21 research outputs found
Game-like interactive exercise versus visual feedback in patients with chemotherapy induced peripheral neuropathy post mastectomy: A randomized comparative study
No full textBackground Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects of antineoplastic agents, with a prevalence of 19 to 85%. In terms of clinical manifestations, CIPN is primarily a sensory neuropathy with motor and autonomic alterations of varying intensity and duration. CIPN consider as major problem for both cancer patients and survivors, as well as for their healthcare providers, possibly increasing the risk of falling. Objective: To evaluate the efficacy of game-like interactive exercise versus visual feedback training on the risk of falling and sensory integration in patients with chemotherapy-induced peripheral neuropathy after mastectomy. Methods: In this randomized comparative study, 30 female patients diagnosed with chemotherapy-induced peripheral neuropathy after mastectomy were randomly allocated into two equal groups; group (A) underwent game-like interactive exercise using the Biodex Balance System (BBS), while group (B) underwent a visual feedback training program using BBS. The treatment was applied for three sessions per week for four consecutive weeks. All subjects in both groups were assessed using the fall risk index and sensory integration test (sway index) in four sensory conditions at baseline and at the end of the study for both groups
Application of SMA fiber composite as seismic reinforcement for concrete moment resisting frames
No full textFor many years, steel has been used as the primary reinforcing material for concrete structures. Despite requisite stiffness, strength, ductility and desired deflection properties, steel reinforcing bars have tendency to incur permanent plastic deformations under excessive loading. Recently, fiber reinforced polymer (FRP) reinforcing bars have also been used in concrete structures to address corrosion issues typically associated with conventional steel bars. However, due to their linear elastic behavior, they are not considered in structures which require ductility and damping characteristics. The use of shape memory alloys (SMAs) with their nonlinear-elastic behavior in the composite could potentially provide solution for this problem. Small diameter super-elastic Nickel-Titanium (NiTi) SMA wires, coupled with polymer matrix is sought in this research as reinforcing bars in reinforced concrete (RC) moment resisting frames (MRFs) to improve the performance of the frames in terms of reducing residual inter-story drifts and damage under earthquake loading, while still maintaining the elastic characteristics associated with FRP. SMA fibers, conventional polymeric fibers and resin are infused together to manufacture the new composite under high pressure and temperature. Uni-axial cyclic tensile tests are carried out to characterize the mechanical hysteretic behavior of the new composite. Analytical constitutive models are developed for the SMA-based composite materials and calibrated based on experimental test results. These material models are then extended for use in structural models to capture the hysteretic behavior of the composite. The new SMA composite reinforcement is placed at the plastic hinge region of the MRFs, where most of the damage is expected. RC MRF prototype structures reinforced with steel, SMA-FRP and conventional glass-FRP (GFRP) composite reinforcement are designed using two different approaches involving equivalent static force procedure and capacity spectrum method. Multiple non-linear time history analyses are conducted using incremental dynamic technique for assessing the performance of the MRFs under suite of ground motions. Main shock-aftershock ground motion sequences are utilized to examine the efficacy of using SMA-FRP composite in plastic hinge zones of MRFs. Damage assessment is performed based on residual inter-story drift and drift performance levels. Efficacy of proposed SMA-FRP composite reinforcement is further explored by embedding it in a small scale beam tested under 3-point bending.Item withdrawn by Mark Zulauf ([email protected]) on 2013-04-17T20:23:49Z
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Virtual reality-based exercises to improve balance and hand grip strength in patients with hemiparesis caused by an electrical burn: A randomized controlled study
No full textThere are many complications after an electrical burn injury, including neuromuscular defects, paresis or paralysis, Gillian barre syndrome, transverse myelitis, or amyotrophic lateral sclerosis. The aim of this study was to investigate the effect of virtual reality-based exercises on balance and hand grip strength in post electrical burn-induced hemiparetic patients. A randomized control trial pre- and post-experimental design with intra-rater reliability and inter-rater agreement was undertaken. Thirty post-electrical burn-induced hemiparetic patients (19 males and 11 females, aged 15 to 25 years) were randomly allocated into two equal groups (group A and B). Group A (n = 15) received virtual reality-based exercise in addition to the conventional physical therapy program. Group B (n = 15) received conventional physical therapy program only. The treatment was applied 3 sessions per week for 12 consecutive weeks. Posture stability and hand grip strength were measured by the Biodex balance system and handheld dynamometer, respectively. Data was collected prior to the first treatment and at the end of the 12-week trial and all statistical calculations were done using the computer program IBM SPSS. A statistically significant increase in the overall stability index and the power of hand grip strength was observed in both groups after treatment (p < 0.05), especially in group A, which received VR - based exercise training. Thus, group A showed a greater improvement in postural stability and hand grip strength than group B (p < 0.05). Virtual reality-based exercises as well as conventional physical therapy program were effective in improving posture stability and hand grip strength in post electrical burn-induced hemiparetic patients
Virtual reality-based exercises to improve balance and hand grip strength in patients with hemiparesis caused by an electrical burn: A randomized controlled study
No full textThere are many complications after an electrical burn injury, including neuromuscular defects, paresis or paralysis, Gillian barre syndrome, transverse myelitis, or amyotrophic lateral sclerosis. The aim of this study was to investigate the effect of virtual reality-based exercises on balance and hand grip strength in post electrical burn-induced hemiparetic patients. A randomized control trial pre- and post-experimental design with intra-rater reliability and inter-rater agreement was undertaken. Thirty post-electrical burn-induced hemiparetic patients (19 males and 11 females, aged 15 to 25 years) were randomly allocated into two equal groups (group A and B). Group A (n = 15) received virtual reality-based exercise in addition to the conventional physical therapy program. Group B (n = 15) received conventional physical therapy program only. The treatment was applied 3 sessions per week for 12 consecutive weeks. Posture stability and hand grip strength were measured by the Biodex balance system and handheld dynamometer, respectively. Data was collected prior to the first treatment and at the end of the 12-week trial and all statistical calculations were done using the computer program IBM SPSS. A statistically significant increase in the overall stability index and the power of hand grip strength was observed in both groups after treatment (p < 0.05), especially in group A, which received VR - based exercise training. Thus, group A showed a greater improvement in postural stability and hand grip strength than group B (p < 0.05). Virtual reality-based exercises as well as conventional physical therapy program were effective in improving posture stability and hand grip strength in post electrical burn-induced hemiparetic patients
Game-like Interactive Exercise Versus Visual Feedback in Patients with Chemotherapy Induced Peripheral Neuropathy Post Mastectomy: A Randomized Comparative Study
No full textBackground Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects of antineoplastic agents, with a prevalence of 19 to 85%. In terms of clinical manifestations, CIPN is primarily a sensory neuropathy with motor and autonomic alterations of varying intensity and duration. CIPN consider as major problem for both cancer patients and survivors, as well as for their healthcare providers, possibly increasing the risk of falling. Objective: To evaluate the efficacy of game-like interactive exercise versus visual feedback training on the risk of falling and sensory integration in patients with chemotherapy-induced peripheral neuropathy after mastectomy. Methods: In this randomized comparative study, 30 female patients diagnosed with chemotherapy-induced peripheral neuropathy after mastectomy were randomly allocated into two equal groups; group (A) underwent game-like interactive exercise using the Biodex Balance System (BBS), while group (B) underwent a visual feedback training program using BBS. The treatment was applied for three sessions per week for four consecutive weeks. All subjects in both groups were assessed using the fall risk index and sensory integration test (sway index) in four sensory conditions at baseline and at the end of the study for both groups
Treatment of multiple sclerosis in special populations: The case of refugees
No full textMultiple sclerosis was long considered a relatively rare entity in the Middle East, but research over the past 10 years and the publication of the Middle East North Africa Committee for Treatment and Research in Multiple Sclerosis guidelines for multiple sclerosis have allowed diagnosis and treatment to occur more efficiently. Most of the first and second-line disease-modifying therapies approved by the Food and Drug Administration and the European Medicine Agency are available in the Middle East. However, the availability of disease-modifying therapies is quite variable, with some countries having access to all multiple sclerosis disease-modifying therapies, while in others there is only one therapeutic option. Economic limitations remain a challenge for the management of multiple sclerosis, especially in countries of war. Moreover, the burden of multiple sclerosis treatment in Syrian and Palestinian refugees is likely high due to the non-availability of funds to cover the high cost of disease-modifying therapies. © The Author(s) 2020
Transtheoretical Model-based Interventions are Effective in Promoting Healthy Behaviors Related to Modifiable Risk Factors of Noncommunicable Diseases: A Systematic Review
No full textIntroduction: Noncommunicable diseases (NCDs) such as heart diseases, type II diabetes mellitus, cancers, and stroke represent significant public health challenges globally. Modifiable risk factors, including insufficient physical activity (PA), overweight or obesity, and smoking, contribute significantly to the prevalence of these diseases. The transtheoretical model (TTM) offers a structured approach to behavior change, identifying stages of readiness and change processes. This systematic review (SR) aims to evaluate the effectiveness of TTM-based interventions in promoting healthy behaviors to mitigate these risk factors.
Methods: This systematic review addresses the PICO question: In adults aged 18 years and older with modifiable risk behaviors related to NCDs, how effective are TTM-based interventions compared to standard care in increasing physical activity levels (PAL), reducing weight or body mass index, improving dietary habits, and promoting smoking cessation (SC)? A comprehensive search of predetermined databases was conducted using nine research strings, adhering to strict inclusion and exclusion criteria. A six-stage process was employed to select studies for inclusion, followed by data extraction and narrative synthesis to identify relevant patterns, trends, and associations.
Results: Of the 259 articles retrieved, eight met the inclusion criteria. Baseline assessments determined participants’ readiness for change. TTM-based interventions included feedback or counseling sessions, feedback materials, and reports delivered in-person, online, and by telephone. Follow-up durations varied from 2 weeks to 2 years. Five out of six studies supported the effectiveness of TTM-based interventions in enhancing PAL. Four out of five studies demonstrated their efficacy in weight management and improving dietary habits. However, only two out of five studies confirmed their effectiveness in SC.
Discussion: The findings indicate that TTM-based interventions are promising for improving PAL and, to a lesser extent, for managing weight and promoting healthy dietary behaviors. The limited effectiveness observed in SC interventions suggest a need for further research and possibly tailored strategies within this context.
Conclusion: TTM-based interventions effectively promote PA and weight management, with moderate success in improving dietary habits. However, their effectiveness in SC remains inconclusive, highlighting the necessity for further investigation and potential refinement of intervention strategies
Grading reflective essays: The reliability of a newly developed tool- GRE-9
No full textBackground: The main objective of this study is the development of a short reliable easy-to-use assessment tool in the aim of providing feedback to the reflective writings of medical students and residents. Methods: This study took place in a major tertiary academic medical center in Beirut, Lebanon. Seventy-seven reflective essays written by 18 residents in the department of Family Medicine at the American University of Beirut Medical Center (AUBMC) were graded by 3 raters using the newly developed scale to assess the scale reliability. Following a comprehensive search and analysis of the literature, and based on their experience in reflective grading, the authors developed a concise 9-item scale to grade reflective essays through repeated cycles of development and analysis as well as the determination of the inter-rater reliability (IRR) using intra-class correlation coefficients (ICC) and Krippendorff's Alpha. Results: The inter-rater reliability of the new scale ranges from moderate to substantial with ICC of 0.78, 95% CI 0.64-0.86, p < 0.01 and Krippendorff's Alpha was 0.49. Conclusions: The newly developed scale, GRE-9, is a short, concise, easy-to-use reliable grading tool for reflective essays that has demonstrated moderate to substantial inter-rater reliability. This will enable raters to objectively grade reflective essays and provide informed feedback to residents and students. © 2020 The Author(s)
Efficient spectrum availability information recovery for wideband dsa networks: A weighted compressive sampling approach
No full textThere have recently been research efforts that leverage compressive sampling to enable wideband spectrum sensing recovery at sub-Nyquist rates. These efforts consider homogenous wideband spectrum, where all bands are assumed to have similar primary user traffic characteristics. In practice, however, wideband spectrum is not homogeneous, in that different bands could present different occupancy patterns. In fact, applications of similar types are often assigned spectrum bands within the same block, dictating that wideband spectrum is indeed heterogeneous. In this paper, we consider heterogeneous wideband spectrum and exploit its inherent block-like structure to design efficient compressive spectrum sensing techniques that are well suited for heterogeneous wideband spectrum. We propose a weighted ?(1) -minimization sensing information recovery algorithm that achieves more stable recovery than that achieved by existing approaches, while accounting for the variations of spectrum occupancy across both the time and frequency dimensions. In addition, we show that our proposed algorithm requires a smaller number of sensing measurements when compared to the state-of-the-art approaches.Manuscript received December 6, 2016; revised June 6, 2017, September 27, 2017, and November 30, 2017; accepted December 26, 2017. Date of publication January 9, 2018; date of current version April 8, 2018. This work was supported in part by the U.S. National Science Foundation through the NSF Award under Grant CNS-1162296. The associate editor coordinating the review of this paper and approving it for publication was X. Zhou. (Corresponding author: Bassem Khalfi.) B. Khalfi and B. Hamdaoui are with the School of EECS, Oregon State University, Corvallis, OR 97331 USA (e-mail: [email protected]).Scopu
Survival outcome after radiation therapy for patients with early cervical carcinoma undergoing inadequate primary surgery
No full textObjective: The aim of this study was to investigate the survival outcome after radiation therapy for patients with early cervical carcinoma undergoing inadequate primary surgery. Methods: A retrospective analysis of medical charts of all patients with stage IA2 to IIA carcinoma who were referred with inappropriate primary surgery and treated with radiation therapy was reviewed. The collected data include age, presenting symptoms, retrospective stage, lymph node status, histology type, type of surgery, baseline radiologic status before radiotherapy, details of radiation therapy, follow-up, and details of disease recurrence, disease-free survival, and overall survival (OS). Kaplan-Meier survival curves were used to show the OS and recurrence-free survival. Results: A total of 32 patients were treated. The median age of the patients was 48.2 years, with a range of 27.6 to 79.2 years. Twenty-three patients had retrospective stage IB1, and 9 had stage IIA disease. The most common type of surgery (62.5percent) was total abdominal hysterectomy with or without bilateral salpingo-oophorectomy. The pelvic lymph node dissection (PLND) status was not determined in 20 patients, 11 had PLND surgical assessment (2 were positive), and 1 had bulky PLND by computed tomographic scan. Baseline assessment showed that 14 patients had no residual disease, 11 had microscopic disease, and 7 had macroscopic disease. The follow-up ranged from 3.3 to 77.8 months, with a median of 24.3 months. Eleven patients developed disease recurrence, and all of them died of their disease. Two- and 5-year OS rates were 79percent and 51.7percent. Univariate analysis did not show a statistically significant effect of either the disease stage or residual disease survival. Conclusions: Survival outcome after radiation therapy for patients with early-stage cervical cancer undergoing inadequate surgery seems to be markedly worse than that for patients of comparable stage treated initially with radical radiation. © 2013 by IGCS and ESGO.AMPIL F, 1987, CANCER, V60, P280, DOI 10.1002-1097-0142(19870801)60:3280::AID-CNCR28206003033.0.CO;2-1; ANDRAS EJ, 1973, AM J OBSTET GYNECOL, V115, P647; Buckley SL, 1996, GYNECOL ONCOL, V63, P4, DOI 10.1006-gyno.1996.0268; Choi DH, 1997, GYNECOL ONCOL, V65, P506, DOI 10.1006-gyno.1997.4711; Creasman WT, 1998, AM J OBSTET GYNECOL, V178, P62, DOI 10.1016-S0002-9378(98)70628-3; DAVY M, 1977, ACTA OBSTET GYN SCAN, V56, P105; DURRANCE FY, 1968, AMER J ROENTGENOL RA, V102, P165; Franco EL, 2003, CANCER J, V9, P348, DOI 10.1097-00130404-200309000-00004; HELLER PB, 1986, OBSTET GYNECOL, V67, P187; HOPKINS MP, 1990, GYNECOL ONCOL, V36, P7, DOI 10.1016-0090-8258(90)90100-Y; KINNEY WK, 1992, GYNECOL ONCOL, V44, P24, DOI 10.1016-0090-8258(92)90006-5; Landoni F, 1997, LANCET, V350, P535, DOI 10.1016-S0140-6736(97)02250-2; MATSUYAMA T, 1984, CANCER, V54, P3072, DOI 10.1002-1097-0142(19841215)54:123072::AID-CNCR28205412443.0.CO;2-E; Munstedt K, 2002, GYNECOL ONCOL, V86, P337, DOI 10.1006-gyno.2002.6767; NEWTON M, 1975, AM J OBSTET GYNECOL, V123, P535; ORR JW, 1986, OBSTET GYNECOL, V68, P353; PERKINS PL, 1984, GYNECOL ONCOL, V17, P340, DOI 10.1016-0090-8258(84)90219-1; RODDICK JW, 1971, AM J OBSTET GYNECOL, V109, P754; ROMAN LD, 1993, GYNECOL ONCOL, V50, P179, DOI 10.1006-gyno.1993.1189; Wilson CM, 2004, INT J GYNECOL CANCER, V14, P1, DOI 10.1111-j.1048-891x.2004.14178.x0
