Search results for: virtual therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3027

Search results for: virtual therapy

2667 Responsive Integrative Therapeutic Method: Paradigm for Addressing Core Deficits in Autism by Balkibekova

Authors: Balkibekova Venera Serikpaevna

Abstract:

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

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

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2666 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials

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

Abstract:

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

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

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2665 Drug Therapy Problems and Associated Factors among Patients with Heart Failure in the Medical Ward of Arba Minch General Hospital, Ethiopia

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

Abstract:

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

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

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2664 Wound Healing Dressing and Some Composites Such as Zeolite, TiO2, Chitosan and PLGA as New Alternative for Melanoma Therapy: A Review

Authors: L. B. Naves, L. Almeida

Abstract:

The development of Drugs Delivery System (DDS), has been wildly investigated in the last decades. In this paper, first a general overview of traditional and modern wound dressing is presented. This is followed by a review of what scientist have done in the medical environment, focusing the possibility to develop a new alternative for DDS through transdermal pathway, aiming to treat melanoma skin cancer.

Keywords: cancer therapy, dressing polymers, melanoma, wound healing

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2663 Utilizing Literature Review and Shared Decision-Making to Support a Patient Make the Decision: A Case Study of Virtual Reality for Postoperative Pain

Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

Abstract:

Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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2662 Children of Syria: Using Drawings for Diagnosing and Treating Trauma

Authors: Fatten F. Elkomy

Abstract:

The Syrian refugees are the largest refugee population since World War II. Mostly, children, these individuals were exposed to intense traumatic events in their homeland, throughout their journey, and during settlement in foreign lands. Art is a universal language to express feelings and tough human experiences. It is also a medium for healing and promoting creativity and resilience. Literature review was conducted to examine the use of art to facilitate psychiatric interviews, diagnosis, and therapy with traumatized children. Results show a severe impact of childhood trauma on the increased risk for abuse, neglect, and psychiatric disorders. Clinicians must recognize, evaluated and provide help for these children. In conclusion, drawings are used to tell a story, reflect deep emotions, and create a meaningful self-recognition and determination. Participants will understand art therapy using the expressive therapies continuum framework to evaluate drawings and to promote healing for refugee children.

Keywords: art therapy, children drawings, Syrian refugees, trauma in childhood

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2661 Modeling of Virtual Power Plant

Authors: Muhammad Fanseem E. M., Rama Satya Satish Kumar, Indrajeet Bhausaheb Bhavar, Deepak M.

Abstract:

Keeping the right balance of electricity between the supply and demand sides of the grid is one of the most important objectives of electrical grid operation. Power generation and demand forecasting are the core of power management and generation scheduling. Large, centralized producing units were used in the construction of conventional power systems in the past. A certain level of balance was possible since the generation kept up with the power demand. However, integrating renewable energy sources into power networks has proven to be a difficult challenge due to its intermittent nature. The power imbalance caused by rising demands and peak loads is negatively affecting power quality and dependability. Demand side management and demand response were one of the solutions, keeping generation the same but altering or rescheduling or shedding completely the load or demand. However, shedding the load or rescheduling is not an efficient way. There comes the significance of virtual power plants. The virtual power plant integrates distributed generation, dispatchable load, and distributed energy storage organically by using complementing control approaches and communication technologies. This would eventually increase the utilization rate and financial advantages of distributed energy resources. Most of the writing on virtual power plant models ignored technical limitations, and modeling was done in favor of a financial or commercial viewpoint. Therefore, this paper aims to address the modeling intricacies of VPPs and their technical limitations, shedding light on a holistic understanding of this innovative power management approach.

Keywords: cost optimization, distributed energy resources, dynamic modeling, model quality tests, power system modeling

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2660 Sexual Cognitive Behavioral Therapy: Psychological Performance and Openness to Experience

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Amin Asadi Hieh, Majid Kazemnezhad

Abstract:

This research was conducted with the aim of determining the effectiveness of sexual cognitive behavioral therapy on psychological performance and openness to experience in women. The type of research was experimental in the form of pre-test-post-test. The statistical population of this research was made up of all working and married women with membership in the researcher's Instagram social network who had problems in marital-sexual relationships (N=900). From the statistical community, which includes working and married women who are members of the researcher's Instagram social network who have problems in marital-sexual relationships, there are 30 people including two groups (15 people in the experimental group and 15 people in the control group) as available sampling and selected randomly. They were placed in two experimental and control groups. The anxiety, stress, and depression scale (DASS) and the Costa and McCree personality questionnaire were used to collect data, and the cognitive behavioral therapy protocol of Dr. Mehrnaz Ali Akbari was used for the treatment sessions. To analyze the data, the covariance test was used in the SPSS22 software environment. The results showed that sexual cognitive behavioral therapy has a positive and significant effect on psychological performance and openness to experience in women. Conclusion: It can be concluded that interventions such as cognitive-behavioral sex can be used to treat marital problems.

Keywords: sexual cognitive behavioral therapy, psychological function, openness to experience, women

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2659 The Legal Position of Criminal Prevention in the Metaverse World

Authors: Andi Intan Purnamasari, Supriyadi, Sulbadana, Aminuddin Kasim

Abstract:

Law functions as social control. Providing arrangements not only for legal certainty, but also in the scope of justice and expediency. The three values ​​achieved by law essentially function to bring comfort to each individual in carrying out daily activities. However, it is undeniable that global conditions have changed the orientation of people's lifestyles. Some people want to ensure their existence in the digital world which is popularly known as the metaverse. Some countries even project their city to be a metaverse city. The order of life is no longer limited to the real space, but also to the cyber world. Not infrequently, legal events that occur in the cyber world also force the law to position its position and even prevent crime in cyberspace. Through this research, conceptually it provides a view of the legal position in crime prevention in the Metaverse world. when the law acts to regulate the situation in the virtual world, of course some people will feel disturbed, this is due to the thought that the virtual world is a world in which an avatar can do things that cannot be done in the real world, or can be called a world without boundaries. Therefore, when the law is present to provide boundaries, of course the concept of the virtual world itself becomes no longer a cyber world that is not limited by space and time, it becomes a new order of life. approach, approach, approach, approach, and approach will certainly be the method used in this research.

Keywords: crime, cyber, metaverse, law

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2658 Effectiveness of Exercise and TENS in the Treatment of Temporomandibular Joint Disorders

Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

Abstract:

Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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2657 Intelligent Tutor Using Adaptive Learning to Partial Discharges with Virtual Reality Systems

Authors: Hernández Yasmín, Ochoa Alberto, Hurtado Diego

Abstract:

The aim of this study is developing an intelligent tutoring system for electrical operators training with virtual reality systems at the laboratory center of partials discharges LAPEM. The electrical domain requires efficient and well trained personnel, due to the danger involved in the partials discharges field, qualified electricians are required. This paper presents an overview of the intelligent tutor adaptive learning design and user interface with VR. We propose the develop of constructing a model domain of a subset of partial discharges enables adaptive training through a trainee model which represents the affective and knowledge states of trainees. According to the success of the intelligent tutor system with VR, it is also hypothesized that the trainees will able to learn the electrical domain installations of partial discharges and gain knowledge more efficient and well trained than trainees using traditional methods of teaching without running any risk of being in danger, traditional methods makes training lengthily, costly and dangerously.

Keywords: intelligent tutoring system, artificial intelligence, virtual reality, partials discharges, adaptive learning

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2656 Diagnosis and Treatment of Sleep Disorders

Authors: Andrew Anis Fakhrey Mosaad

Abstract:

Introduction: There are many different types of sleep disorders, each with serious implications for a person's health and a large financial burden on society. Method: This review offers a framework based on the International Classification of Sleep Disorders to aid in the diagnosis and treatment of sleep disorders. Differentiating between primary and secondary insomnia is covered, along with pharmacological and nonpharmacological therapy options. Common abnormalities of the circadian rhythm are mentioned along with their therapies, such as light therapy and chronotherapy. This article discusses the identification and management of periodic limb movement disorder and restless legs syndrome. The therapy of upper airway resistance syndrome and obstructive sleep apnea are the main topics of discussion. Conclusion: The range of narcolepsy symptoms and results, as well as diagnostic procedures and treatment, are discussed. The causes, outcomes, and treatments of many types of insomnias, such as sleep terrors, somnambulism, and rapid eye movement (REM) behavior sleep disorders, are discussed.

Keywords: diagnosis, treatment, sleep disorders, insomnia

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2655 Development of Generally Applicable Intravenous to Oral Antibiotic Switch Therapy Criteria

Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

Abstract:

Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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2654 Large Amplitude Free Vibration of a Very Sag Marine Cable

Authors: O. Punjarat, S. Chucheepsakul, T. Phanyasahachart

Abstract:

This paper focuses on a variational formulation of large amplitude free vibration behavior of a very sag marine cable. In the static equilibrium state, the marine cable has a very large sag configuration. In the motion state, the marine cable is assumed to vibrate in in-plane motion with large amplitude from the static equilibrium position. The total virtual work-energy of the marine cable at the dynamic state is formulated which involves the virtual strain energy due to axial deformation, the virtual work done by effective weight, and the inertia forces. The equations of motion for the large amplitude free vibration of marine cable are obtained by taking into account the difference between the Euler’s equation in the static state and the displaced state. Based on the Galerkin finite element procedure, the linear and nonlinear stiffness matrices, and mass matrices of the marine cable are obtained and the eigenvalue problem is solved. The natural frequency spectrum and the large amplitude free vibration behavior of marine cable are presented.

Keywords: axial deformation, free vibration, Galerkin finite element method, large amplitude, variational method

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2653 Improving Patient and Clinician Experience of Oral Surgery Telephone Clinics

Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

Abstract:

During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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2652 The Effectiveness of Group Counseling of Mindfulness-Based Cognitive Therapy on Cognitive Emotion Regulation in High School Students

Authors: Hossein Ilanloo, Sedigheh Ahmadi, Kianoosh Zahrakar

Abstract:

The present study aims at investigating the effectiveness of group counseling of mindfulness-based cognitive therapy on cognitive emotion regulation in high school students. The research design was quasi-experimental and pre-test-post-test type and a two-month follow-up with a control group. The statistical population of the study consisted of all-male high school students in Takestan city in the Academic Year 2020-2021. The sample comprised 30 high school male students selected through the convenience sampling method and randomly assigned to experimental (n=15) and control (n=15) groups. The experimental group then received ten sessions of 90-minute group counseling of mindfulness-based cognitive therapy, and the control group did not receive any intervention. In order to collect data, the author used the Cognitive Emotion Regulation Questionnaire (CERQ). The researcher also used multivariate analysis of covariance, repeated measures, LSD post hoc test, and SPSS-26 software for data analysis.

Keywords: mindfulness-based cognitive therapy, cognitive emotion regulation, students, high schools

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2651 Successful Treatment of Multifocal XDR Tuberculosis Osteomyelitis

Authors: Abeer N. Alshukairi, Abdulrahman A. Alrajhi, Abdulfattah W. Alamri, Adel F. Alothman

Abstract:

We described the nosocomial transmission of a pre-XDR or an MDR case of pulmonary tuberculosis in a HIV negative health care worker in an area endemic for MDR & XDR tuberculosis. With inadequate therapy and non-compliance, his strain developed acquired resistance and he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after 2 years of therapy with various anti-tuberculous drugs in addition to interferon gamma.

Keywords: osteomyelitis, treatment, XDR tuberculosis, successful treatment

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2650 Psychological Predictors in Performance: An Exploratory Study of a Virtual Ultra-Marathon

Authors: Michael McTighe

Abstract:

Background: The COVID-19 pandemic caused the cancellation of many large-scale in-person sporting events, which led to an increase in the availability of virtual ultra-marathons. This study intended to assess how participation in virtual long distances races relates to levels of physical activity for an extended period of time. Moreover, traditional ultra-marathons are known for being not only physically demanding, but also mentally and emotionally challenging. A second component of this study was to assess how psychological contructs related to emotion regulation and mental toughness predict overall performance in the sport. Method: 83 virtual runners participating in a four-month 1000-kilometer race with the option to exceed 1000 kilometers completed a questionnaire exploring demographics, their performance, and experience in the virtual race. Participants also completed the Difficulties in Emotions Regulation Scale (DERS) and the Sports Mental Toughness Questionnaire (SMTQ). Logistics regressions assessed these constructs’ utility in predicting completion of the 1000-kilometer distance in the time allotted. Multiple regression was employed to predict the total distance traversed during the fourmonth race beyond 1000-kilometers. Result: Neither mental toughness nor emotional regulation was a significant predictor of completing the virtual race’s basic 1000-kilometer finish. However, both variables included together were marginally significant predictors of total miles traversed over the entire event beyond 1000 K (p = .051). Additionally, participation in the event promoted an increase in healthy activity with participants running and walking significantly more in the four months during the event than the four months leading up to it. Discussion: This research intended to explore how psychological constructs relate to performance in a virtual type of endurance event, and how involvement in these types of events related to levels of activity. Higher levels of mental toughness and lower levels in difficulties in emotion regulation were associated with greater performance, and participation in the event promoted an increase in athletic involvement. Future psychological skill training aimed at improving emotion regulation and mental toughness may be used to enhance athletic performance in these sports, and future investigations into these events could explore how general participation may influence these constructs over time. Finally, these results suggest that participation in this logistically accessible, and affordable type of sport can promote greater involvement in healthy activities related to running and walking.

Keywords: virtual races, emotion regulation, mental toughness, ultra-marathon, predictors in performance

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2649 Virtual and Augmented Reality Based Heritage Gamification: Basilica of Smyrna in Turkey

Authors: Tugba Saricaoglu

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This study argues about the potential representation and interpretation of Basilica of Smyrna through gamification. Representation can be defined as a key which plays a role as a converter in order to provide interpretation of something according to the person who perceives. Representation of cultural heritage is a hypothetical and factual approach in terms of its sustainable conservation. Today, both site interpreters and public of cultural heritage have varying perspectives due to their different demographic, social, and even cultural backgrounds. Additionally, gamification application offers diversion of methods suchlike video games to improve user perspective of non-game platforms, contexts, and issues. Hence, cultural heritage and video game decided to be analyzed. Moreover, there are basically different ways of representation of cultural heritage such as digital, physical, and virtual methods in terms of conservation. Virtual reality (VR) and augmented reality (AR) technologies are two of the contemporary digital methods of heritage conservation. In this study, 3D documented ruins of the Basilica will be presented in the virtual and augmented reality based technology as a theoretical gamification sample. Also, this paper will focus on two sub-topics: First, evaluation of the video-game platforms applied to cultural heritage sites, and second, potentials of cultural heritage to be represented in video game platforms. The former will cover the analysis of some case(s) with regard to the concepts and representational aspects of cultural heritage. The latter will include the investigation of cultural heritage sites which carry such a potential and their sustainable conversation. Consequently, after mutual collection of information from cultural heritage and video game platforms, a perspective will be provided in terms of interpretation of representation of cultural heritage by sampling that on Basilica of Smyrna by using VR and AR based technologies.

Keywords: Basilica of Smyrna, cultural heritage, digital heritage, gamification

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2648 Positive Effect of Manipulated Virtual Kinematic Intervention in Individuals with Traumatic Stiff Shoulder: Pilot Study

Authors: Isabella Schwartz, Ori Safran, Naama Karniel, Michal Abel, Adina Berko, Martin Seyres, Tamir Tsoar, Sigal Portnoy

Abstract:

Virtual Reality allows to manipulate the patient’s perception, thereby providing a motivational addition to real-time biofeedback exercises. We aimed to test the effect of manipulated virtual kinematic intervention on measures of active and passive Range of Motion (ROM), pain, and disability level in individuals with traumatic stiff shoulder. In a double-blinded study, patients with stiff shoulder following proximal humerus fracture and non-operative treatment were randomly divided into a non-manipulated feedback group (NM-group; N=6) and a manipulated feedback group (M-group; N=7). The shoulder ROM, pain, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores were tested at baseline and after the 6 sessions, during which the subjects performed shoulder flexion and abduction in front of a graphic visualization of the shoulder angle. The biofeedback provided to the NM-group was the actual shoulder angle and the feedback provided to the M-group was manipulated so that 10° were constantly subtracted from the actual angle detected by the motion capture system. The M-group showed greater improvement in the active flexion ROM, with median and interquartile range of 197.1 (140.5-425.0) compared to 142.5 (139.1-151.3) for the NM-group (p=.046). Also, the M-group showed greater improvement in the DASH scores, with median and interquartile range of 67.7 (52.8-86.2) compared to 89.7 (83.8-98.3) for the NM-group (p=.022). Manipulated intervention is beneficial in individuals with traumatic stiff shoulder and should be further tested for other populations with orthopedic injuries.

Keywords: virtual reality, biofeedback, shoulder pain, range of motion

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2647 Application of Metaverse Service to Construct Nursing Education Theory and Platform in the Post-pandemic Era

Authors: Chen-Jung Chen, Yi-Chang Chen

Abstract:

While traditional virtual reality and augmented reality only allow for small movement learning and cannot provide a truly immersive teaching experience to give it the illusion of movement, the new technology of both content creation and immersive interactive simulation of the metaverse can just reach infinite close to the natural teaching situation. However, the mixed reality virtual classroom of metaverse has not yet explored its theory, and it is rarely implemented in the situational simulation teaching of nursing education. Therefore, in the first year, the study will intend to use grounded theory and case study methods and in-depth interviews with nursing education and information experts. Analyze the interview data to investigate the uniqueness of metaverse development. The proposed analysis will lead to alternative theories and methods for the development of nursing education. In the second year, it will plan to integrate the metaverse virtual situation simulation technology into the alternate teaching strategy in the pediatric nursing technology course and explore the nursing students' use of this teaching method as the construction of personal technology and experience. By leveraging the unique features of distinct teaching platforms and developing processes to deliver alternative teaching strategies in a nursing technology teaching environment. The aim is to increase learning achievements without compromising teaching quality and teacher-student relationships in the post-pandemic era. A descriptive and convergent mixed methods design will be employed. Sixty third-grade nursing students will be recruited to participate in the research and complete the pre-test. The students in the experimental group (N=30) agreed to participate in 4 real-time mixed virtual situation simulation courses in self-practice after class and conducted qualitative interviews after each 2 virtual situation courses; the control group (N=30) adopted traditional practice methods of self-learning after class. Both groups of students took a post-test after the course. Data analysis will adopt descriptive statistics, paired t-tests, one-way analysis of variance, and qualitative content analysis. This study addresses key issues in the virtual reality environment for teaching and learning within the metaverse, providing valuable lessons and insights for enhancing the quality of education. The findings of this study are expected to contribute useful information for the future development of digital teaching and learning in nursing and other practice-based disciplines.

Keywords: metaverse, post-pandemic era, online virtual classroom, immersive teaching

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2646 Vital Pulp Therapy: The Minimally Invasive Endodontic Therapy for Mature Permanent Teeth

Authors: Fadwa Chtioui

Abstract:

Vital Pulp Therapy (VPT) is nowadays challenging the deep-rooted dogma of root canal treatment, being the only therapeutic option for permanent teeth diagnosed with irreversible pulpitis or carious pulp exposure. Histologic and clinical research has shown that compromised dental pulp can be treated without the full removal or excavation of all healthy pulp, and the outcome of the partial or full pulpotomy followed by a Tricalcium-Silicate-based dressing seems to show promising results in maintaining pulp vitality and preserving affected teeth in the long term. By reviewing recent advances in the techniques of VPT and their clinical effectiveness and safety in permanent teeth with irreversible Pulpitis, this work provides a new understanding of pulp pathophysiology and defense mechanisms and will reform dental practitioners' decision-making in treating irreversible pulpits from root canal therapy to vital pulp therapy by taking advantage of the biological effects of Tricalcium Silicate materials. Biography of presenting author: Fadwa Chitoui graduated from the school of Dental Medicine of Monastir, Tunisia, in 2015. After getting her DDS degree with honors, she earned her Postgraduate master's Degree in Endodontics and Restorative Dentistry from her Faculty. Since 2021, she has Started her own private and specialized practice based in the capital Tunis. She enjoys the sphere of associative life, worked with national and international associations, and got engaged in scientific dental research, whereby she tailored her passion for her field of specialty towards broadening her knowledge and ambitions, holding conferences and workshops nationally and internationally and publishing scientific articles in several journals.

Keywords: irreversible pulpitis, permanenet teeth, vital pulp therapy, pulpotomy

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2645 Investigating the Effect of VR, Time Study and Ergonomics on the Design of Industrial Workstations

Authors: Aydin Azizi, Poorya Ghafoorpoor Yazdi

Abstract:

This paper presents the review of the studies on the ergonomics, virtual reality, and work measurement (time study) at the industrial workstations because each of these three individual techniques can be used to improve the design of workstations and task position. The objective of this paper is to give an overall literature review that if there is any relation between these three different techniques. Therefore, it is so important to review the scientific studies to find a better and effective way for improving design of workstations. On the other hand, manufacturers found that instead of using one of the approaches, utilizing the combination of these individual techniques are more effective to reduce the cost and production time.

Keywords: ergonomics, time study, virtual reality, workplace

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2644 Palliative Orthovoltage Radiotherapy and Subcutaneous Infusion of Carboplatin for Treatment of Appendicular Osteosarcoma in Dogs

Authors: Kathryn L. Duncan, Charles A. Kuntz, Alessandra C. Santamaria, James O. Simcock

Abstract:

Access to megavoltage radiation therapy for small animals is limited in many locations around the world. This can preclude the use of palliative radiation therapy for the treatment of appendicular osteosarcoma in dogs. The objective of this study was to retrospectively assess the adverse effects and survival times of dogs with appendicular osteosarcoma that were treated with hypofractionated orthovoltage radiation therapy and adjunctive carboplatin chemotherapy administered via a single subcutaneous infusion. Medical records were reviewed retrospectively to identify client-owned dogs with spontaneously occurring appendicular osteosarcoma that was treated with palliative orthovoltage radiation therapy and a single subcutaneous infusion of carboplatin. Data recorded included signalment, tumour location, results of diagnostic imaging, haematologic and serum biochemical analyses, adverse effects of radiation therapy and chemotherapy, and survival times. Kaplan-Meier survival analysis was performed, and log-rank analysis was used to determine the impact of specific patient variables on survival time. Twenty-three dogs were identified that met the inclusion criteria. Median survival time for dogs was 182 days. Eleven dogs had adverse haematologic effects, 3 had adverse gastrointestinal effects, 6 had adverse effects at the radiation site and 7 developed infections at the carboplatin infusion site. No statistically significant differences were identified in survival times based on sex, tumour location, development of infection, or pretreatment serum alkaline phosphatase. Median survival time and incidence of adverse effects were comparable to those previously reported in dogs undergoing palliative radiation therapy with megavoltage or cobalt radiation sources and conventional intravenous carboplatin chemotherapy. The use of orthovoltage palliative radiation therapy may be a reasonable alternative to megavoltage radiation in locations where access is limited.

Keywords: radiotherapy, veterinary oncology, chemotherapy, osteosarcoma

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2643 Fiction and Reality in Animation: Taking Final Flight of the Osiris as an Example

Authors: Syong-Yang Chung, Xin-An Chen

Abstract:

This study aims to explore the less well-known animation “Final Flight of the Osiris”, consisting of an initial exploration of the film color, storyline, and the simulacrum meanings of the roles, which leads to a further exploration of the light-shadow contrast and the psychological images presented by the screen colors and the characters. The research is based on literature review, and all data was compiled for the analysis of the visual vocabulary evolution of the characters. In terms of the structure, the relational study of the animation and the historical background of that time came first, including The Wachowskis’ and Andy Jones’ impact towards the cinematographic version and the animation version of “The Matrix”. Through literature review, the film color, the meaning and the relevant points were clarified. It was found in this research that “Final Flight of the Osiris” separates the realistic and virtual spaces by the changing the color tones; the "self" of the audience gradually dissolves into the "virtual" in the simulacra world, and the "Animatrix" has become a virtual field for the audience to understand itself about "existence" and "self".

Keywords: the matrix, the final flight of Osiris, Wachowski brothers, simulacres

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2642 Trauma-Informed Applied Theatre: Using Performance to Connect with Mental Dysfunction Using Physical Embodiment Begins with Ancient Civilizations

Authors: Stephanie Elizabeth Talder

Abstract:

Art therapy is a field that is growing exponentially with new groundbreaking discoveries that allow for embodying trauma and mental healing. Applied theatre and performance is a continuously growing and developing field that can help people who are struggling to work through traumatic experiences plaguing their life. By using performance, there is an ability to target sensitive topics in a manner that does not lead to re-traumatization. The use of theatre as a healing agent has been going on for centuries, with clear applications beginning in Greek theatre and tragedy. When working with complex mental illness, issues such as PTSD, anxiety, and depression can be managed and worked through. A central component of drama therapy is the connection to community and self. The ability to connect mind-body to stories as well as to other people allows for healing to occur. There is the opportunity for healing through emotional catharsis and community building. Applied theatre in connection to the medical field can allow for there to be a meaningful impact made on mental health. Though there is still a significant amount of progress to be made within the stigmatization of mental health problems, bringing in a varying option that allows for there to be movement and community building possesses a strong ability to impact people in a positive way.

Keywords: applied theatre, drama therapy, art therapy, performance, theatre

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2641 Frequency of Gastrointestinal Manifestations in Systemic Sclerosis and Impact of Rituximab Treatment

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

Abstract:

Objectives. Gastrointestinal involvement is one of the most common manifestations of systemic sclerosis (SSc). The aim of our study was to assess the frequency of gastrointestinal manifestations in SSc patients (pts) with interstitial lung disease (ILD) and their changes to rituximab (RTX) therapy. Methods. There were 103 pts with SSc in this study. The mean follow-up period was 12.6±10.7 months. The mean age was 47±12.9 years, females - 87 pts (84%), and the diffuse cutaneous subset of the disease 55 pts (53%). The mean disease duration was 6.2±5.5 years. All pts had ILD and were positive for ANA. 67% of them were positive for anti-topoisomerase-1. All patients received prednisolone at a dose of 11.3±4.5 mg/day, and immunosuppressants at inclusion received 47% of them. Pts received RTX due to the ineffectiveness of previous therapy for ILD. The cumulative mean dose of RTX was 1.7±0.6 grams. 90% of pts received omeprazole at a dose of 20-40 mg/day. Results. At inclusion, dysphagia was observed in 76 pts (74%), early satiety or vomiting in 32 pts (31%), and diarrhea in 20 pts (19%). We didn't observe any changes in gastrointestinal manifestation during RTX therapy. There was a decrease in the number of pts with dysphagia from 76 (74%) to 66 (64%), but it was insignificant. The number of pts with early satiety or vomiting and diarrhea didn't change. Conclusion. In our study, gastrointestinal involvement was observed in most of the pts with SSc-ILD. We didn't find any significant changes in gastrointestinal manifestations during RTX therapy. RXT does not worsen gastrointestinal manifestations in SSc-ILD.

Keywords: systemic sclerosis, dysphagia, rituximab, gastrointestinal manifestations

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2640 Quality of Life of Patients on Oral Anticoagulant Therapy in Outpatient Cardiac Department Dr. Hasan Sadikin Central General Hospital Bandung

Authors: Mochammad Indra Permana, Andhiani Sharfina Arnellya, Dika Pramita Destiani, Budhi Prihartanto

Abstract:

Cardiovascular disease is the cause of the highest mortality rates in the world. The number of cardiovascular disease patients is increasing every year. Data obtained from World Health Organization (WHO) that 17,5 million people died from this disease. The condition of cardiovascular diseases such as atrial fibrillation, myocardial infarction, venous thromboembolism, and several other conditions need anticoagulant therapy. Results of the anticoagulant therapy are measured not only by the effectiveness of International Normalized Ratio (INR) value but also by the quality of life of the patients. The purpose of this study was to determine the quality of life of patients on oral anticoagulant therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This is a cross-sectional study with collecting data from the quality of life questionnaire and medical record of the patients. The results of this study showed that 28 patients (46,7%) had a good quality of life, 30 patients (50%) had a moderate quality of life, and 2 patients (3,3%) had a poor quality of life with no significant differences in quality of life based on age, gender, diagnosis, and duration of drug use.

Keywords: anticoagulant, cardiovascular diseases, INR, quality of life

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2639 A Virtual Grid Based Energy Efficient Data Gathering Scheme for Heterogeneous Sensor Networks

Authors: Siddhartha Chauhan, Nitin Kumar Kotania

Abstract:

Traditional Wireless Sensor Networks (WSNs) generally use static sinks to collect data from the sensor nodes via multiple forwarding. Therefore, network suffers with some problems like long message relay time, bottle neck problem which reduces the performance of the network. Many approaches have been proposed to prevent this problem with the help of mobile sink to collect the data from the sensor nodes, but these approaches still suffer from the buffer overflow problem due to limited memory size of sensor nodes. This paper proposes an energy efficient scheme for data gathering which overcomes the buffer overflow problem. The proposed scheme creates virtual grid structure of heterogeneous nodes. Scheme has been designed for sensor nodes having variable sensing rate. Every node finds out its buffer overflow time and on the basis of this cluster heads are elected. A controlled traversing approach is used by the proposed scheme in order to transmit data to sink. The effectiveness of the proposed scheme is verified by simulation.

Keywords: buffer overflow problem, mobile sink, virtual grid, wireless sensor networks

Procedia PDF Downloads 356
2638 Film Therapy on Adolescent Body Image: A Pilot Study

Authors: Sonia David, Uma Warrier

Abstract:

Background: Film therapy is the use of commercial or non-commercial films to enhance healing for therapeutic purposes. Objectives: The mixed-method study aims to evaluate the effect of film-based counseling on body image dissatisfaction among adolescents to precisely ascertain the cause of the alteration in body image dissatisfaction due to the said intervention. Method: The one group pre-test post-test research design study using inferential statistics and thematic analysis is based on a pre-test post-test design conducted on 44 school-going adolescents between 13 and 17. The Body Shape Questionnaire (BSQ- 34) was used as a pre-test and post-test measure. The film-based counseling intervention model was used through individual counseling sessions. The analysis involved paired sample t-test used to examine the data quantitatively, and thematic analysis was used to evaluate qualitative data. Findings: The results indicated that there is a significant difference between the pre-test and post-test means. Since t(44)= 9.042 is significant at a 99% confidence level, it is ascertained that film-based counseling intervention reduces body image dissatisfaction. The five distinct themes from the thematic analysis are “acceptance, awareness, empowered to change, empathy, and reflective.” Novelty: The paper originally contributes to the repertoire of research on film therapy as a successful counseling intervention for addressing the challenges of body image dissatisfaction. This study also opens avenues for considering alteration of teaching pedagogy to include video-based learning in various subjects.

Keywords: body image dissatisfaction, adolescents, film-based counselling, film therapy, acceptance and commitment therapy

Procedia PDF Downloads 256