Search results for: delivery process

Authors: Herlangga Pramaditya, Agus Sulistyono, Risa Etika, Budiono Budiono, Alvin Saputra

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Preterm birth and anemia of prematurity are the most common cause of morbidity and mortality in neonates, and anemia of the preterm neonates has become a major issue. The timing of umbilical cord clamping after a baby is born determines the amount of blood transferred from the placenta to fetus, Delayed Cord Clamping (DCC) has proven to prevent anemia in the neonates but it is constrained concern regarding the delayed in neonatal resuscitation. Umbilical Cord Milking (UCM) could be an alternative method for clamping the umbilical cord due to the active blood transfer from the placenta to the fetus. The aim of this study was to analyze the difference between maternal and neonatal outcome in preterm abdominal delivery who underwent UCM compared to ECC. This was an experimental study with randomized post-test only control design. Analyzed maternal and neonatal outcomes, significant P values (P <0.05). Statistical comparison was carried out using Paired Samples t-test (α two tailed 0,05). The result was the mean of preoperative mother’s hemoglobin in UCM group compared to ECC (10,9 + 0,9 g/dL vs 10,4 + 0,9 g/dL) and postoperative (11,1 + 1,1 g/dL vs 10,5 + 0,7 g/dL), the delta was (0,2 + 0,7 vs 0,1 + 0,6.). It showed no significant difference (P=0,395 vs 0,627). The mean of 3rd phase labor duration in UCM group vs ECC was (20,5 + 3,5 second vs 21,1 + 3,3 second), showed insignificant difference (P=0,634). The amount of bleeding after delivery in UCM group compared to ECC has the median of 190 cc (100-280cc) vs 210 cc (150-330 cc) showed insignificant difference (P=0,083) so the incidence of post-partum bleeding was not found. The mean of the neonates hemoglobin, hematocrit and erythrocytes of UCM group compared to ECC was (19,3 + 0,7 vs 15,9 + 0,8 g/dl), (57,1 + 3,6 % vs 47,2 + 2,8 %), and (5,4 + 0,4 g/dl vs 4,5 + 0,3 g/dl) showed significant difference (P<0,0001). There was no baby in UCM group received blood transfusion and one baby in the control ECC group received blood transfusion was found. Umbilical Cord Milking has shown to increase the baby’s blood component such as hemoglobin, hematocrit, and erythrocytes 6 hours after birth as well as lowering the incidence of blood transfusions. Maternal and neonatal morbidity were not found. Umbilical Cord Milking was the act of clamping the umbilical cord that was more beneficial to the baby and no adverse or negative effects on the mother.

Keywords: umbilical cord milking, early cord clamping, maternal and neonatal outcome, preterm, abdominal delivery

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Authors: Rajiv Kumar Srivastava

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Manufacturing of complex products such as automobiles and computers requires a very large number of parts and sub-assemblies. The design of mechanisms for delivery of these materials to the point of assembly is an important manufacturing system and supply chain challenge. Different approaches to this problem have been evolved for assembly lines designed to make large volumes of standardized products. However, contemporary assembly systems are required to concurrently produce a variety of products using approaches such as mixed model production, and at times even mass customization. In this paper we examine the material supply approaches for variety production in moderate to large volumes. The conventional approach for material delivery to high volume assembly lines is to supply and stock materials line-side. However for certain materials, especially when the same or similar items are used along the line, it is more convenient to supply materials in kits. Kitting becomes more preferable when lines concurrently produce multiple products in mixed model mode, since space requirements could increase as product/ part variety increases. At times such kits may travel along with the product, while in some situations it may be better to have delivery and station-specific kits rather than product-based kits. Further, in some mass customization situations it may even be better to have a single delivery and assembly station, to which an entire kit is delivered for fitment, rather than a normal assembly line. Finally, in low-moderate volume assembly such as in engineered machinery, it may be logistically more economical to gather materials in an order-specific kit prior to launching final assembly. We have studied material supply mechanisms to support assembly systems as observed in case studies of firms with different combinations of volume and variety/ customization. It is found that the appropriate approach tends to be a hybrid between direct line supply and different kitting modes, with the best mix being a function of the manufacturing and supply chain environment, as well as space and handling considerations. In our continuing work we are studying these scenarios further, through the use of descriptive models and progressing towards prescriptive models to help achieve the optimal approach, capturing the trade-offs between inventory, material handling, space, and efficient line supply.

Keywords: assembly systems, kitting, material supply, variety production

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Authors: Yaping Gao

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With the increasing globalization of education and the continued momentum and wider adoption of online education and digital learning all over the world, post pandemic, it is crucial that best practices and extensive experience and knowledge gained from the higher education community over the past few decades be adopted and adapted to benefit the broader international communities, which can be vastly different culturally and pedagogically. Schools and institutions worldwide should consider to adopt, adapt and apply these proven practices to develop strategic plans for digital transformation at institutional levels, and to improve or develop quality online or digital learning environments at course and program levels to help all students succeed. The presenter will introduce the primary components of the US-based quality assurance process, including: 1) five sets of research-supported standards to guide the design, development and review of online and hybrid courses; 2) professional development offerings and pathways for administrators, faculty and instructional support staff; 3) a peer-review process for course/program reviews resulting in constructive recommendations for continuous improvement, certification of quality and international recognition; and 4) implementation of the quality assurance process on a continuum to program excellence, achievement of institutional goals, and facilitation of accreditation process and success. Regardless language, culture, pedagogical practices, or technological infrastructure, the core elements of quality teaching and learning remain the same across all delivery formats. What is unique is how to ensure quality of teaching and learning in online education and digital learning. No one knows all the answers to everything but no one needs to reinvent the wheel either. Together the international education community can support and learn from each other to achieve institutional goals and ensure all students succeed in the digital learning environments.

Keywords: online education, digital learning, quality standards, best practices, online teaching and learning

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Authors: Burcu Kaya, Jan-Martin Kaiser, Karl-Friedrich Becker, Tanja Braun, Klaus-Dieter Lang

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Quality of the molded packages is strongly influenced by the process parameters of the transfer molding. To achieve a better package quality and a stable transfer molding process, it is necessary to understand the influence of the process parameters on the package quality. This work aims to comprehend the relationship between the process parameters, and to identify the optimum process parameters for the transfer molding process in order to achieve less voids and wire sweep. To achieve this, a DoE is executed for process optimization and a regression analysis is carried out. A systematic approach is represented to generate models which enable an estimation of the number of voids and wire sweep. Validation experiments are conducted to verify the model and the results are presented.

Keywords: dielectric analysis, electronic packages, epoxy molding compounds, transfer molding process

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Authors: Mohd Mudasir Shafi, Zafrul Hasan, Talat Saleem

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Information and communication Technology (ICT) services have been defined as a route to good governance. Introduction of ICT into Governance has given rise to the idea of e-governance which helps in enhancing transparency, generating accountability and responsiveness in the system in order to provide faster and quality service to the citizen. Advancement in ICT has provided governments all over the world to speed up the delivery of information and services to citizens and businesses and increase their participation in governance. There has been varying degree of success over the past decade into providing services to the citizens using internet and different web services. These e-government initiatives have been extensively researched. Our research is aimed at the transition from electronic government to mobile government (m-government) initiatives implementing the mobile services and concerned to understand the major factors which will aid to adoption and distribution of these services. There must be some amount of research done in the integration process between e-government and m-government. There must also be enough amount of investigation done all the factors that could affect the transition process. Such factors differ between different places and the advancement in information and technology available there. In this paper, we have discussed why mobile communication system can be used for effective e-governance and the areas where m-governance can be implemented. The paper will examine some of the reasons as well as the main opportunities for improving effective governance through mobile phones.

Keywords: e-governance, mobile phones, information technology, m-government

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Authors: Abbas Al-Refaie

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This study optimized the performance of plastic extrusion process of drip irrigation pipes using fuzzy goal programming. Two main responses were of main interest; roll thickness and hardness. Four main process factors were studied. The L₁₈ array was then used for experimental design. The individual-moving range control charts were used to assess the stability of the process, while the process capability index was used to assess process performance. Confirmation experiments were conducted at the obtained combination of optimal factor setting by fuzzy goal programming. The results revealed that process capability was improved significantly from -1.129 to 0.8148 for roll thickness and from 0.0965 to 0.714 and hardness. Such improvement results in considerable savings in production and quality costs.

Keywords: fuzzy goal programming, extrusion process, process capability, irrigation plastic pipes

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Authors: Nitin Dwivedi, Jigna Shah

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Brain tumor is metastatic neoplasm of central nervous system, in most of cases it is life threatening disease with low survival rate. Despite of enormous efforts in the development of therapeutics and diagnostic tools, the treatment of brain tumors and gliomas remain a considerable challenge in the area of neuro-oncology. The most reason behind of this the presence of physiological barriers including blood brain barrier and blood brain tumor barrier, lead to insufficient reach ability of therapeutic agents at the site of tumor, result of inadequate destruction of gliomas. So there is an indeed need empowerment of brain tumor imaging for better characterization and delineation of tumors, visualization of malignant tissue during surgery, and tracking of response to chemotherapy and radiotherapy. Multifunctional different generations of dendrimer offer an improved effort for potentiate drug delivery at the site of brain tumor and gliomas. So this article emphasizes the innovative dendrimer approaches in tumor targeting, tumor imaging and delivery of therapeutic agent.

Keywords: blood brain barrier, dendrimer, gliomas, nanotechnology

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Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

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Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

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Authors: Paul Ihuoma Oluikpe

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The purpose of this paper is to explore and highlight the process of creating value for strategy management by embedding knowledge management in the business process. Knowledge management can be seen from a three-dimensional perspective of content, connections and competencies. These dimensions can be embedded in the knowledge processes (create, capture, share, and apply) and operationalized within a business process to effectively create a scenario where knowledge can be focused on enabling a process and the process in turn generates outcomes. The application of knowledge management on business processes of organizations is rare and underreported. Few researches have explored this paradigm although researches have tended to reinforce the notion that competitive advantage sits within the internal aspects of the firm. Given this notion, it is surprising that knowledge management research and practice have not focused sufficiently on the business process which is the basic unit of organizational decision implementation. This research serves to generate understanding on applying KM in business process using a large multinational in Sub-Saharan Africa.

Keywords: knowledge management, business process, strategy, multinational

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Authors: Gert Van Schalkwyk, Chris Cloete

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South Africa is experiencing a massive housing backlog in urban low-cost housing. A backlog in the transfer of low-cost housing units is exacerbated by various impediments and delays that exist in the current legal framework. Structured interviews were conducted with forty-five practicing conveyancers and fifteen deeds office examiners at the Deeds Office in Pretoria, South Africa. One of the largest, the Deeds Office in Pretoria implements a uniform registration process and can be regarded as representative of other deeds offices in South Africa. It was established that a low percentage of low-cost properties are freely transferable. The main economic impediments are the absence of financing and the affordability or payment of rates and taxes to local government. Encroachment of buildings on neighboring stands caused by the enlargement of existing small units on small stands also causes long-term unresolved legal disputes. In addition, as the transfer of properties is dependent on the proper functioning of administrative functions of various government departments, the adverse service delivery of government departments hampers transfer. Addressing the identified problems will contribute to a more sustainable process for the transfer of low-cost housing units in South Africa.

Keywords: conveyancing, low-cost housing, South Africa, tenure, titling, transfer

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Authors: A. C. Rana, Abhinav Singh Rana

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Layer by layer coating of biocompatible polyelectrolytes converts the liposomes into stable version i.e 'layersomes'. This system was further used to deliver the Amphotericin B through the oral route. Extensive optimization of different process variables resulted in the formation of layersomes with the particle size of 238.4±5.1, PDI of 0.24±0.16, the zeta potential of 34.6±1.3, and entrapment efficiency of 71.3±1.2. TEM analysis further confirmed the formation of spherical particles. Trehalose (10% w/w) resulted in the formation of fluffy and easy to redisperse cake in freeze dried layersomes. Controlled release up to 50 % within 24 h was observed in the case of layersomes. The layersomes were found stable in simulated biological fluids and resulted in the 3.59 fold higher bioavailability in comparison to free Amp-B. Furthermore, the developed formulation was found to be safe in comparison to Fungizone as indicated by blood urea nitrogen (BUN) and creatinine level.

Keywords: amphotericin B, layersomes, liposomes, toxicity

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Authors: Pramod Jagtap, Kisan Jadhav, Neha Dand

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Risperidone (RISP) is an antipsychotic agent and has low water solubility and nontargeted delivery results in numerous side effects. Hence, an attempt was made to develop SLNs hydrogel for intranasal delivery of RISP to achieve maximum bioavailability and reduction of side effects. RISP loaded SLNs composed of 1.65% (w/v) lipid mass were produced by high shear homogenization (HSH) coupled ultrasound (US) method using glyceryl monostearate (GMS) or Imwitor 900K (solid lipid). The particles were loaded with 0.2% (w/v) of the RISP & surface-tailored with a 2.02% (w/v) non-ionic surfactant Tween® 80. Optimization was done using 32 factorial design using Design Expert® software. The prepared SLNs dispersion incorporated into Polycarbophil AA1 hydrogel (0.5% w/v). The final gel formulation was evaluated for entrapment efficiency, particle size, rheological properties, X ray diffraction, in vitro diffusion, ex vivo permeation using sheep nasal mucosa and histopathological studies for nasocilliary toxicity. The entrapment efficiency of optimized SLNs was found to be 76 ± 2 %, polydispersity index <0.3., particle size 278 ± 5 nm. This optimized batch was incorporated into hydrogel. The pH was found to be 6.4 ± 0.14. The rheological behaviour of hydrogel formulation revealed no thixotropic behaviour. In histopathology study, there was no nasocilliary toxicity observed in nasal mucosa after ex vivo permeation. X-ray diffraction data shows drug was in amorphous form. Ex vivo permeation study shows controlled release profile of drug.

Keywords: ex vivo, particle size, risperidone, solid lipid nanoparticles

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Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

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Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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Authors: C. W. F. Che Wan Putra, M. Alshawi, M. S. Al Ahbabi, M. Jabakhanji

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The construction industry is a multi-disciplinary and multi-national industry, which has an important role to play within the overall economy of any country. There are major challenges to an improved performance within the industry. Particularly lacking is, the ability to capture the large amounts of information generated during the life-cycle of projects and to make these available, in the right format, so that professionals can then evaluate alternative solutions based on life-cycle analysis. The fragmented nature of the industry is the main reason behind the unavailability and ill utilisation of project information. The lack of adequately engaging clients and managing their requirements contributes adversely to construction budget and schedule overruns. This is a difficult task to achieve, particularly if clients are not continuously and formally involved in the design and construction process, which means that the design intent is left to designers that may not always satisfy clients’ requirements. Client lead is strongly recognised in bringing change through better collaboration between project stakeholders. However, one of the major challenges is that collaboration is operated under conventional procurement methods, which hugely limit the stakeholders’ roles and responsibilities to bring about the required level of collaboration. A research has been conducted with a typical project in the UAE. A qualitative research work was conducted including semi-structured interviews with project partners to discover the real reasons behind this delay. The case study also investigated the real causes of the problems and if they can be adequately addressed by BIM and IPD. Special focus was also placed on the Client leadership and the role the Client can play to eliminate/minimize these problems. It was found that part of the ‘key elements’ from which the problems exist can be attributed to the client leadership and the collaborative environment and BIM.

Keywords: client leadership, building information modelling (BIM), integrated project delivery (IPD), case study

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Authors: Totok R. Biyanto, Arif T. Mardianto, M. Farid R. R., Luthfi Machmudi, kandi mulakasti

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The main objective of this research is optimizing the electrocoagulation process design as a post-treatment for biologically vinasse effluent process. The first principle model with three independent variables that affect the energy consumption of electrocoagulation process i.e. current density, electrode distance, and time of treatment process are chosen as optimized variables. The process condition parameters were determined with the value of pH, electrical conductivity, and temperature of vinasse about 6.5, 28.5 mS/cm, 52 oC, respectively. Aluminum was chosen as the electrode material of electrocoagulation process. Duelist algorithm was used as optimization technique due to its capability to reach a global optimum. The optimization results show that the optimal process can be reached in the conditions of current density of 2.9976 A/m2, electrode distance of 1.5 cm and electrolysis time of 119 min. The optimized energy consumption during process is 34.02 Wh.

Keywords: optimization, vinasse effluent, electrocoagulation, energy consumption

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Authors: Morteza Keshavarz

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In this work, using density functional theory (DFT) thermodynamic stability and quantum molecular descriptors of cyclophoshphamide (an anticancer drug)-functionalized zigzag (8,0) CNT, armchair (4,4) CNT and nanocone complexes in water, for two attachment namely the sidewall and tip, is considered. Calculation of the total electronic energy (Et) and binding energy (Eb) of all complexes indicates that the most thermodynamic stability belongs to the sidewall-attachment of cyclophosphamide into functional nanocone. On the other hand, results from chemical hardness show that drug-functionalized zigzag (8,0) and armchair (4,4) complexes in the tip-attachment configuration possess the smallest and greatest chemical hardness, respectively. By computing the solvation energy, it is found that the solution of the drug and all complexes are spontaneous in water. Furthermore, chirality, type of nanovector (nanotube or nanocone), or attachment configuration have no effects on solvation energy of complexes.

Keywords: carbon nanotube, drug delivery, cyclophosphamide drug, density functional theory (DFT)

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Authors: Aitor Bilbao, Dragos Axinte, John Billingham

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The inverse problem in Energy Beam (EB) Processes consists of defining the control parameters, in particular the 2D beam path (position and orientation of the beam as a function of time), to arrive at a prescribed solution (freeform surface). This inverse problem is well understood for conventional machining, because the cutting tool geometry is well defined and the material removal is a time independent process. In contrast, EB machining is achieved through the local interaction of a beam of particular characteristics (e.g. energy distribution), which leads to a surface-dependent removal rate. Furthermore, EB machining is a time-dependent process in which not only the beam varies with the dwell time, but any acceleration/deceleration of the machine/beam delivery system, when performing raster paths will influence the actual geometry of the surface to be generated. Two different EB processes, Abrasive Water Machining (AWJM) and Pulsed Laser Ablation (PLA), are studied. Even though they are considered as independent different technologies, both can be described as time-dependent processes. AWJM can be considered as a continuous process and the etched material depends on the feed speed of the jet at each instant during the process. On the other hand, PLA processes are usually defined as discrete systems and the total removed material is calculated by the summation of the different pulses shot during the process. The overlapping of these shots depends on the feed speed and the frequency between two consecutive shots. However, if the feed speed is sufficiently slow compared with the frequency, then consecutive shots are close enough and the behaviour can be similar to a continuous process. Using this approximation a generic continuous model can be described for both processes. The inverse problem is usually solved for this kind of process by simply controlling dwell time in proportion to the required depth of milling at each single pixel on the surface using a linear model of the process. However, this approach does not always lead to the good solution since linear models are only valid when shallow surfaces are etched. The solution of the inverse problem is improved by using a discrete adjoint optimization algorithm. Moreover, the calculation of the Jacobian matrix consumes less computation time than finite difference approaches. The influence of the dynamics of the machine on the actual movement of the jet is also important and should be taken into account. When the parameters of the controller are not known or cannot be changed, a simple approximation is used for the choice of the slope of a step profile. Several experimental tests are performed for both technologies to show the usefulness of this approach.

Keywords: abrasive waterjet machining, energy beam processes, inverse problem, pulsed laser ablation

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Authors: Anisur Rahman, Sabyasachi Behera, Pawan Pathak, Benazir Patil, Rajesh Khanna

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Background: Nearly half of India’s population is expected to reside in urban areas by 2030. The extent to which India's health system can provide for this large and growing city-based population will determine the country's success in achieving universal health coverage and improved national health indices. National Urban Health Mission (NUHM) strive for improving access to primary health care in urban areas. Implementation of NUHM solicits sensitive, effective and sustainable strategies to strengthen the service delivery mechanisms. The Challenge Initiative for Healthy Cities (TCIHC) is working with the Government of India and three provincial states to develop effective service delivery mechanisms for reproductive, maternal, newborn and child health (RMNCH) through a health systems approach for the urban poor. Method: A rapid assessment study was conceptualized and executed to generate evidence in order to address the challenges impeding in functioning of urban health facilities to deliver effective, efficient and equitable health care services in 7 cities spread across two project States viz. Madhya Pradesh and Odisha. Results: The findings of the assessment reflect: 1. The overall ecosystem pertaining to planning and management of public health interventions is not conducive. 2. The challenges regarding population dynamics like migration keeps on influencing the demand-supply-enabling environment triangle for both public and private service providers. 3. Lack of norms for planning and benchmark for service delivery further impedes urban health system as a whole. 4. Operationalization of primary level services have enough potential to meet the demand of slum dwellers at large. 5. Lack of policy driven strategies on how to integrate the NUHM with other thematic areas of Maternal, Newborn & Child Health (MNCH) and Family Planning (FP). 5. The inappropriate capacity building and acute shortage of Human Resources has huge implication on service provisioning and adherence to the service delivery protocols. Conclusion: The findings from rapid assessment are aimed to inform pertinent stakeholders to develop a multiyear city health action plan to strengthen the health systems in order to improve the efficacy of service delivery mechanism in urban settings.

Keywords: city health plan, health system, rapid assessment, urban mission

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Authors: Asawari Alok Pawaskar

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This study was aimed at investigating quality assurance (QA) done with IBA matrix, the discrepan­cies observed for helical tomotherapy plans. A selection of tomotherapy plans that initially failed the with Matrix process was chosen for this investigation. These plans failed the fluence analysis as assessed using gamma criteria (3%, 3 mm). Each of these plans was modified (keeping the planning constraints the same), beamlets rebatched and reoptimized. By increasing and decreasing the modula­tion factor, the fluence in a circumferential plane as measured with a diode array was assessed. A subset of these plans was investigated using varied pitch values. Factors for each plan that were examined were point doses, fluences, leaf opening times, planned leaf sinograms, and uniformity indices. In order to ensure that the treatment constraints remained the same, the dose-volume histograms (DVHs) of all the modulated plans were compared to the original plan. It was observed that a large increase in the modulation factor did not significantly improve DVH unifor­mity, but reduced the gamma analysis pass rate. This also increased the treatment delivery time by slowing down the gantry rotation speed which then increases the maximum to mean non-zero leaf open time ratio. Increasing and decreasing the pitch value did not substantially change treatment time, but the delivery accuracy was adversely affected. This may be due to many other factors, such as the complexity of the treatment plan and site. Patient sites included in this study were head and neck, breast, abdomen. The impact of leaf tim­ing inaccuracies on plans was greater with higher modulation factors. Point-dose measurements were seen to be less susceptible to changes in pitch and modulation factors. The initial modulation factor used by the optimizer, such that the TPS generated ‘actual’ modulation factor within the range of 1.4 to 2.5, resulted in an improved deliverable plan.

Keywords: dose volume histogram, modulation factor, IBA matrix, tomotherapy

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Authors: Charlotte Zamani

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Children's and young people’s (CYP’s) perspectives on using client preference tools are central to understanding youth mental health therapy engagement. This systematic literature review attempts to understand the meanings of CYP using preference tools that may allow greater connection with the therapeutic process. Following a systematic search using PRISMA guidelines, seven studies were identified that reported qualitative feedback on preferred treatment options or activities within therapy. The data were analysed using interpretative phenomenological analysis (IPA). Three group experiential themes were found: ‘Tailor my support’, ‘My autonomy leads to greater engagement’ and ‘Preferences facilitate my authentic self’. CYP is broadly divided into those who thrive in decision-making and those who require more support. Being offered a choice in therapy delivery provides easier access and means more freedom for CYP. Preferences in therapy appeared to enable greater self-knowledge and a deeper connection to the therapeutic process. The therapist is integral in using preference tools in therapy. Youth feedback is currently limited, yet essential and ethical in order to understand critical factors of CYP engagement and for future research.

Keywords: child and adolescent, client preferences, mental health therapy, qualitative

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Authors: Hesham Kozou

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Sensorineural hearing loss (SNHL) poses a significant challenge due to limited access to the inner ear for therapies. Emerging treatments such as regenerative, genetic, and pharmacotherapies offer hope for addressing this condition. This study aims to highlight the potential of cochlear implants and emerging therapies in managing sensorineural hearing loss by improving access to the inner ear. The study is conducted through a review of relevant literature and research articles in the field of cochlear implants and emerging therapies for hearing loss. It outlines how advancements in cochlear implant technologies, electrodes, and surgical techniques can facilitate the delivery of therapies to the inner ear, potentially revolutionizing the treatment of sensorineural hearing loss. The study underscores the potential of cochlear implants and emerging therapies in revolutionizing the treatment landscape for sensorineural hearing loss, emphasizing the feasibility of curing this condition by leveraging technological advancements.

Keywords: therapies for hearing loss management, future of CI as a cochlear delivery channel, regenerative, genetic and pharmacotherapeutic management of hearing loss

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Authors: Evgeny E. Tereshatov

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Astatine-211 is considered one of the most promising radionuclides for Targeted Alpha Therapy. In order to develop reliable procedures to label biomolecules and utilize efficient delivery vehicle principles, one should understand the main chemical characteristics of astatine. The short half-life of 211At (~7.2 h) and absence of any stable isotopes of this element are limiting factors towards studying the behavior of astatine. Our team has developed a procedure for rapid and efficient isolation of astatine from irradiated bismuth material in nitric acid media based on 3-octanone and 1-octanol extraction chromatography resins. This process has been automated and it takes 20 min from the beginning of the target dissolution to the At-211 fraction elution. Our next step is to consider commercially available chromatography resins and their applicability in astatine purification in the same media. Results obtained along with the corresponding sorption mechanisms will be discussed.

Keywords: astatine-211, chromatography, automation, mechanism, radiopharmaceuticals

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Authors: Jungkyun Im

Abstract:

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for relieving pain and reducing inflammation. They are nonselective inhibitors of two isoforms of COX, cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), and thereby inhibiting the production of hormone-like lipid compounds such as, prostaglandins and thromboxanes which cause inflammation, pain, fever, platelet aggregation, etc. In addition, recently there are many research articles reporting the neuroprotective effect of NSAIDs in neurodegenerative diseases, such as Alzheimer’s disease (AD) and Parkinson’s disease (PD). However, the clinical use of NSAIDs in these diseases is limited by low brain distribution. Therefore, in order to assist the in-depth investigation on the pharmaceutical mechanism of flurbiprofen in neuroprotection and to make flurbiprofen a more potent drug to prevent or alleviate neurodegenerative diseases, delivery of flurbiprofen to brain should be effective and sufficient amount of flurbiprofen must penetrate the BBB thus gaining access into the patient’s brain. We have recently developed several types of guanidine-rich molecular carriers with high molecular weights and good water solubility that readily cross the blood-brain barrier (BBB) and display efficient distributions in the mouse brain. The G8 (having eight guanidine groups) molecular carrier based on D-sorbitol was found to be very effective in delivering anticancer drugs to a mouse brain. In the present study, employing the same molecular carrier, we prepared the flurbiprofen conjugate and studied its BBB permeation by mouse tissue distribution study. Flurbiprofen was attached to a molecular carrier with a fluorescein probe and multiple terminal guanidiniums. The conjugate was found to internalize into live cells and readily cross the BBB to enter the mouse brain. Our novel synthetic flurbiprofen conjugate will hopefully delivery NSAIDs into brain, and is therefore applicable to the neurodegenerative diseases treatment or prevention.

Keywords: flurbiprofen, drug delivery, molecular carrier, organic synthesis

Procedia PDF Downloads 231

Authors: Rajinikanth Siddalingam, Poonguzhali Subramanian

Abstract:

The present study aims to prepare and evaluate the self-nano emulsifying drug delivery (SNEDDS) system to enhance the dissolution rate of a poorly soluble drug dutasteride. The formulation was prepared using capryol PGMC, Cremophor EL, and polyethylene glycol (PEG) 400 as oil, surfactant and co-surfactant, respectively. The pseudo-ternary phase diagrams with presence and absence of drug were plotted to find out the nano emulsification range and also to evaluate the effect of dutasteride on the emulsification behavior of the phases. Prepared SNEDDS formulations were evaluated for its particle size distribution, nano emulsifying properties, robustness to dilution, self-emulsification time, turbidity measurement, drug content and in-vitro dissolution. The optimized formulations are further evaluated for heating cooling cycle, centrifugation studies, freeze-thaw cycling, particle size distribution and zeta potential were carried out to confirm the stability of the formed SNEDDS formulations. The particle size, zeta potential and polydispersity index of the optimized formulation found to be 35.45 nm, -15.45 and 0.19, respectively. The in vitro results are revealed that the prepared formulation enhanced the dissolution rate of dutasteride significantly as compared with pure drug. The in vivo studies in was conducted using rats and the results are revealed that SNEDDS formulation has enhanced the bioavailability of dutasteride drug significantly as compared with raw drug. Based the results, it was concluded that the dutasteride-loaded SNEDDS shows potential to enhance the dissolution of dutasteride, thus improving the bioavailability and therapeutic effects.

Keywords: self-emulsifying drug delivery system, dutasteride, enhancement of bioavailability, dissolution enhancement

Procedia PDF Downloads 267

Authors: Yuan-Chung Tsai, Masao Kamimura, Kohei Soga, Hsin-Cheng Chiu

Abstract:

In order to enhance the photodynamic/photothermal therapeutic efficacy on glioblastoma, the functionized upconversion nanoparticles with the capability of converting the deep tissue penetrating near-infrared light into visible wavelength for activating photochemical reaction were developed. The drug-loaded nanoparticles (NPs) were obtained from the self-assembly of oleic acid-coated upconversion nanoparticles along with maleimide-conjugated poly(ethylene glycol)-cholesterol (Mal-PEG-Chol), as the NP stabilizer, and hydrophobic photosensitizers, IR-780 (for photothermal therapy, PTT) and mTHPC (for photodynamic therapy, PDT), in aqueous phase. Both the IR-780 and mTHPC were loaded into the hydrophobic domains within NPs via hydrophobic association. The peptide targeting ligand, angiopep-2, was further conjugated with the maleimide groups at the end of PEG adducts on the NP surfaces, enabling the affinity coupling with the low-density lipoprotein receptor-related protein-1 of tumor endothelial cells and malignant astrocytes. The drug-loaded NPs with the size of ca 80 nm in diameter exhibit a good colloidal stability in physiological conditions. The in vitro data demonstrate the successful targeting delivery of drug-loaded NPs toward the ALTS1C1 cells (murine astrocytoma cells) and the pronounced cytotoxicity elicited by combinational effect of PDT and PTT. The in vivo results show the promising brain orthotopic tumor targeting of drug-loaded NPs and sound efficacy for brain tumor dual-modality treatment. This work shows great potential for improving photodynamic/photothermal therapeutic efficacy of brain cancer.

Keywords: drug delivery, orthotopic brain tumor, photodynamic/photothermal therapies, upconversion nanoparticles

Procedia PDF Downloads 195

Authors: A. Lambert-Mogiliansky

Abstract:

In this paper, we investigate the properties of simple rules for reappointment aimed at holding a public official accountable and monitor his activity. The public official allocates budget resources to various activities which results in the delivery of public services to citizens. He has discretion over the use of resource so he can divert some of them for private ends. Because of a liability constraint, zero diversion can never be secured in all states. The optimal reappointment mechanism under complete information is shown to exhibit some leniency thus departing from the zero tolerance principle. Under asymmetric information (about the state), a rule with random verification in a pre-announced subset is shown to be optimal in a class of common rules. Surprisingly, those common rules make little use of hard information about service delivery when available. Similarly, PO's claim about his record is of no value to improve the performance of the examined rules. In contrast requesting that the PO defends his records publicly can be very useful if the service users are given the chance to refute false claims with cheap talk complaints: the first best complete information outcome can be approached in the absence of any observation by the manager of the accountability mechanism.

Keywords: accountability, corruption, persuasion, debate

Procedia PDF Downloads 382

Authors: James Newman

Abstract:

Process mining is an emerging technology that looks to serialize enterprise data in time series data. It has been used by many companies and has been the subject of a variety of research papers. However, the majority of current efforts have looked at how to best create process mining from standard relational databases. This paper is the first pass at outlining a database custom-built for the minimal viable product of process mining. We present Block Miner, a blockchain protocol to store process mining data across a distributed network. We demonstrate the feasibility of storing process mining data on the blockchain. We present a proof of concept and show how the intersection of these two technologies helps to solve a variety of issues, including but not limited to ransomware attacks, tax documentation, and conflict resolution.

Keywords: blockchain, process mining, memory optimization, protocol

Procedia PDF Downloads 104

Authors: Yaowaporn Sangsen, Kittisak Likhitwitayawuid, Boonchoo Sritularak, Kamonthip Wiwattanawongsa, Ruedeekorn Wiwattanapatapee

Abstract:

Novel solid lipid nanoparticles (SLNs) were developed to improve oral bioavailability of oxyresveratrol (OXY). The SLNs were prepared by a high speed homogenization technique, at an effective speed and time, using Compritol® 888 ATO (5% w/w) as the solid lipid. The appropriate weight proportions (0.3% w/w) of OXY affected the physicochemical properties of blank SLNs. The effects of surfactant types on the properties of the formulations such as particle size and entrapment efficacy were also investigated. Conclusively, Tween 80 combined with soy lecithin was the most appropriate surfactant to stabilize OXY-loaded SLNs. The mean particle size of the optimized formulation was 134.40 ± 0.57 nm. In vitro drug release study, the selected S2 formulation showed a retarded release profile for OXY with no initial burst release compared to OXY suspension in the simulated gastrointestinal fluids. Therefore, these SLNs could provide a suitable system to develop for the oral OXY delivery.

Keywords: solid lipid nanoparticles, physicochemical properties, in vitro drug release, oxyresveratrol

Procedia PDF Downloads 398

Authors: Simona Dostalova, Dita Munzova, Ana Maria Jimenez Jimenez, Marketa Vaculovicova, Vojtech Adam, Rene Kizek

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The boom of nanomedicine in recent years has led to the development of numerous new nanomaterials that can be used as nanocarriers in the drug delivery. These nanocarriers can either be synthetic or natural-based. The disadvantage of many synthetic nanocarriers is their toxicity in patient’s body. Protein cages that can naturally be found in human body do not exhibit such disadvantage. However, the release of cargo from some protein cages in target cells can be problematic. As a special type of protein cages can serve the capsid of many viruses, including phage. Phages infect bacterial cells; therefore they are not harmful to human cells. The targeting of phage particles to cancer cells can be solved by producing of empty phage capsids during which the targeting moieties (e.g. peptides) can be cloned into genes of phage capsid to decorate its surface. Moreover, the produced capsids do not contain viral nucleic acid and are therefore not infectious to beneficial bacteria in the patient’s body. The protein cage composed of viral capsid is larger than other frequently used apoferritin cage but its size is still small enough to benefit from passive targeting by Enhanced Permeability and Retention effect. In this work, bacteriophage λ was used, both whole and its empty capsid for delivery of different cytotoxic drugs (cisplatin, carboplatin, oxaliplatin, etoposide and doxorubicin). Large quantities of phage λ were obtained from phage λ-producing strain of E. coli cultivated in medium with 0.2 % maltose. After killing of E. coli with chloroform and its removal by centrifugation, the phage was concentrated by ultracentrifugation at 130 000 g and 4 °C for 3 h. The encapsulation of the drugs was performed by infusion method and four different concentrations of the drugs were encapsulated (200; 100; 50; 25 µg/ml). Free molecules of drugs were removed by dialysis. The encapsulation was verified using spectrophotometric and electrochemical methods. The amount of encapsulated drug linearly increased with the amount of applied drug (determination coefficient R2=0.8013). 76% of applied drug was encapsulated in phage λ particles (concentration of 10 µg/ml), even with the highest applied concentration of drugs, 200 µg/ml. Only 1% of encapsulated drug was detected in phage DNA. Similar results were obtained with encapsulation in phage empty capsid. Therefore, it can be concluded that the encapsulation of drugs into phage particles is efficient and mostly occurs by interaction of drugs with protein capsid.

Keywords: cytostatics, drug delivery, nanocarriers, phage capsid

Procedia PDF Downloads 496

Authors: Seung-Lock Seo

Abstract:

This work presents a data-mining empirical monitoring scheme for industrial processes with partially unbalanced data. Measurement data of good operations are relatively easy to gather, but in unusual special events or faults it is generally difficult to collect process information or almost impossible to analyze some noisy data of industrial processes. At this time some noise filtering techniques can be used to enhance process monitoring performance in a real-time basis. In addition, pre-processing of raw process data is helpful to eliminate unwanted variation of industrial process data. In this work, the performance of various monitoring schemes was tested and demonstrated for discrete batch process data. It showed that the monitoring performance was improved significantly in terms of monitoring success rate of given process faults.

Keywords: data mining, process data, monitoring, safety, industrial processes

Procedia PDF Downloads 401