuracy. The results demonstrate the potentials of the developed sEMG signal acquisition interface along with the proposed feature selection algorithm.

Keywords: classifiers, feature selection, locomotion, sEMG

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Authors: Isha Ranadive, Sonam Patel, Suresh Balakrishnan

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It has been observed that in lizards wound can be healed by either a scar free mechanism or by scarring. The animal model used to study both these healing processes was Northern House Gecko. In lizard, the tail when amputated heals by scar free mechanism which allows it to regenerate, the same is not seen when the limb is amputated. Proliferation, apoptosis, and angiogenesis are the main events which succeed an injury. We observed that proliferation of the cells beneath the wound epidermis was much higher in case of wound healing in tail. This could be because after the wound gets covered by the epithelium, it enters in to a cross-talk with the underlying mesenchyme to recruit a pool of blastemal cells which proliferate and later differentiate to form the lost part through epimorphic regeneration. This was substantiated by mRNA expression levels of various FGFs which facilitate the cross-talk and also by PCNA which is a marker for proliferation. Western blot result reaffirms the same notion. However, in case of the limb, the rate of apoptosis was more than proliferation as there are a lot of debris that needs to be removed. We came to this conclusion as we observed that p53 the apoptotic gene was highly upregulated in case of the scarred tissue. Further, we confirmed this result by checking the anti-apoptotic gene bcl2 and found it to be significantly down-regulated. As we noticed heightened proliferation in the case of scar-free wound healing in tail, angiogenesis was targeted for the study. This is because, when the cells are proliferating they require constant supply of blood and hence neo-vascularization is inevitable. It was observed that the marker of angiogenesis, VEGF, was expressed more during wound healing as compared to the resting stage of tail. Moreover, a high up-regulation was seen in KDR, a receptor of VEGF. Thus, this study reveals how proliferation, apoptosis, and angiogenesis play a key role in the scar-free as well as scarred wound healing.

Keywords: epimorphic regeneration, injury, northern house gecko, wound healing

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Authors: Vinay Suhalka

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In India, the official nomenclature used by the State for persons with disability is divyang (literally, the one with a divine limb), a word coming from the Sanskrit language. Disability thus gets portrayed as divine, at least in the welfare sector from where it flows down even to the popular imagination where it gets equated to divinity. This paper looks at reference to persons with disabilities as divyangs and goes on to discusses what such usage for an already marginalized group achieves and misses out. The issue of nomenclature and language has always been a contested one when it comes to disability. At the same time, there is also an issue of who determines these labels for the persons with disability. Nomenclature and language used for disability can have real consequences for the population of persons with disability as it may empower or disempower them. Thus, this paper looks at the issue of what it means for persons with disabilities as ‘exceptionally gifted’ and hence divyang. Language can be a powerful tool to communicate meanings and messages associated with a term. When the persons with disabilities as a group are described as ‘exceptionally gifted, talented and the source of inspiration’, it essentially stereotypes and marginalizes them by putting a burden of performance that all of them ought to be achievers, and it is only then that they would be assimilated in the larger society. This paper also argues that such a situation creates a ‘double bind’ where the person is always trying to match up to the labels (the disabled as ‘achiever, overcomer, inspirational’) created by somebody else and looks at self through the eyes of others. This conceptual paper also presents an overview of disability labels while simultaneously looking at projecting disability as divinity which has the potential to wrongly portray the lives of persons with disability in India due to the official usage of the term. It also explores the question of visibility of disability since the idea of divyang implicitly assumes that all disabilities are visible. In reality, however, it may not be the case simply because all forms of disabilities are not visible, people may choose not to visibilize their disabilities if they can and pass as able-bodied, fearing the stigma that surrounds disability. Finally, it argues for an increased focus on understanding the everyday lived realities of those with disability in order to regard it as an important form of difference which could be a potential resource for the society.

Keywords: persons with disability, labels, language use, divinity

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Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly

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Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.

Keywords: femur fracture, nerve block, fentanyl, ultrasound guided

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Authors: Fadzel Wong Chee Ping, Chee Keong Chen, Foong Kiew Ooi, Mahaneem Mohamed

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Introduction: To date, information on the effects of bee bread supplementation on isokinetic muscular performance are lacking. Therefore, this study was carried out to investigate the effects of 8-week bee bread supplementation on isokinetic muscular strength and power in young athletes. Methodology: Twelve male athletes (age: 24.0±1.8 years; BMI: 22.3 ± 1.3 kg.m-2; VO2max: 52.0 ± 2.8 mL.kg-1.min-1) were recruited in this randomised double blind, placebo-controlled crossover study. Participants consumed either bee bread at a dosage of 20 g.d-1 or placebo for 8 weeks. An isokinetic dynamometer was used to measure participants’ lower limb muscular strength and power prior (pre-test) and post (post-test) 8 weeks of experimental period. Testing angular velocities were set at 180o.s-1 and 300o.s-1 to determine knee flexion and extension muscular peak torque (an indicator of muscular strength) and average power of the participants. Statistical analyses were performed using ANOVA with repeated measures. Results: Isokinetic knee extension peak torque and average power at 180o.s-1, and isokinetic knee flexion peak torque and average power at 180o.s-1 were significantly (p<0.05) higher at post-test compared to pre-test with bee bread supplementation. However, significant differences were not observed in the measured parameters between pre- and post-test with placebo supplementation. Conclusion: Supplementation of bee bread for 8 weeks at a dosage of 20 g daily increased some of the measured isokinetic muscular strength and power parameters in young athletes.

Keywords: bee bread, isokinetic, power, strength

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Authors: Peter O. Osifo, Hein W. J. P. Neomagus

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In this study, a predicted pH model was used to determine adsorption equilibrium properties of copper, lead, zinc and cadmium. Chitosan was prepared from the exoskeleton of Cape rock-lobsters, collected from the surroundings of Cape Town, South Africa. The beads were cross-linked with gluteraldehyde to restore its chemical stability in acid media. The chitosan beads were characterized; the beads water contents and pKa varied in the range of 90-96% and 4.3-6.0 respectively and the degree of crosslinking for the beads was 18%. A pH-model, which described the reversibility of the metal adsorbed onto the beads, was used to predict the equilibrium properties of copper, lead, zinc and cadmium adsorption onto the cross-linked beads. The model accounts for the effect of pH and the important model parameters; the equilibrium adsorption constant (Kads) and to a lesser extent the adsorbent adsorption capacity (qmax). The adsorption equilibrium constant for copper, lead, zinc and cadmium were found to be 2.58×10-3, 2.22×0-3, 9.55×0-3, and 4.79×0-3, respectively. The adsorbent maximum capacity was determined to be 4.2 mmol/g.

Keywords: chitosan beads, adsorption, heavy metals, waste water

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Authors: Sigal Portnoy, Jason Friedman, Eitan Raveh

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Introduction: Sensory substitution is possible due to the capacity of our brain to adapt to information transmitted by a synthetic receptor via an alternative sensory system. Practical sensory substitution systems are being developed in order to increase the functionality of individuals with sensory loss, e.g. amputees. For upper limb prosthetic-users the loss of tactile feedback compels them to allocate visual attention to their prosthesis. The effect of adding vibrotactile feedback (VTF) to the applied force has been studied, however its effect on the allocation if visual attention during dual-tasking and the response during misleading visual feedback have not been studied. We hypothesized that VTF will improve the performance and reduce visual attention during dual-task assignments in healthy individuals using a robotic hand and improve the performance in a standardized functional test, despite the presence of misleading visual feedback. Methods: For the dual-task paradigm, twenty healthy subjects were instructed to toggle two keyboard arrow keys with the left hand to retain a moving virtual car on a road on a screen. During the game, instructions for various activities, e.g. mix the sugar in the glass with a spoon, appeared on the screen. The subject performed these tasks with a robotic hand, attached to the right hand. The robotic hand was controlled by the activity of the flexors and extensors of the right wrist, recorded using surface EMG electrodes. Pressure sensors were attached at the tips of the robotic hand and induced VTF using vibrotactile actuators attached to the right arm of the subject. An eye-tracking system tracked to visual attention of the subject during the trials. The trials were repeated twice, with and without the VTF. Additionally, the subjects performed the modified box and blocks, hidden from eyesight, in a motion laboratory. A virtual presentation of a misleading visual feedback was be presented on a screen so that twice during the trial, the virtual block fell while the physical block was still held by the subject. Results: This is an ongoing study, which current results are detailed below. We are continuing these trials with transradial myoelectric prosthesis-users. In the healthy group, the VTF did not reduce the visual attention or improve performance during dual-tasking for the tasks that were typed transfer-to-target, e.g. place the eraser on the shelf. An improvement was observed for other tasks. For example, the average±standard deviation of time to complete the sugar-mixing task was 13.7±17.2s and 19.3±9.1s with and without the VTF, respectively. Also, the number of gaze shifts from the screen to the hand during this task were 15.5±23.7 and 20.0±11.6, with and without the VTF, respectively. The response of the subjects to the misleading visual feedback did not differ between the two conditions, i.e. with and without VTF. Conclusions: Our interim results suggest that the performance of certain activities of daily living may be improved by VTF. The substitution of visual sensory input by tactile feedback might require a long training period so that brain plasticity can occur and allow adaptation to the new condition.

Keywords: prosthetics, rehabilitation, sensory substitution, upper limb amputation

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Authors: AliAkbar Hafezi, Jalal Taherian, Jamshid Abedi, Mahsa Elahi, Behnam Kadkhodaei

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Background: Soft tissue sarcomas (STS) are generally treated with a combination of limb preservation surgery and radiation therapy. Today, preoperative radiation therapy is considered for accurate treatment volume and smaller field size. Therefore, this study was performed to compare preoperative with postoperative radiation therapy in patients with extremity STS. Methods: In this non-randomized clinical trial, patients with localized extremity STS referred to the orthopedic clinics in Iran from 2021 to 2023 were studied. Patients were randomly divided into two groups: preoperative and postoperative radiation therapy. The two groups of patients were compared in terms of acute (wound dehiscence and infection) and late (limb edema, subcutaneous fibrosis, and joint stiffness) complications and their severity, as well as local recurrence and other one-year outcomes. Results: A total of 80 patients with localized extremity STS were evaluated in two treatment groups. The groups were matched in terms of age, sex, history of diabetes mellitus, hypertension, smoking, involved side, involved extremity, lesion location, and tumor histopathology. The acute complications of treatment in the two groups of patients did not differ significantly (P > 0.05). Of the late complications, only joint stiffness between the two groups had significant statistical differences (P < 0.001). The severity of all three late complications in the postoperative radiation therapy group was significantly higher (P < 0.05). There was no significant difference between the two groups in terms of the rate of local recurrence of other one-year outcomes (P > 0.05). Conclusion: This study showed that in patients with localized extremity STS, the two therapeutic approaches of adjuvant and neoadjuvant radiation therapy did not differ significantly in terms of local recurrence and distant metastasis during the one-year follow-up period and due to fewer late complications in preoperative radiotherapy group, this treatment approach can be a better choice than postoperative radiation therapy.

Keywords: soft tissue sarcoma, extremity, preoperative radiation therapy, postoperative radiation therapy

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Authors: Yah-Ling Hung

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eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.

Keywords: eHealth, health intervention, health literacy, usability evaluation

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Authors: Asrarul Fikri Abu Hassan, Muhammad Hafiz bin Hanafi, Jafri Malin Abdullah

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This study is to compare the motor evoked potential (MEP) changes using different settings of repetitive transcranial magnetic stimulation (rTMS) in the post-haemorrhagic stroke patient which treated conservatively. The goal of the study is to determine changes in corticomotor excitability and functional outcome after repetitive transcranial magnetic stimulation (rTMS) therapy regime. 20 post-stroke patients with upper limb hemiparesis were studied due to haemorrhagic stroke. One of the three settings; (I) Inhibitory setting, or (II) facilitatory setting, or (III) control group, no excitatory or inhibitory setting have been applied randomly during the first meeting. The motor evoked potential (MEP) were recorded before and after application of the rTMS setting. Functional outcomes were evaluated using the Barthel index score. We found pre-treatment MEP values of the lesional side were lower compared to post-treatment values in both settings. In contrast, we found that the pre-treatment MEP values of the non-lesional side were higher compared to post-treatment values in both settings. Interestingly, patients with treatment, either facilitatory setting and inhibitory setting have faster motor recovery compared to the control group. Our data showed both settings might improve the MEP of the upper extremity and functional outcomes in the haemorrhagic stroke patient.

Keywords: Barthel index, corticomotor excitability, motor evoked potential, repetitive transcranial magnetic stimulation, stroke

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Authors: Majid Manawer Alenezi, Gavin Lawrence, Hans-Peter Kubis

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Imagery training could be an important treatment for muscle function improvements in patients who are facing limitations in exercise training by pain or other adverse symptoms. However, recent studies are mostly limited to small muscle groups and are often contradictory. Moreover, a possible bilateral transfer effect of imagery training has not been examined. We, therefore, investigated the effectiveness of unilateral imagery training in comparison with exercise training on hip abductor muscle strength and EMG. Additionally, both limbs were assessed to investigate bilateral transfer effects. Healthy individuals took part in an imagery or exercise training intervention for two weeks and were assesses pre and post training. Participants (n=30), after randomization into an imagery and an exercise group, trained 5 times a week under supervision with additional self-performed training on the weekends. The training consisted of performing, or to imagine, 5 maximal isometric hip abductor contractions (= one set), repeating the set 7 times. All measurements and trainings were performed laying on the side on a dynamometer table. The imagery script combined kinesthetic and visual imagery with internal perspective for producing imagined maximal hip abduction contractions. The exercise group performed the same number of tasks but performing the maximal hip abductor contractions. Maximal hip abduction strength and EMG amplitudes were measured of right and left limbs pre- and post-training period. Additionally, handgrip strength and right shoulder abduction (Strength and EMG) were measured. Using mixed model ANOVA (strength measures) and Wilcoxen-tests (EMGs), data revealed a significant increase in hip abductor strength production in the imagery group on the trained right limb (~6%). However, this was not reported for the exercise group. Additionally, the left hip abduction strength (not used for training) did not show a main effect in strength, however, there was a significant interaction of group and time revealing that the strength increased in the imagery group while it remained constant in the exercise group. EMG recordings supported the strength findings showing significant elevation of EMG amplitudes after imagery training on right and left side, while the exercise training group did not show any changes. Moreover, measures of handgrip strength and shoulder abduction showed no effects over time and no interactions in both groups. Experiments showed that imagery training is a suitable method for effectively increasing functional parameters of larger limb muscles (strength and EMG) which were enhanced on both sides (trained and untrained) confirming a bilateral transfer effect. Indeed, exercise training did not reveal any increases in the parameters above omitting functional improvements. The healthy individuals tested might not easily achieve benefits from exercise training within the time tested. However, it is evident that imagery training is effective in increasing the central motor command towards the muscles and that the effect seems to be segmental (no increase in handgrip strength and shoulder abduction parameters) and affects both sides (trained and untrained). In conclusion, imagery training was effective in functional improvements in limb muscles and produced a bilateral transfer on strength and EMG measures.

Keywords: imagery, exercise, physiotherapy, motor imagery

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Authors: Najebah Alsaleh, Nirpendra Singh, Udo Schwingenschlogl

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The electronic and transport properties of bulk and monolayer CuSbS2 and CuSbSe2 are determined by using density functional theory and semiclassical Boltzmann transport theory, in order to investigate the role of interlayer coupling for the thermoelectric properties. The calculated band gaps of the bulk compounds are in agreement with experiments and significantly higher than those of the monolayers, which thus show lower Seebeck coefficients. Since also the electrical conductivity is lower, the monolayers are characterized by lower power factors. Therefore, interlayer coupling is found to be essential for the excellent thermoelectric response of CuSbS2 and CuSbSe2, even though it is weak.

Keywords: density functional theory, thermoelectric, electronic properties, monolayer

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Authors: Abdul Salam Turkmani

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The Lower Cretaceous rocks are exposed only in the mountains regions of Syria, such as the Anti- Lebanon mountain on the western side of Damascus. The lower cretaceous sequences are made up of different rocks. The upper and middle parts of the section are composed mainly of carbonate sediments and, less frequently, gypsum and anhydrite. The lower beds are mainly composed of sandstone, conglomerate and clay. Clay samples were collected from the study area, which is located about 45 km west of the city of Damascus, near the border village of Kfer Yabous and to the left of the Damascus -Beirut International Road, within the lower Cretaceous upper Aptian deposits. The properties of clay were carried out by X-ray diffraction (XRD) and, X-ray fluorescence (XRF) and Thermal Analysis (DTA-TG-DSC) techniques. The studied samples of clay were mainly composed of kaolinite, quartz, illite. Chemical analysis shows the content of SiO₂ varied between 46.06 to 73 % Al₂O₃ 14.55-26.56%, about the staining oxides (Fe₂O₃ + TiO₂), the total content is about 4.3 to 12.5%. The physical properties were determined by studying the behavior of the body before and after firing, showed low bending strength values (22.5 kg/cm²) after drying, and (about 247 kg/cm²) after firing at 1180°C, water absorption value was about 10%. The cubic thermal expansion coefficient at 1140°C is 213.77 x 10-7 /°C. All of the presented results confirm the suitability of this clay for the ceramic industry.

Keywords: anti-Lebanon, Damascus, ceramic, clay, thermal analysis, thermal expansion coefficient

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Authors: Matei Tudor Berceanu, Hema Viswambharan, Kirti Kain, Chew Weng Cheng

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Background - Obesity parameters, particularly visceral obesity as measured by the waist-to-height ratio (WHtR), correlate with insulin resistance. The metabolic microvascular changes associated with insulin resistance causes increased peripheral arteriolar resistance primarily to the lower limb vessels. We hypothesize that ankle systolic blood pressures (SBPs) are more significantly associated with visceral obesity than brachial SBPs. Methods - 1098 adults enriched in south Asians or Europeans with diabetes (T2DM) were recruited from a primary care practice in West Yorkshire. Their medical histories, including T2DM and cardiovascular disease (CVD) status, were gathered from an electronic database. The brachial, dorsalis pedis, and posterior tibial SBPs were measured using a Doppler machine. Their body mass index (BMI) and WHtR were calculated after measuring their weight, height, and waist circumference. Linear regressions were performed between the 6 SBPs and both obesity parameters, after adjusting for covariates. Results - Generally, the left posterior tibial SBP (P=4.559*10⁻¹⁵) and right posterior tibial SBP (P=1.114* 10⁻¹³ ) are the pressures most significantly associated with the BMI, as well as in south Asians (P < 0.001) and Europeans (P < 0.001) specifically. In South Asians, although the left (P=0.032) and right brachial SBP (P=0.045) were associated to the WHtR, the left posterior tibial SBP (P=0.023) showed the strongest association. Conclusion - Regardless of ethnicity, ankle SBPs are more significantly associated with generalized obesity than brachial SBPs, suggesting their screening potential for screening for early detection of T2DM and CVD. A combination of ankle SBPs with WHtR is proposed in south Asians.

Keywords: ankle blood pressures, body mass index, insulin resistance, waist-to-height-ratio

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Authors: L. Parisi

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A method which allows a diabetic quadriplegic patient that has had four limb amputations (above the knee and elbow) to self-administer injections of insulin has been designed. The aim of this research project is to improve a quadriplegic patient’s self-management, affected by diabetes, by designing a suitable device for self-administering insulin.The quadriplegic patient affected by diabetes has to be able to self-administer insulin safely and independently to guarantee stable healthy conditions. The device also should be designed to adapt to a number of different varying personal characteristics such as height and body weight.

Keywords: robotic arm, self-administration, insulin, diabetes, quadriplegia

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Authors: Yildiz Erdoganoglu, Unzile Tunc

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The aim of this study was to determine the relationship of body, upper extremity, lower extremity endurance, and core functionality with body perception and self-esteem in individuals who applied for a bodybuilding exercise program. Forty volunteer male subjects who underwent bodybuilding exercises for one year or more were included in the study. After obtaining demographic information of the individuals, trunk endurance was evaluated by curl-up and modified Sorensen test, upper extremity endurance by push-up test, lower extremity endurance by repeated squat test, core functionalities by single-leg wall sitting and repeated single-leg squatting tests. body perception, body image perception scale, and self-esteem were evaluated with Rosenberg self-esteem scale. The mean age of the individuals was 25.60 ± 4.70 years, mean exercise time was 22.47 ± 34.60 months. At the end of the study, body perception was low, and self-esteem was moderate. There was no significant relationship between abdominal endurance, back extensor endurance, upper extremity, and lower extremity endurance, core functionality, and body perception (p > 0.05). Also, there was no significant relationship between abdominal extensor, back extensor, upper extremity and lower extremity endurance, core functionality, and self-esteem (p > 0.05). The body, upper and lower extremity endurance, and core functionality of bodybuilders did not have any effect on body perception and self-esteem, suggesting that these individuals did not contribute positively to their efforts to improve their body perception and self- esteem.

Keywords: body endurance, body perception, core functionality, self esteem

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Authors: Alain Kusmoko, Druce Dunne, Huijun Li

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Stellite 6 was deposited by laser cladding on a chromium bearing substrate (P91) with energy inputs of 1 kW (P91-1) and 1.8 kW (P91-1.8). The chemical compositions and microstructures of these coatings were characterized by atomic absorption spectroscopy, optical microscopy and scanning electron microscopy. The microhardness of the coatings was measured and the wear mechanism of the coatings was assessed using a pin-on-plate (reciprocating) wear testing machine. The results showed less cracking and pore development for Stellite 6 coatings applied to the P91 steel substrate with the lower heat input (P91-1). Further, the Stellite coating for P91-1 was significantly harder than that obtained for P91-1.8. The wear test results indicated that the weight loss for P91-1 was much lower than for P91-1.8. It is concluded that the lower hardness of the coating for P91-1.8, together with the softer underlying substrate structure, markedly reduced the wear resistance of the Stellite 6 coating.

Keywords: friction and wear, laser cladding, P91 steel, Stellite 6 coating

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Authors: Jong Yeop Kim, Jong Bum Choi, Hyun Jeong Kwak, Sook Young Lee

Abstract:

Background: Each supraglottic airway requires different anesthetic depth because it has a specific structure and different compressive force in the oropharyngeal cavity. We designed the study to investigate remifentanil effect-site concentration (Ce) in 50% of patients (EC50) for successful insertion of i- gel, and to compare it with that for laryngeal mask airway (LMA) insertion during propofol target-controlled infusion (TCI). Methods: Forty-one female patients were randomized to the i-gel group (n=20) or the LMA group (n=21). Anesthesia induction was performed using propofol Ce of 5 μg/ml and the predetermined remifentanil Ce, and i-gel or LMA insertion was attempted 5 min later. The remifentanil Ce was estimated by modified Dixon's up-and-down method (initial concentration: 3.0 ng/ml, step size: 0.5 ng/ml). The patient’s response to device insertion was classified as either ‘success (no movement)’ or ‘failure (movement)’. Results: Using the Dixon’s up and down method, EC50 of remifentanil Ce for i-gel (1.58 ± 0.41 ng/ml) was significantly lower than that for LMA (2.25 ± 0.55 ng/ml) (p=0.038). Using isotonic regression, EC50 (83% CI) of remifentanil in the i-gel group [1.50 (1.37-1.80) ng/ml] was statistically lower than that in the LMA group [2.00 (1.82-2.34) ng/ml]. EC95 (95% CI) of remifentanil in the i-gel group [2.38 (1.48-2.50) ng/ml] was statistically lower than that in the LMA group [3.35 (2.58-3.48) ng/ml]. Conclusion: We found that EC50 of remifentanil Ce for i-gel insertion (1.58 ng/ml) was significantly lower than that for LMA insertion (2.25 ng/ml), in female patients during propofol TCI without neuromuscular blockade.

Keywords: i-gel, laryngeal mask airway, propofol, remifentanil

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Authors: Clement Ndoricimpa

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The expression of stance is highly expected in writing at tertiary level. Through a selection of linguistic and rhetorical elements, writers express commitment, critical distance and build a critically discerning reader in texts. Despite many studies on patterns of stance in students’ academic writing, little may not be known about how English as a Foreign Language students learns to build a critically discerning reader in their texts. Therefore, this study examines patterns of stance in essays written by students majoring in business administration at English-medium University in Burundi as part of classroom assignments. It draws on systemic functional linguistics to analyze qualitatively and quantitatively the data. The quantitative analysis is used to identify the differences in frequency of stance patterns in the essays. The results show a significant difference in the use of boosters by lower- and upper-level students. Lower-level students’ writing contains more boosters and many idiosyncratic sentence structures than do upper-level students’ writing, and upper-level students’ essays contain more hedging and few grammatical mistakes than do lower-level students’ essays. No significant difference in the use of attitude markers and concessive and contrastive expressions. Students in lower- and upper-level do not use attitude markers and disclaimer markers appropriately and accurately. These findings suggest that students should be taught the use of stance patterns in academic writing.

Keywords: academic writing, metadiscourse, stance, student corpora

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Authors: Dilek Cetin Alisar, Oya Umit Yemisci, Selin Ozen, Seyhan Sozay

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New approaches and treatment modalities are being developed to make patients more functional and independent in stroke rehabilitation. One of these approaches is transcranial direct stimulation therapy (tDCS), which aims to improve the hemiplegic upper limb function of stroke patients. tDCS therapy is not in the routine rehabilitation program; however, the studies about tDCS therapy on stroke rehabilitation was increased in recent years. Evaluate the effect of tDCS treatment on upper extremity motor function in patients with subacute stroke was aimed in our study. 32 stroke patients (16 tDCS group, 16 sham groups) who were hospitalized for rehabilitation in Başkent University Physical Medicine and Rehabilitation Clinic between 01.08.2016-20.01-2018 were included in the study. The conventional upper limb rehabilitation program was used for both tDCS and control group patients for 3 weeks, 5 days a week, for 60-120 minutes a day. In addition to the conventional stroke rehabilitation program in the tDAS group, bihemispheric tDCS was administered for 30 minutes daily. Patients were evaluated before treatment and after 1 week of treatment. Functional independence measure self-care score (FIM), Brunnstorm Recovery Stage (BRS), and Fugl-Meyer (FM) upper extremity motor function scale were used. There was no difference in demographic characteristics between the groups. There were no significant differences between BRS and FM scores in two groups, but there was a significant difference FIM score (p=0.05. FIM, BRS, and FM scores are significantly in the tDCS group, when before therapy and after 1 week of therapy, however, no difference is found in the shame group (p < 0,001). When FBS and FM scores were compared, there were statistical significant differences in tDCS group (p < 0,001). In conclusion, this randomized double-blind study showed that bihemispheric tDCS treatment was found to be superior to upper extremity motor and functional enhancement in addition to conventional rehabilitation methods in subacute stroke patients. In order for tDCS therapy to be used routinely in stroke rehabilitation, there is a need for more comprehensive, long-termed, randomized controlled clinical trials in order to find answers to many questions, such as the duration and intensity of treatment.

Keywords: cortical stimulation, motor function, rehabilitation, stroke

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Authors: Hannah S. Waldron

Abstract:

Background: The government has proposed sugar reduction targets in an effort to tackle childhood obesity, focussing on those of low socioeconomic status (SES). Supermarkets are a key location for reducing the amount of sugar purchased, but success so far in this environment has been limited. Building on previous research, this study will assess the impact of restricting the availability of higher sugar biscuits as a strategy to encourage lower sugar biscuit purchasing, and whether the effects vary by customer SES. Method: 14 supermarket convenience stores were divided between control (n=7) and intervention (n=7) groups. In the intervention stores, biscuits with sugar above the government’s target (26.2g/100g) were removed from sale and replaced with lower sugar ( < 26.2g sugar/100g) alternatives. Sales and customer demographic information were collected using loyalty card data and point-of-sale transaction data for 8-weeks pre and post the intervention for lower sugar biscuits, total biscuits, alternative higher sugar products, and all products. Results were analysed using three-way and two-way mixed ANOVAs. Results: The intervention resulted in a significant increase in lower sugar biscuit purchasing (p < 0.001) and a significant decline in overall biscuit sales (p < 0.001) between the time periods compared to control stores. Sales of higher sugar products and all products increased significantly between the two time periods in both the intervention and control stores (p < 0.05). SES showed no significant effect on any of the reported outcomes (p > 0.05). Conclusion: Restricting the availability of higher sugar products may be a successful strategy for encouraging lower sugar purchasing across all SES groups. However, larger-scale interventions are required in additional categories to assess the long term implications for both consumers and retailers.

Keywords: biscuits, nudging, sugar, supermarket

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Authors: Ahmed Ghachem, Johann Colomba, Denis Prud'homme, Martin Brochu

Abstract:

Background: Inactive obese postmenopausal women, are at greater risk for metabolic complications. On the other hand, high levels of cardiorespiratory fitness (CRF) are associated with a lower risk of metabolic complications. Objective: To compare inactive obese postmenopausal women displaying ‘lower’ vs ‘higher’ levels of CRF for body composition, metabolic profile, inflammatory profile and measures of energy expenditure. Methods: 132 women (age: 57.6 ± 4.8 yrs; BMI: 32.3 ± 4.6 kg/m2; Peak VO2: 17.81 ± 3.02 ml O2•kg-1•min-1) were studied. They were first divided into tertiles based on their CRF. Then, women in the first (< 16.51 ml O2•min-1•kg-1) and second tertiles (16.51 to 19.22 ml O2•min-1•kg-1) were combined (N= 88), and compared with those in the third tertile (> 19.22 ml O2•min-1•kg-1) (N= 44). Variables of interest were: Peak VO2 (stationary bike), body composition (DXA), body fat distribution (CT scan), glucose homeostasis (fasting state and euglycemic/ hyperinsulinemic clamp), fasting lipids, resting blood pressure, inflammatory profile and energy expenditure (DLW). Results: Both CRF groups (lower= 16.0 ± 2.0 ml O2•kg-1•min-1 vs higher= 21.2 ± 1.7 ml O2•kg-1•min-1; p < 0.001) were similar for age. Significant differences were observed between groups for body composition; with lower values for body weight, BMI, fat mass and visceral fat in women with higher CRF (p between 0.001 and 0.005). Also, women with higher CRF had lower values for fasting insulin (13.4 ± 4.5 vs 15.6 ± 6.6 μU/ml; p = 0.03) and CRP levels (2.31 ± 1.97 vs 3.83 ± 3.24 mg/liter; p = 0.001); and higher values for glucose disposal (6.71 ± 1.78 vs 5.92 ± 1.67 mg/kg/min; p = 0.01). However, these differences were no longer significant after controlling for visceral adipose tissue accumulations. Finally, no significant difference was observed between groups for the other variables of interest. Conclusion: Our results suggest that, among inactive overweight/obese postmenopausal women, those with higher CRF levels have a better metabolic profile; which is caused by lower visceral fat accumulations.

Keywords: cardiorespiratory fitness, metabolic profile, menopause, obesity

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