Patient use of complementary and alternative medicine for psoriasis vulgaris and factors believed to trigger the disease: A multicenter cross-sectional study with 1621 patients

Introduction: Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. Objectives: To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. Methods: The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Results: Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Conclusions: Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians

Habits of using social media and the internet in psoriasis patients

Introduction: Psoriasis significantly affects the patients quality of life, which often leads patients to seek online information about this disease. Objectives: To explore the habits of patients with psoriasis related to their use of social media (SM) and the internet to obtain information about their disease. Methods: 1,520 patients completed the survey and the Dermatology Life Quality Index (DLQI) questionnaire. The Psoriasis Area Severity Index scores (PASI) and clinical data of the patients were recorded by their physicians. Results: Of the 1,114 patients that reported using SM and internet, 48.38% regularly and 31.14% sometimes resorted to obtain information about psoriasis. The use of SM and internet for psoriasis was statistically significantly higher among young people (P = 0.000), those with university or higher education (P = 0.009), higher DLQI (P = 0.000) and PASI (P = 0.011) scores, facial (P = 0.050), scalp (P = 0.032), hand (P = 0.048), genital (P = 0.001) and inverse (P = 0.000) involvement, and arthralgia/arthritis (P = 0.006). The participants mostly used the Google (86%) and Facebook (41%). More than half of the participants (62.8%) expected dermatologists to inform society that psoriasis is not contagious. Conclusions: Internet and SM being widely available and offering substantial information to be easily accessed make it very attractive for patients to use these platforms to investigate diseases, including psoriasis. If what is presented on SM conflicts with what the physician says, patients mostly trust the latter, but at the same time, they tend not to share the results of their online inquiries with their physicians

The effect of interlaminar graphene nano-sheets reinforced e-glass fiber/ epoxy on low velocity impact response of a composite plate

Due to copyright restrictions, the access to the full text of this article is only available via subscription.In this study, we compare the inter-laminar effect of graphene nano-sheets (GNSs) and CNTs on the single and multiple dynamic impact response of E-glass fiber reinforced epoxy composite (GFEP). In the comparisons, raw GFEP composite is used as baseline for quantifying the improvement on the dynamic impact response. For that purpose, finite element based models are developed for GNSs on GFEP, graphene coating on glass fibers, inter-laminar composite of CNTs reinforced polyester at 7.5 vol%, and combinations of all these reinforcements. Comparisons are made on three metrics: (i) total deformation, (ii) the contact force, and (iii) internal energy of the composite plate. The improvement on axial modulus (E1) of GFEP reinforced with one layer of GNS (0.5 wt%) without polyester at lamination sequence of [0]8 is 29.4%, which is very close to the improvement of 31% on storage modulus for multi-layer graphene with 0.5 wt% reinforced E-glass/epoxy composite at room temperature. Using three GNSs (1.5 wt%) reinforced polyester composite as interlaminar layer results in an improvement of 57.1% on E1 of GFEP composite. The simulation results reveal that the interlaminar three GNSs/polyester composite at mid-plane of GFEP laminated composite can significantly improve the dynamic impact resistance of GFEP structure compared to the other aforementioned structural reinforcements. Reinforcing GFEP composite with three layers of GNSs/polyester composite at mid-plane results in an average of 35% improvement on the dynamic impact resistance for healthy and damaged composite plate under low velocity impacts of single and multiple steel projectiles. This model can find application in various areas including structural health monitoring, fire retardant composite, and manufacturing of high strength and lightweight mechanical parts such as gas tank, aircraft wings and wind turbine blades

A methodology to design multi-axis test rigs for vibration and durability testing using frequency response functions

Due to copyright restrictions, the access to the full text of this article is only available via subscription.The multi-axis simulators are designed for experimental verification of the safe functioning of large components and subsystems under real world customer usage in vibration and durability testing. Transformation of the full vehicle conditions to mast rig testing with correct system dynamics and vibration characteristics and boundary conditions is a key challenge in the development of the experimental set-up. In this paper, a systematic methodology is formalized how to design the experimental set-up on MAST rig to replicate the vehicle dynamics and vibration characteristics in vehicle conditions. System modes and frequency response functions are chosen as key performance metrics to compare the dynamics of the system to be tested for both full vehicle and rig design. Criteria on the metrics are defined to make decision if the test rig design is sufficiently replicating the in-vehicle conditions. The methodology is illustrated on a side skirt attached to a heavy duty truck chassis that demonstrates the application of the methodology in practice

Active learning applications in the history of chemistry: Pre-service chemistry teachers' level of knowledge and views

© 2014 HKIEd APFSLT.This study aims to investigate the effects of a History and Philosophy of Chemistry-I course based on active learning applications on the level of knowledge of pre-service chemistry teachers about the history of chemistry. The views of pre-service chemistry teachers about these activities were also investigated. The study was carried out with 38 pre-service chemistry teachers from a university in Turkey in the academic year 2012-2013. In the History and Philosophy of Chemistry-I course; instruction was carried out based on five steps that included pre-service teachers' oral presentations, poster presentations, the assessment of the pre-service teachers' posters presentations with a rubric, preparing a timeline, and an assessment of the pre-service teachers' timelines. The data of this study was collected with an open-ended questionnaire. The questionnaire was administered to all the pre-service teachers before and after the instruction. The results of the study indicated that the pre-service teachers' level of knowledge about the history of chemistry had increased after the instruction. Also, interviews revealed that the pre-service teachers had positive views about the active learning activities

An integrated homogenization based topology optimization via RBF mapping strategies for additively manufactured FGLS and its application to bandgap structures

The manufacturing of lattice structures has been greatly facilitated thanks to the advances in additive manufacturing. Functionally graded lattice (FGL) structures, a major class of such structures, developed using topology optimization (TO) are known to have superior mechanical characteristics such as high stiffness to weight ratio. A new design methodology using an integrated TO process is proposed for the development of FGL structures in this research. For that purpose, a material-penalization formula derived by the application of homogenization is integrated into the TO process. As a result, relative densities of the TO are mapped directly. This approach is more advantageous compared with the alternative techniques as there is no need to post-process the optimization results. Therefore, the degradation of the optimization results from post-processing is eliminated. Then, radial basis functions (RBFs) are used to create the geometry of the FGLs efficiently. The proposed methodology is demonstrated on a case study, where a cantilever beam with a desired bandgap characteristic is designed. Numerical results using the proposed method show that the first and second bending frequencies with the resulting optimized geometry are within 3% and 12% of the original TO design, whereas using method 1 the calculated relative errors are 24% and 74% and method 2 these errors are calculated as 8% and 34%, respectively. These comparative results indicate that the geometry created by the new method is superior to other design strategies as evidenced by the improved compatibility level between the bandgap performance results of the original unpenalized TO and structures generated using alternative techniques.TÜBİTA

Optimal stiffness tuning for a lower body exoskeleton with spring-supported passive joints

Due to copyright restrictions, the access to the full text of this article is only available via subscription.This paper presents a framework to optimally tune the stiffness values of spring-supported passive joints that are included in lower body exoskeletons. First, a dynamic model of a combined human-exoskeleton system was created in MSC.ADAMS software. Second, a gradient-descent based algorithm was used to find the optimum value to minimize the ZMP for a range of ankle stiffness values. In order to corroborate the proposed method, simulation experiments were conducted by considering three cases in which different body mass and heights were assigned to the combined human-exoskeleton system. The simulation results indicate that the proposed methodology is effective in order to find the optimum ankle stiffness for the combined human-exoskeleton systems, resulting in reductions in ZMP variations and therefore increasing the balancing ability. As a consequence, it may be possible to reduce the number of active joints in exoskeletons that aim crutch-free 3-D walking motion support.TÜBİTAK ; COST Actions Inclusiveness Target Countries (ITC