Behind the scenes of caregiving in patients with advanced cancer: A qualitative study on family caregivers

Objective

Family caregivers may have concerns that they do not want to disclose to others. This study aims to delve into the concealed facets of care provided by family caregivers to patients with advanced cancer.

Methods

A qualitative approach was conducted in Iran from June 2022 to February 2023. Face-to-face, in-depth semi-structured interviews were carried out with 16 Iranian family caregivers of patients with advanced cancer, employing purposive sampling. The gathered data were analyzed using conventional content analysis, and Lincoln and Guba's criteria for rigor were applied to ensure the study's trustworthiness.

Results

The analysis of the data resulted in the identification of three main themes with nine subthemes. The key themes derived from the experiences of family caregivers encompassed (1) chaotic mentalities, (2) troubling interdependence, and (3) desperational emotions.

Conclusions

Caregivers of patients with advanced cancer commonly experience a highly fragile psychological state and are profoundly impacted by their concerns for the patient. Healthcare systems should prioritize ensuring that caregivers receive sufficient support and care.

Evaluating Dose-response of Cataract Induction in Radiotherapy of Head and Neck Cancers Patients

BACKGROUND

Head and neck cancers are currently the most common types of cancers. 3D-conformal radiation therapy is the most common dose delivery technique for head and neck cancers. Eye Lens is a radio sensitive structure and cataract formation as a visual disorder associated with exposure to ionizing radiation which is documented.

OBJECTIVE

Determining the radiation dose to eye lens during head and neck radiography and estimating the probability of cataract induction are essential.

MATERIAL AND METHODS

This experimental study was performed on 14 patients with head and neck cancers through experimental study analysis. The maximum opacity of the eyes lens were measured by pentacamTM before radiation therapy. CT data of patients were transmitted to Isogray treatment planning Software, and dose calculations for each patient was performed. At the end of radiation treatment, 3 and 6 months after radiotherapy, the eye lens opacity of the patients was assessed.

RESULTS

Overall, 28 lenses were studied. Statistical one sample K- S test proved normality of obtained data. Using repeated measures test, the relation before and 3 months after radiotherapy, as well as the relationship before and 6 months after radiotherapy proved a significant relationship.

CONCLUSION

The opacity caused by radiation in eyes is a non-statistical and linear-quadratic response curve with no threshold. This opacity can also appear within 3 months after completion of radiation therapy.

Estimation of the aerobic capacity by step test in the workers of a tile factory in Yazd in 2017

Introduction: Estimation of the maximum aerobic capacity to find a physiological fitness between worker and the work is of great importance. The purpose of this study was to estimate the highest aerobic capacity and physical work capacity of tile and ceramic workers. Materials and methods: In this cross-sectional study, 90 workers were randomly selected from tile and ceramic workers in Yazd. A questionnaire consisting of two parts was used as data collection tool. The first part of the questionnaire included demographic characteristics completed by the interview. In the second part, parameters including height, weight, BMI and heart rate were inserted in the questionnaire. The Queen step test was used to measure the maximum aerobic capacity. The data were analyzed by SPSS software using Mann-Whitney and Kruskal-Wallis tests and Spearman,s test. Results: The maximum aerobic capacity in tile and ceramic workers was estimated to be 3.60±.0.03 L/m. The results showed that aerobic capacity was significantly correlated with weight and body mass index. Also, there was no significant relationship between aerobic capacity, smoking and exercise, and education, but there was a significant relationship between gob title and aerobic capacity. Conclusion: Weight, BMI and type of occupation affect the aerobic capacity of workers.

Evaluation of the effect of BMSCs condition media and methylprednisolone in TGF-β expression and functional recovery after an acute spinal cord injury

The purpose of this experimental study is evaluation of the effect of BMSCs Condition Media and Methylprednisolone in TGF-β expression and functional recovery after acute spinal cord injury in adult wistar rat.

MATERIAL AND METHODS

After an acute spinal cord injury, MP and BMSC-CM were injected intraperitoneally and the recovery rate was evaluated by BBB and narrow beam test. Real time PCR, H[et]E staining, cavity formation and stereology was done after 12 weeks post injury.

RESULT

There were significant differences in functional recovery between MP+CM group, relative to other groups. TGF-β1 expression decreased in MP+CM group compared to the control group. Cavity size in experimental groups decreased compared to the control group. The mean volume of spinal cord demonstrated a significant increase in the MP+CM group in comparison to the other experimental groups.

CONCLUSION

Simultaneous use of MP and BMSC-CM will improve recovery from the spinal cord injury, reduce inflammation and improve functional recovery (Tab. 1, Fig. 8, Ref. 26).

Empowerment of women and mental health improvement with a Preventive approach

AIM AND BACKGROUND

Mental health and empowerment are two of the women's essential needs. These two related concepts play an important role in women's lives. Therefore, this study aimed to investigate empowerment of women and its relation with mental health problem prevention during difficult situations.

METHODS

This qualitative study was conducted through semi-structured interviews with 33 experts in the fields of psychology, social sciences, women studies, medicine and crisis management specialists using snowball sampling in cities of Tehran, Isfahan, Tabriz, and Mashhad during the year 1395 (March 2016-March 2017). Samples were selected heterogeneously. The interview transcripts and codes were presented to the participants, and structural analysis was used for data evaluation.

RESULTS

The factors related to empowerment of women with consideration to their mental health were determined based on Longew theory and interviews and include: welfare (primary needs (biological and security) and developmental needs (social needs and dignity), access (facilities and values), knowledge (about inequalities and rights), participation (in politics, decision-making and society), and control (implementation and institutionalization of the above-mentioned needs).

CONCLUSIONS

The indicators determined in this study show that empowerment has an important role in determining women's real position in society. Since women make up half of the population and affect society as a whole, the advantages of empowerment of women will be felt in the entire society.

Exchange, correlation, and scattering effects on surface plasmons in arm-chair graphene nanoribbons

Using Maxwell's equations for the incoming and outgoing electromagnetic field, in interaction with a metallic arm-chair graphene nanoribbon (AGNR), and the relationship between the density-density response function and the conductivity, we study surface plasmons (SPs) in a AGNR following the Lindhard, random-phase approximation (RPA), and Hubbard approaches. For transverse magnetic (TM) modes we obtain analytical dispersion relations (DRs) valid for q ≤ kF and assess their width dependence. In all approaches we include screening. In the long-wavelength limit q → 0 there is a small but noticeable difference between the DRs of the three approaches. In this limit the respective, scattering-free conductivities differ drastically from those obtained when scattering by impurities is included. We demonstrate that the SP field is proportional to the square of the quality factor Q. The reflection amplitude shows that metallic AGNRs do not support Brewster angles. In addition, AGNRs do not support transverse electric (TE) SPs.

Adipose derived mesenchymal stem cells express keratinocyte lineage markers in a co-culture model

Cutaneous wound healing is a complex type of biological event involving proliferation, differentiation, reprograming, trans/de-differentiation, recruitment, migration, and apoptosis of a number of cells (keratinocytes, fibroblasts, endothelial cells, nerve cells and stem cells) to regenerate a multi-layered tissue that is damaged by either internal or external factors. The exact regeneration mechanism of damaged skin is still unknown but the epithelial and other kinds of stem cells located in skin play crucial roles in the healing process. In this work, a co-culture model composed of adipose derived mesenchymal stem cells and keratinocytes was developed to understand the cellular differentiation behaviour in wound healing. Human mesenchymal stem cells were isolated from waste lipoaspirates. Keratinocytes were isolated from neonatal rats skin as well from human adult skin. Both types of cells were cultured and their culturing behaviour was observed microscopically under regular intervals of time. The identity of both cells was confirmed by flow cytometry and qRT-PCR. Cells were co-cultured under the proposed co-culturing model and the model was observed for 7, 14 and 21 days. The cellular behaviour was studied based on change in morphology, colonization, stratification, migration and expression of molecular markers. Expression of molecular markers was studied at transcriptional level and change in cellular morphology and migration capabilities was observed under the invert microscope regularly. Successfully isolated and characterized mesenchymal stem cells were found to express keratinocyte lineage markers i.e. K5, K10, K14, K18, K19 and Involucrin when co-cultured with keratinocytes after 14 and 21 days. Their expression was found to increase by increasing the time span of cell culturing. The keratinocyte colonies started to disappear after 10 days of culturing which might be due to stratification process initiated by possibly transdifferentiated stem cells. It can be concluded that mesenchymal stem cells can regenerate the damaged skin if transplanted to damaged area but for their successful differentiation and enhanced regeneration, they need a population of keratinocytes in situ which need further experiments for validation of co-culture model and its potential for being used in clinics.

Upper Bounds on Spontaneous Wave-Function Collapse Models Using Millikelvin-Cooled Nanocantilevers

Collapse models predict a tiny violation of energy conservation, as a consequence of the spontaneous collapse of the wave function. This property allows us to set experimental bounds on their parameters. We consider an ultrasoft magnetically tipped nanocantilever cooled to millikelvin temperature. The thermal noise of the cantilever fundamental mode has been accurately estimated in the range 0.03-1 K, and any other excess noise is found to be negligible within the experimental uncertainty. From the measured data and the cantilever geometry, we estimate the upper bound on the continuous spontaneous localization collapse rate in a wide range of the correlation length r_{C}. Our upper bound improves significantly previous constraints for r_{C}>10^{-6}  m, and partially excludes the enhanced collapse rate suggested by Adler. We discuss future improvements.

Room-temperature synthesis of graphene-like carbon sheets from C2H2, CO2 and CO on copper foil

Static electrons, generated from piezoelectric material, flow to the copper foil and increase the charge density of the catalyst surface. Subsequently this density flows from the catalyst into the antibonding orbitals of acetylene molecules and decompose it.

Investigation of subwavelength grating structure for enhanced surface plasmon resonance detection

A metallic subwavelength grating structure built on a thin gold film is studied for surface plasmon resonance (SPR) detection of refractive index variations of biological buffer solutions. By employing finite element analysis as a numerical method, characteristics of the angle interrogated SPR sensor were calculated and discussed in a broad operating wavelength varying from visible to near-infrared (NIR). The effects of grating structural parameters such as grating depth, grating period, and grating fill factor in different operating wavelengths have been evaluated on the sensor performance parameters of sensitivity, full width at half-minimum, minimum reflectance at resonance, and resonance angle. Numerical results indicate that adjusting grating geometrical parameters can enhance the performance parameters of the sensor especially in the NIR wavelengths. The enhanced sensor performance parameters for optimizing grating geometry have been explored in detail for visible and NIR wavelengths of 633 and 984 nm, respectively. These findings are important for developing localized surface plasmon sensors with enhanced performance.

Design study of nanograting-based surface plasmon resonance biosensor in the near-infrared wavelength

A key issue with surface plasmon resonance (SPR) biosensors, which are the focus of many researchers, is improving their sensitivity to detect lower amounts of analyte in a solution. Most SPR developments have focused on the grating-based sensitivity-enhancement approach. In addition to sensitivity, a substantial enhancement of other sensor characteristics such as resolution and signal-to-noise ratio (SNR) is desired for designing a practical sensor. So, in this paper, the characteristics of surface plasmon polaritons sustained by 1D subwavelength metallic gratings on a thin metal slab (under the Krestchmann configuration) have been investigated numerically for the analyte-ligand interactions detection. Effects of different structural parameters, such as grating period, grating depth, metal film thickness, and fill factor have been evaluated on the sensor sensitivity as well as resolution and SNR. Numerical results indicate that the sensor working in the near-infrared wavelength has a better performance than that in the visible one. The result of numerical investigation has been used to design an optimized sensor with the best figure of merit.

The Relationship Between Social Support and Adherence of Dietary and Fluids Restrictions among Hemodialysis Patients in Iran

INTRODUCTION

Patient's noncompliance dietary and fluids intake can lead to a build-up of toxic fluids and metabolic end-products in the blood stream which may result in an increased morbidity and premature death. The aim of the study is investigate relationship between the social support and adherence to dietary and fluid restrictions in hemodialysis patients.

METHODS

In this correlational study upon 237 hemodialysis patients, the data was collected with the dialysis diet and fluids non-adherences hemodialysis questionnaire (DDFQ), and the multidimensional scale of perceived Social Support (MSP). Interdialytic weight gain, predialytic serum potassium levels, and predialytic serum phosphate levels was considered as biochemical indicators of dietary and fluid adherence. Data were analyzed by SPSS Ver.11.5.

RESULTS

About 41.1% of patients reported non-adherence to diet and 45.2% of them reported non-adherence to fluid. Frequency of non-adherence to fluid was more common in patients. The highest level of perceived support was the family support 11.19 (1.34). There was a significant relationship between social support and adherence to dietary and fluid restrictions. Noncompliances to dietary and fluid restrictions were related to laboratory results.

CONCLUSION

This way those patients who more supported had more adherences of diet and fluid restrictions and had lower level of phosphorus and potassium in laboratory results. Nurses have the main role to identify different methods providing social support for patients, also to encourage the families to support their hemodialysis patients.

Why do the [PhSiO1.5]8,10,12 cages self-brominate primarily in the ortho position? Modeling reveals a strong cage influence on the mechanism

(PhSiO_1.5)_8,10,12 cages are bulky, electron withdrawing like CF₃; yet self-brominate (60 °C), favoring ortho substitution: PhT₈ (≈85%), PhT₁₀ (≈75%) and PhT₁₂ (60%).

Are collapse models testable with quantum oscillating systems? The case of neutrinos, kaons, chiral molecules

Collapse models provide a theoretical framework for understanding how classical world emerges from quantum mechanics. Their dynamics preserves (practically) quantum linearity for microscopic systems, while it becomes strongly nonlinear when moving towards macroscopic scale. The conventional approach to test collapse models is to create spatial superpositions of mesoscopic systems and then examine the loss of interference, while environmental noises are engineered carefully. Here we investigate a different approach: We study systems that naturally oscillate-creating quantum superpositions-and thus represent a natural case-study for testing quantum linearity: neutrinos, neutral mesons, and chiral molecules. We will show how spontaneous collapses affect their oscillatory behavior, and will compare them with environmental decoherence effects. We will show that, contrary to what previously predicted, collapse models cannot be tested with neutrinos. The effect is stronger for neutral mesons, but still beyond experimental reach. Instead, chiral molecules can offer promising candidates for testing collapse models.

Effects of microstructure on flow properties of fibrous porous media at moderate Reynolds number

In this study, effects of microstructure on the viscous permeability and Forchheimer coefficient of monodispersed fibers are investigated. The porous material is represented by a unit cell which is assumed to be repeated throughout the medium. Based on the orientation of the fibers in the space, fibrous media are divided into three categories: one-, two-, and three-directional (1D, 2D, and 3D) structures. Parallel and transverse flow through square arrangements of 1D fibers, simple 2D mats, and 3D simple cubic structures are solved numerically over a wide range of porosity (0.35 < ε < 0.95) and Reynolds number (0.01 < Re < 200). The results are used to calculate the permeability and the inertial coefficient of the considered geometries. An experimental study is performed; the flow coefficients of three different ordered tube banks in the moderate range of Reynolds number (0.001 < Re < 15) are determined. The numerical results are successfully compared with the present and the existing experimental data in the literature. The results suggest that the permeability and Forchheimer coefficient are functions of porosity and fiber orientation. A comparison of the experimental and numerical results with the Ergun equation reveals that this equation is not suitable for highly porous materials. As such, accurate correlations are proposed for determining the Forchheimer coefficient in fibrous porous media.

Ilizarov Versus AO External Fixator for the Treatment of Tibia Open Fractures

BACKGROUND

In developing countries, Ilizarov or AO external fixator is usually used for treatment of tibial open fractures. The purpose of this study was to compare the efficacy of these two methods for treatment of tibial open fractures.

METHODS

From April 2002 to April 2010, 120 patients with open tibial fractures admitted to the Department of Orthopedics of Babol University of Medical Sciences entered this study. In each arm, 60 subjects randomly received Ilizarov or AO external fixator. All patients were followed at least for one year. These two groups were compared regarding non-union, malunion and cure rates.

RESULTS

The mean age of the patients in Ilizarov group was 32.35±11.28 and for AO were 31.3±10.99 years. Mean time for union in Ilizarov group was 5.25±1.85 and for AO external fixator was 5.85±2.13 months. Nonunion rate in Ilizarov group was 10% and for AO external fixator was 11.7%. Malunion rate in Ilizarov group was 10% and for AO external fixator was 18.3%. Totally, efficacy of treatment in the Ilizarov group was 81.7% and in AO external fixator was 65%.

CONCLUSION

The efficacy of treatment in Ilizarov was higher than that AO external fixator in treatment of open tibial fractures.

Comparison of the effects of low energy laser and ultrasound in treatment of shoulder myofascial pain syndrome: a randomized single-blinded clinical trial

BACKGROUND

Myofascial pain syndrome (MPS) is one of the most prevalent musculoskeletal diseases. MPS impaired quality of life in the patients. There is a lot of controversy about different treatment options which include medical treatments, physical therapy, injections, ultrasound and laser. The effects of laser in MPS are challenging.

AIM

To assess the effects of laser and ultrasound in treatment of MPS.

DESIGN

Randomized single blinded clinical trial

SETTING

Outpatient physical therapy clinic at university hospital

POPULATION

Sixty three subjects (females: 46, males: 17), (age range: 17-55 year old) who had a diagnosis of definite MPS were entered in the study.

METHODS

We measured the pain intensity at rest, during activity and at night using Visual Analogue Scale (VAS) questionnaire. The patients also filled the Neck Disability Index (NDI) form and the pain threshold provoked by pressure was determined using algometric assessment. Then, the patients were categorized randomly in groups A, B and C (receiving laser therapy, ultrasound and sham laser therapy, respectively). Six weeks after the initial visit, they were visited again and filled the forms again.

RESULTS

Ultrasound was effective in VAS improvement during activity (46%), at rest (39%) and at night (35%). It also improved NDI scores (34%) and algometric assessment (37%). Laser was effective in VAS improving during activity (54%), at night (51%) and at rest (51%) and also improved NDI scores (73%). It was also found effective in algometric assessment improvement (105%). Laser resulted in more NDI score and algometric assessment improvements comparing to ultrasound (p<0.05).

CONCLUSION

This study introduces laser as one of the preferred treatments of myofascial pain syndrome in shoulder.

Methodology for artificial microswimming using magnetic actuation

We propose a methodology for swimming at low-Reynolds-number flows based on ciliary motion of a microswimmer using magnetic actuation of artificial cilia. By solving the coupled magnetic-elastic-hydrodynamic problem, we demonstrate nonreciprocal effective and recovery strokes for cilia that nicely mimic natural cilia beating. Cilia drag forces, microswimmer net displacement, velocity, and efficiency are calculated, and we show the model can swim using a prespecified magnetic actuation. The proposed methodology can be used for devising biomedical microdevices that swim in viscous flows inside the human body.

Computational modeling of a carbon nanotube-based DNA nanosensor

During the last decade the design of biosensors, based on quantum transport in one-dimensional nanostructures, has developed as an active area of research. Here we investigate the sensing capabilities of a DNA nanosensor, designed as a semiconductor single walled carbon nanotube (SWCNT) connected to two gold electrodes and functionalized with a DNA strand acting as a bio-receptor probe. In particular, we have considered both covalent and non-covalent bonding between the DNA probe and the SWCNT. The optimized atomic structure of the sensor is computed both before and after the receptor attaches itself to the target, which consists of another DNA strand. The sensor's electrical conductance and transmission coefficients are calculated at the equilibrium geometries via the non-equilibrium Green's function scheme combined with the density functional theory in the linear response limit. We demonstrate a sensing efficiency of 70% for the covalently bonded bio-receptor probe, which drops to about 19% for the non-covalently bonded one. These results suggest that a SWCNT may be a promising candidate for a bio-molecular FET sensor.

Effectiveness of strategies to disseminate and implement clinical guidelines for the management of impacted and unerupted third molars in primary dental care, a cluster randomised controlled trial

OBJECTIVE

To investigate the effectiveness and cost-effectiveness of different guideline implementation strategies, using the Scottish Intercollegiate Guidelines Network (SIGN) Guideline 42 "Management of unerupted and impacted third molar teeth" (published 2000) as a model.

DESIGN

A pragmatic, cluster RCT (2x2 factorial design).

SUBJECTS

Sixty-three dental practices across Scotland. Clinical records of all 16-24-year-old patients over two, four-month periods in 1999 (pre-intervention) and 2000 (post-intervention) were searched by a clinical researcher blind to the intervention group. Data were also gathered on the costs of the interventions.

INTERVENTIONS

Group 1 received a copy of SIGN 42 Guideline and had an opportunity to attend a postgraduate education course (PGEC). In addition to this, group 2 received audit and feedback (A and F). Group 3 received a computer aided learning (CAL) package. Group 4 received A and F and CAL. PRINCIPAL OUTCOME MEASUREMENT: The proportion of patients whose treatment complied with the guideline.

RESULTS

The weighted t-test for A and F versus no A and F (P=0.62) and CAL versus no CAL (P=0.76) were not statistically significant. Given the effectiveness results (no difference) the cost effectiveness calculation became a cost-minimisation calculation. The minimum cost intervention in the trial consisted of providing general dental practitioners (GDPs) with guidelines and the option of attending PGEC courses. Routine data which subsequently became available showed a Scotland-wide fall in extractions prior to data collection.

CONCLUSION

In an environment in which pre-intervention compliance was unexpectedly high, neither CAL nor A and F increased the dentists' compliance with the SIGN guideline compared with mailing of the guideline and the opportunity to attend a postgraduate course. The cost of the CAL arm of the trial was greater than the A and F arm. Further work is required to understand dental professionals' behaviour in response to guideline implementation strategies.

Can psychological models bridge the gap between clinical guidelines and clinicians' behaviour? A randomised controlled trial of an intervention to influence dentists' intention to implement evidence-based practice

OBJECTIVE

The lag between publication of evidence for clinical practice and implementation by clinicians may be decades. Research using psychological models demonstrates that changing intention is very important in changing behaviour. This study examined an intervention (rehearsing alternative actions) to change dentists' intention to implement evidence-based practice (EBP) for third molar (TM) management.

DESIGN

Randomised controlled trial / postal.

SETTING

Primary care.

SUBJECTS AND METHODS

Dentists were randomly selected from the Scottish Dental Practice Board Register, then randomly allocated to intervention or control groups, and sent a questionnaire. The intervention group listed management alternatives to TM extraction prior to their TM extraction intention, and the control group did not. Based on psychological models for reducing a behaviour's frequency (EBP is weighted against TM extraction), prior listing of alternatives should decrease extraction intention.

MAIN OUTCOME MEASURES

Intention to extract TMs.

RESULTS

A total of 99 dentists - 70 Males, 29 Females; mean age = 41.42 years (SD = 8.62) participated in the study. The intervention significantly influenced intention to extract TMs, as desired. Despite similar background and knowledge of management alternatives, participants in the intervention group had significantly lower intention to extract: control group mean (SD) = 0.39 (1.99); intervention group mean (SD) = -0.78 (1.89); mean difference (SE) = 1.17 (0.42); 95% confidence interval for the difference = 0.34 to 1.99.

CONCLUSION

Results suggest this intervention, which successfully influenced a proximal predictor of behaviour pertinent to dental EBP, may result in improved EBP in a service-level trial. Basing implementation interventions and trial methodology on psychological models may effectively bridge the gap between clinical guidelines and practice.

Dental students' knowledge and compliance in cross infection control procedures at a UK dental hospital

OBJECTIVES

To assess the knowledge and clinical practice of dental students in infection control procedures at a UK dental hospital.

DESIGN

A questionnaire concerning various aspects of infection control was completed by all clinical dental students under examination conditions. Their actual clinical practice was later observed and certain aspects recorded.

SETTING

A UK dental hospital.

SUBJECTS

One hundred and eleven dental students from three clinical years completed the questionnaire. Clinical practice for all 3 years was observed in a total of 280 treatment events.

METHODS

The questionnaire was marked by two of the authors and observations recorded by another author.

MAIN OUTCOME MEASURES

Degree of compliance with recognised policy for infection control.

RESULTS

Knowledge of infection control procedures was variable particularly concerning duties usually undertaken by the dental nurse. The suggested high compliance with masks and eye protection was not always apparent in clinical practice, although virtually all students washed their hands prior to donning gloves, which were worn by all students.

CONCLUSION

There can be marked differences between what students say they would do and what they actually do in clinical practice. The topic of infection control requires a pro-active approach throughout the course, since results for the final year were not significantly different from the other clinical years. Ways of improving compliance are discussed.

Model reference direct adaptive control of nonlinear plants using neural networks

A learning scheme for multilayer feedforward neural networks used as direct adaptive controllers of nonlinear plants is suggested. This scheme is a supervised steepest descent one that does not require backpropagation of the error. Using a neural network controller trained with this method does not require the identification stage and this makes it superior to the other methodologies. Methods for using neural networks in plant control suggested in the literature are discussed and compared with the proposed system. The structure of the network and the training method used are explained. Simulations based on model reference control of some nonlinear plants show satisfactory performance.