Search results for: physiological barriers to drug delivery

Authors: Ardiansyah I. Ryan, Ashsholih K. R., Fathurrohman G. R., Kurniadi M. R., Huda P. A

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The burden of brain-related disease is very high. There are a lot of brain-related diseases with limited treatment result and thus raise the burden more. The Parkinson Disease (PD), Mental Health Problem, or Paralysis of extremities treatments had risen concern, as the patients for those diseases usually had a low quality of life and low chance to recover fully. There are also many other brain or related neural diseases with the similar condition, mainly the treatments for those conditions are still limited as our understanding of the brain function is insufficient. Brain Implant Technology had given hope to help in treating this condition. In this paper, we examine the current update of the brain implant technology. Neurotechnology is growing very rapidly worldwide. The United States Food and Drug Administration (FDA) has approved the use of Deep Brain Stimulation (DBS) as a brain implant in humans. As for neural implant both the cochlear implant and retinal implant are approved by FDA too. All of them had shown a promising result. DBS worked by stimulating a specific region in the brain with electricity. This device is planted surgically into a very specific region of the brain. This device consists of 3 main parts: Lead (thin wire inserted into the brain), neurostimulator (pacemaker-like device, planted surgically in the chest) and an external controller (to turn on/off the device by patient/programmer). FDA had approved DBS for the treatment of PD, Pain Management, Epilepsy and Obsessive Compulsive Disorder (OCD). The target treatment of DBS in PD is to reduce the tremor and dystonia symptoms. DBS has been showing the promising result in animal and limited human trial for other conditions such as Alzheimer, Mental Health Problem (Major Depression, Tourette Syndrome), etc. Every surgery has risks of complications, although in DBS the chance is very low. DBS itself had a very satisfying result as long as the subject criteria to be implanted this device based on indication and strictly selection. Other than DBS, there are several brain implant devices that still under development. It was included (not limited to) implant to treat paralysis (In Spinal Cord Injury/Amyotrophic Lateral Sclerosis), enhance brain memory, reduce obesity, treat mental health problem and treat epilepsy. The potential of neurotechnology is unlimited. When brain function and brain implant were fully developed, it may be one of the major breakthroughs in human history like when human find ‘fire’ for the first time. Support from every sector for further research is very needed to develop and unveil the true potential of this technology.

Keywords: brain implant, deep brain stimulation (DBS), deep brain stimulation, Parkinson

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Authors: Oseyemi Omowunmi Olubomehin, Olufemi Michael Denton

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Diabetes mellitus is a disease that is related to the digestion of carbohydrates, proteins and fats and how this affects the blood glucose levels. Various synthetic drugs employed in the management of the disease work through different mechanisms. Keeping postprandial blood glucose levels within acceptable range is a major factor in the management of type 2 diabetes and its complications. Thus, the inhibition of carbohydrate-hydrolyzing enzymes such as α-amylase is an important strategy in lowering postprandial blood glucose levels, but synthetic inhibitors have undesirable side effects like flatulence, diarrhea, gastrointestinal disorders to mention a few. Therefore, it is necessary to identify and explore the α-amylase inhibitors from plants due to their availability, safety, and low costs. In the present study, extracts from the leaves of Rauvolfia vomitoria and seeds of Picralima nitida which are used in the Nigeria traditional system of medicine to treat diabetes were tested for their α-amylase inhibitory effect. The powdered plant samples were subjected to phytochemical screening using standard procedures. The leaves and seeds macerated successively using n-hexane, ethyl acetate and methanol resulted in the crude extracts which at different concentrations (0.1, 0.5 and 1 mg/mL) alongside the standard drug acarbose, were subjected to α-amylase inhibitory assay using the Benfield and Miller methods, with slight modification. Statistical analysis was done using ANOVA, SPSS version 2.0. The phytochemical screening results of the leaves of Rauvolfia vomitoria and the seeds of Picralima nitida showed the presence of alkaloids, tannins, saponins and cardiac glycosides while in addition Rauvolfia vomitoria had phenols and Picralima nitida had terpenoids. The α-amylase assay results revealed that at 1 mg/mL the methanol, hexane, and ethyl acetate extracts of the leaves of Rauvolfia vomitoria gave (15.74, 23.13 and 26.36 %) α-amylase inhibitions respectively, the seeds of Picralima nitida gave (15.50, 30.68, 36.72 %) inhibitions which were not significantly different from the control at p < 0.05, while acarbose gave a significant 56 % inhibition at p < 0.05. The presence of alkaloids, phenols, tannins, steroids, saponins, cardiac glycosides and terpenoids in these plants are responsible for the observed anti-diabetic activity. However, the low percentages of α-amylase inhibition by these plant samples shows that α-amylase inhibition is not the major way by which both plants exhibit their anti-diabetic effect.

Keywords: alpha-amylase, Picralima nitida, postprandial hyperglycemia, Rauvolfia vomitoria

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Authors: Happy Kumar Das, Md. Shahriar Shafiq

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This paper portrays an assumed change in the primary teacher education program in Bangladesh. An initiative has been taken with a vision to ensure an integrated approach to developing trainee teachers’ knowledge and understanding about learning at a deeper level, and with that aim, the Diploma in Primary Education (DPEd) program replaces the Certificate-in-Education (C-in-Ed) program in Bangladeshi context for primary teachers. The stated professional values of the existing program such as ‘learner-centered’, ‘reflective’ approach to pedagogy tend to contradict the practice exemplified through the delivery mechanism. To address the challenges, through the main two components (i) Training Institute-based learning and (ii) School-based learning, the new program tends to cover knowledge and value that underpin the actual practice of teaching. These two components are given approximately equal weighting within the program in terms of both time, content and assessment as the integration seeks to combine theoretical knowledge with practical knowledge and vice versa. The curriculum emphasizes a balance between the taught modules and the components of the practicum. For example, the theories of formative and summative assessment techniques are elaborated through focused reflection on case studies as well as observation and teaching practice in the classroom. The key ideology that is reflected through this newly developed program is teacher’s belief in ‘holistic education’ that can lead to creating opportunities for skills development in all three (Cognitive, Social and Affective) domains simultaneously. The proposed teacher education program aims to address these areas of generic skill development alongside subject-specific learning outcomes. An exploratory study has been designed in this regard where 7 Primary Teachers’ Training Institutes (PTIs) in 7 divisions of Bangladesh was used for experimenting DPEd program. The analysis was done based on document analysis, periodical monitoring report and empirical data gathered from the experimental PTIs. The findings of the study revealed that the intervention brought positive change in teachers’ professional beliefs, attitude and skills along with improvement of school environment. Teachers in training schools work together for collective professional development where they support each other through lesson study, action research, reflective journals, group sharing and so on. Although the DPEd program addresses the above mentioned factors, one of the challenges of the proposed program is the issue of existing capacity and capabilities of the PTIs towards its effective implementation.

Keywords: Bangladesh, effective implementation, primary teacher education, reflective approach

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Authors: Vithya Veeramani, Karunanidhi Subbaiah

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Emotional problems were found to be the predominant cause of suicide and second leading cause of death among adolescents in India. Emotional problems seem to be the underlying cause for various other severe psycho-social problems experienced in adolescence and also in later years of life. The Corporation schools in Chennai city are named as Chennai High School or Chennai Higher Secondary School run by the Corporation of Chennai. These schools fulfill the educational needs of students who hail from lower socio-economic status living in slums of the Chennai city. Adolescent students of Chennai schools tend to lack basic needs like food, clothes, shelter, etc. Some of the other significant problems faced by them are broken family, lack of parental support, frequent quarrel between parents, alcoholic parents, drug abuse and substance abuse among parents and neighbors, extended family, illiterate parents, deprivation of love and care, and lack of sense of belongingness. This prevailing condition may affect them emotionally and could lead to maladaptive behaviour, aggressiveness, poor interpersonal relationship with others, school refusal behaviour, school drop-out, suicide, etc. Therefore, it is very important to investigate the emotional problems faced by the adolescent students studying in Chennai schools, Chennai. A cross-sectional survey design was used to find the prevalence of emotional problems among adolescent students. Cluster sampling technique was used to select the schools for the present study considering the school as a cluster. In total, there are 15 zones, under the control of Chennai Corporation, of which only 7 zones have Corporation Schools in Chennai city, comprising of 32 Chennai Higher Secondary Schools and 38 Chennai High Schools. Out of these 70 schools, 29 schools comprising of 17 high schools and 12 higher secondary schools were selected randomly using lottery method. A sample of 2594 adolescent students from 9th standard and 11th standard was chosen for the study. Percentage analysis was done to find out the prevalence rate of emotional problems among adolescents students studying in Chennai Schools. Results of the study revealed that, out of 2594 students surveyed, 21.04% adolescent students were found to have academic problems (n = 546), 15.99% adolescent students had social problems (n = 415), behaviour problems was found to be prevalent among 12.87% adolescent students (n = 334), depression was prevalent among 15.88% adolescent students (n = 412) and anxiety was prevalent among 14.42% adolescent students (n = 374). Prevalence of emotional problems among male and female revealed that academic problems were more prevalent compared to other problems. Behaviour problems were least prevalent among boys and anxiety was least prevalent among girls than other problems. The overall prevalence rate of emotional problems was found to be on an increasing trend among adolescent students of low socio-economic status in Chennai city. The findings indicated the need for intervention to prevent and rehabilitate these adolescent students.

Keywords: adolescents, corporation schools, emotional problems, prevalence

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Authors: N. F. Mikhailova, M. E. Fattakhova, M. A. Mironova, E. V. Vyacheslavova

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For the mental and social adaptation of the deaf and hard-of-hearing people, cultural and social aspects - the formation of identity (acculturation) and educational conditions – are highly significant. We studied 137 deaf and hard-of-hearing students in different educational situations. We used these methods: Big Five (Costa & McCrae, 1997), TRF (Becker, 1989), WCQ (Lazarus & Folkman, 1988), self-esteem, and coping strategies (Jambor & Elliott, 2005), self-stigma scale (Mikhailov, 2008). Type of self-identification of students depended on the degree of deafness, type of education, method of communication in the family: large hearing loss, education in schools for deaf, and gesture communication increased the likelihood of a 'deaf' acculturation. Less hearing loss, inclusive education in public school or school for the hearing-impaired, mixed communication in the family contributed to the formation of 'hearing' acculturation. The choice of specific coping depended on the degree of deafness: a large hearing loss increased coping 'withdrawal into the deaf world' and decreased 'bicultural skills' coping. People with mild hearing loss tended to cover-up it. In the context of ongoing discussion, we researched personality characteristics in deaf and hard on-hearing students, coping and other deafness associated factors depending on their acculturation type. Students who identified themselves with the 'hearing world' had a high self-esteem, a higher level of extraversion, self-awareness, personal resources, willingness to cooperate, better psychological health, emotional stability, higher ability to empathy, a greater satiety of life with feelings and sense and high sense of self-worth. They also actively used strategies, problem-solving, acceptance of responsibility, positive revaluation. Student who limited themselves within the culture of deaf people had more severe hearing loss and accordingly had more communication barriers. Lack of use or seldom use of coping strategies by these students point at decreased level of stress in their life. Their self-esteem have not been challenged in the specific social environment of the students with the same severity of defect, and thus this environment provided sense of comfort (we can assume that from the high scores on psychological health, personality resources, and emotional stability). Students with bicultural acculturation had higher level of psychological resources - they used Positive Reappraisal coping more often and had a higher level of psychological health. Lack of belonging to certain culture (marginality) leads to personality disintegration, social and psychological disadaptation: deaf and hard-of-hearing students with marginal identification had a lower self-estimation level, worse psychological health and personal resources, lower level of extroversion, self-confidence and life satisfaction. They, in fact, become 'risk group' (many of them dropped out of universities, divorced, and one even ended up in the ranks of ISIS). All these data argue the importance of cultural 'anchor' for people with hearing deprivation. Supported by the RFBR No 19-013-00406.

Keywords: acculturation, coping, deafness, marginality

Procedia PDF Downloads 173

Authors: Magdalena Maria Rost-Roszkowska, Alina Chachulska-Żymełka, Monika Tarnawska, Maria Augustyniak, Alina Kafel, Agnieszka Babczyńska

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The digestive system of insects is composed of three distinct regions: fore-, mid- and hingut. The middle region (the midgut) is treated as one of the barriers which protects the organism against any stressors which originate from external environment, e.g. toxic metals. Such factors can activate the cell death in epithelial cells to preserve the entire tissue/organs against the degeneration. Different mechanisms involved in homeostasis maintenance have been described, but the studies of animals under field conditions do not give the opportunity to conclude about potential ability of subsequent generation to inherit the tolerance mechanisms. It is possible only by a multigenerational strain of an animal led under laboratory conditions, exposed to a selected toxic factor, present also in polluted ecosystems. The main purpose of the project was to check if changes, which appear in the midgut epithelium after Cd treatment, can be fixed during the following generations of insects with the special emphasis on apoptosis. As the animal for these studies we chose 5th larval stage of the beet armyworm Spodoptera exigua Hübner (Lepidoptera: Noctuidae), which is one of pest of many vegetable crops. Animals were divided into some experimental groups: K, Cd, KCd, Cd1, Cd2, Cd3. A control group (K) fed a standard diet, and was conducted for XX generations, a cadmium group (Cd), fed on standard diet supplemented with cadmium (44 mg Cd per kg of dry weight of food) for XXX generations. A reference Cd group (KCd) has been initiated: control insects were fed with Cd supplemented diet (44 mg Cd per kg of dry weight of food). Experimental groups Cd1, Cd2, Cd3 developed from the control one: 5 mg Cd per kg of dry weight of food, 10 mg Cd per kg of dry weight of food, 20 mg Cd per kg of dry weight of food. We were interested in the activation of apoptosis during following generations in all experimental groups. Therefore, during the 1st year of the experiment, the measurements were done for 6 generations in all experimental group. The intensity and the course of apoptosis have been examined using transmission electron microscope (TEM), confocal microscope and flow cytometry. During apoptosis the cell started to shrink, extracellular spaces appeared between digestive and neighboring cells, the nucleus achieved a lobular shape. Eventually, the apoptotic cells was discharged into the midgut lumen. A quantitative analysis revealed that the number of apoptotic cells depends significantly on the generation, tissue and cadmium concentration in the insect rearing medium. In the following 6 generations, we observed that the percentage of apoptotic cells in the midguts from cadmium-exposed groups decreased gradually according to the following order of strains: Cd1, Cd2, Cd3 and KCd. At the same time, it was still higher than the percentage of apoptotic cells in the same tissues of the insects from the control and multigenerational cadmium strain. The results of our studies suggest that changes caused by cadmium treatment were preserved during 6-generational development of lepidopteran larvae. The study has been financed by the National Science Centre Poland, grant no 2016/21/B/NZ8/00831.

Keywords: cadmium, cell death, digestive system, ultrastructure

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Authors: Meherun Nahar

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Background:The Chittagong Hill Tracts (CHT) is one of the most diverse regions in Bangladesh in terms of geography, ethnicity, culture and traditions of the people and home of thirteen indigenous ethnic people. In Bangladesh indigenous children aged 6-10 years remain out of school, and the majority of those who do enroll drop out before completing primary school. According to different study that the dropout rate of indigenous children is much higher than the estimated national rate, children dropping out especially in the early years of primary school. One of the most critical barriers for these children is that they do not understand the national language in the government pre-primary school. And also their school readiness and development become slower. In this situation, indigenous children excluded from the mainstream quality education. To address this issue Save the children in Bangladesh and other organizations are implementing community-based Mother Tongue-Based Multilingual Education program (MTBMLE) in the Chittagong Hill Tracts (CHT) for improving the enrolment rate in Government Primary Schools (GPS) reducing dropout rate as well as quality education. In connection with that Save the children conducted comparative research in Chittagong hill tracts on children readiness through Mother tongue-based and Non-mother tongue ECCD center. Objectives of the Study To assess Mother Language based ECCD centers and Non-Mother language based ECCD centers children’s school readiness and development. To assess the community perception over Mother Language based and Non-Mother Language based ECCD center. Methodology: The methodology of the study was FGD, KII, In-depth Interview and observation. Both qualitative and quantitative research methods were followed. The quantitative part has three components, School Readiness, Classroom observation and Headteacher interview and qualitative part followed FGD technique. Findings: The interviews with children under school readiness component showed that in general, Mother Language (ML) based ECCD children doing noticeably better in all four areas (Knowledge, numeracy, fine motor skill and communication) than their peers from Non-mother language based children. ML students seem to be far better skilled in concepts about print as most of them could identify cover and title of the book that was shown to them. They could also know from where to begin to read the book or could correctly point the letter that was read. A big difference was found in the area of identifying letters as 89.3% ML students of could identify letters correctly whereas for Non mother language 30% could do the same. The class room observation data shows that ML children are more active and remained engaged in the classroom than NML students. Also, teachers of ML appeared to have more engaged in explaining issues relating to general knowledge or leading children in rhyming/singing other than telling something from text books. The participants of FGDs were very enthusiastic on using mother language as medium of teaching in pre-schools. They opined that this initiative elates children to attend school and enables them to continue primary schooling without facing any language barrier.

Keywords: Chittagong hill tracts, early childhood care and development (ECCD), indigenous, mother language

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Authors: Jun Won Kim

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Objective: Theta-phase gamma-amplitude coupling (TGC) was used as a novel evidence-based tool to reflect the dysfunctional cortico-thalamic interaction in patients with schizophrenia. However, to our best knowledge, no studies have reported the diagnostic utility of the TGC in the resting-state electroencephalographic (EEG) of neuroleptic-naive patients with schizophrenia compared to healthy controls. Thus, the purpose of this EEG study was to understand the underlying mechanisms in patients with schizophrenia by comparing the TGC at rest between two groups and to evaluate the diagnostic utility of TGC. Method: The subjects included 90 patients with schizophrenia and 90 healthy controls. All patients were diagnosed with schizophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) by two independent psychiatrists using semi-structured clinical interviews. Because patients were either drug-naïve (first episode) or had not been taking psychoactive drugs for one month before the study, we could exclude the influence of medications. Five frequency bands were defined for spectral analyses: delta (1–4 Hz), theta (4–8 Hz), slow alpha (8–10 Hz), fast alpha (10–13.5 Hz), beta (13.5–30 Hz), and gamma (30-80 Hz). The spectral power of the EEG data was calculated with fast Fourier Transformation using the 'spectrogram.m' function of the signal processing toolbox in Matlab. An analysis of covariance (ANCOVA) was performed to compare the TGC results between the groups, which were adjusted using a Bonferroni correction (P < 0.05/19 = 0.0026). Receiver operator characteristic (ROC) analysis was conducted to examine the discriminating ability of the TGC data for schizophrenia diagnosis. Results: The patients with schizophrenia showed a significant increase in the resting-state TGC at all electrodes. The delta, theta, slow alpha, fast alpha, and beta powers showed low accuracies of 62.2%, 58.4%, 56.9%, 60.9%, and 59.0%, respectively, in discriminating the patients with schizophrenia from the healthy controls. The ROC analysis performed on the TGC data generated the most accurate result among the EEG measures, displaying an overall classification accuracy of 92.5%. Conclusion: As TGC includes phase, which contains information about neuronal interactions from the EEG recording, TGC is expected to be useful for understanding the mechanisms the dysfunctional cortico-thalamic interaction in patients with schizophrenia. The resting-state TGC value was increased in the patients with schizophrenia compared to that in the healthy controls and had a higher discriminating ability than the other parameters. These findings may be related to the compensatory hyper-arousal patterns of the dysfunctional default-mode network (DMN) in schizophrenia. Further research exploring the association between TGC and medical or psychiatric conditions that may confound EEG signals will help clarify the potential utility of TGC.

Keywords: quantitative electroencephalography (QEEG), theta-phase gamma-amplitude coupling (TGC), schizophrenia, diagnostic utility

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Authors: Tina Stavredes

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Increasingly borderless learning opportunities including online learning are expanding. Singapore University of Social Science (SUSS) conducted research in February of 2017 to determine the level of consumer interest in undertaking a completely online distance learning degree program across three countries in the Asian Pacific region. The target audience was potential bachelor degree and post-degree students from Malaysia, Indonesia, and Vietnam. The results gathered were used to assess the market size and ascertain the business potential of online degree programs in Malaysia, Indonesia and Vietnam. Secondly, the results were used to determine the most receptive markets to prioritise entry and identify the most receptive student segments. In order to achieve the key outcomes, the key points of understanding were as follows: -Motivations for higher education & factors that influence the choice of institution, -Interest in online learning, -Interest in online learning from a Singapore university relative to other foreign institutions, -Key drivers and barriers of interest in online learning. An online survey was conducted from from 7th Feb 2017 to 27th Feb 2017 amongst n=600 respondents aged 21yo-45yo, who have a basic command of English, A-level qualifications and above, and who have an intent to further their education in the next 12 months. Key findings from the study regarding enrolling in an online program include the need for a marriage between intrinsic and extrinsic motivation factors and the flexibility and support offered in an online program. Overall, there was a high interest for online learning. Survey participants stated they are intrinsically motivated to learn because of their interest in the program of study and the need for extrinsic rewards including opportunities for employment or salary increment in their current job. Seven out of ten survey participants reported they are motivated to further their education and expand their knowledge to become more employable. Eight in ten claims that the feasibility of furthering their education depends on cost and maintaining a work-life balance. The top 2 programs of interest are business and information and communication technology. They describe their choice of university as a marriage of both motivational and feasibility factors including cost, choice, quality of support facilities, and the reputation of the institution. Survey participants reported flexibility as important and stated that appropriate support assures and grows their intent to enrol in an online program. Respondents also reported the importance of being able to work while studying as the main perceived advantage of online learning. Factors related to the choice of an online university emphasized the quality of support services. Despite concerns, overall there was a high interest for online learning. One in two expressed strong intent to enrol in an online programme of study. However, unfamiliarity with online learning is a concern including the concern with the lack of face-to-face interactions. Overall, the findings demonstrated an interest in online learning. A main driver was the ability to earn a recognised degree while still being able to be with the family and the ability to achieve a ‘better’ early career growth.

Keywords: distance education, student motivations, online learning, online student needs

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Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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Authors: Ivette Gonzalez-Rivera, Diana B. Paz-Trejo, Oscar Galicia-Castillo, David N. Velazquez-Martinez, Hugo Sanchez-Castillo

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Prolonged exposure to stress can cause disorders related with dysfunction in the prefrontal cortex such as generalized anxiety and depression. These disorders involve alterations in neurotransmitter systems; the serotonergic system—a target of the drugs that are commonly used as a treatment to these disorders—is one of them. Recent studies suggest that 5-HT1A receptors play a pivotal role in the serotonergic system regulation and in stress responses. In the same way, there is increasing evidence that astrocytes are involved in the pathophysiology of stress. The aim of this study was to examine the effects of 8-OH-DPAT, a selective agonist of 5-HT1A receptors, in the behavioral signs of anxiety and anhedonia as well as in the number of astrocytes in the medial prefrontal cortex (mPFC) after exposure to chronic stress. They used 50 male Wistar rats of 250-350 grams housed in standard laboratory conditions and treated in accordance with the ethical standards of use and care of laboratory animals. A protocol of chronic unpredictable stress was used for 10 consecutive days during which the presentation of stressors such as motion restriction, water deprivation, wet bed, among others, were used. 40 rats were subjected to the stress protocol and then were divided into 4 groups of 10 rats each, which were administered 8-OH-DPAT (Tocris, USA) intraperitoneally with saline as vehicle in doses 0.0, 0.3, 1.0 and 2.0 mg/kg respectively. Another 10 rats were not subjected to the stress protocol or the drug. Subsequently, all the rats were measured in an open field test, a forced swimming test, sucrose consume, and a cero maze test. At the end of this procedure, the animals were sacrificed, the brain was removed and the tissue of the mPFC (Bregma: 4.20, 3.70, 2.70, 2.20) was processed in immunofluorescence staining for astrocytes (Anti-GFAP antibody - astrocyte maker, ABCAM). Statistically significant differences were found in the behavioral tests of all groups, showing that the stress group with saline administration had more indicators of anxiety and anhedonia than the control group and the groups with administration of 8-OH-DPAT. Also, a dose dependent effect of 8-OH-DPAT was found on the number of astrocytes in the mPFC. The results show that 8-OH-DPAT can modulate the effect of stress in both behavioral and anatomical level. Also they indicate that 5-HT1A receptors and astrocytes play an important role in the stress response and may modulate the therapeutic effect of serotonergic drugs, so they should be explored as a fundamental part in the treatment of symptoms of stress and in the understanding of the mechanisms of stress responses.

Keywords: anxiety, prefrontal cortex, serotonergic system, stress

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Authors: David M. Gilstrap

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Designing effective instructions is a critical dimension of effective teaching systems. Due to a void in interpersonal contact, online courses present new challenges in this regard, especially with large class sizes. This presentation is a case study in how the repetition of instructions within the course design was utilized to increase instructor efficiency in managing a rapid rise in enrollment. World of Turf is a two-credit, semester-long elective course for non-turfgrass majors at Michigan State University. It is taught entirely online and solely by the instructor without any graduate teaching assistants. Discussion forums about subject matter are designated for each lecture, and those forums are moderated by a few undergraduate turfgrass majors. The instructions as to the course structure, navigation, and grading are conveyed in the syllabus and course-introduction lecture. Regardless, students email questions about such matters, and the number of emails increased as course enrollment grew steadily during the first three years of its existence, almost to a point that the course was becoming unmanageable. Many of these emails occurred because the instructor was failing to update and operate the course in a timely and proper fashion because he was too busy answering emails. Some of the emails did help the instructor ferret out poorly composed instructions, which he corrected. Beginning in the summer semester of 2015, the instructor overhauled the course by segregating content into weekly modules. The philosophy envisioned and embraced was that there can never be too much repetition of instructions in an online course. Instructions were duplicated within each of these modules as well as associated modules for syllabus and schedules, getting started, frequently asked questions, practice tests, surveys, and exams. In addition, informational forums were created and set aside for questions about the course workings and each of the three exams, thus creating even more repetition. Within these informational forums, students typically answer each other’s questions, which demonstrated to the students that that information is available in the course. When needed, the instructor interjects with corrects answers or clarifies any misinformation which students might be putting forth. Increasing the amount of repetition of instructions and strategic enhancements to the course design have resulted in a dramatic decrease in the number of email replies necessitated by the instructor. The resulting improvement in efficiency allowed the instructor to raise enrollment limits thus effecting a ten-fold increase in enrollment over a five-year period with 1050 students registered during the most recent academic year, thus becoming easily the largest online course at the university. Because of the improvement in course-delivery efficiency, sufficient time was created that allowed the instructor to development and launch an additional online course, hence further enhancing his productivity and value in terms of the number of the student-credit hours for which he is responsible.

Keywords: design, efficiency, instructions, online, repetition

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Authors: Indika Fernando, Jiangang Fei, Roger Stanley, Hossein Enshaei

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Delicate produce such as fresh fruits are increasingly susceptible to physiological damage during the essential post-harvest operations such as transport and handling. Vibration and shock during the distribution are identified factors for produce damage within post-harvest supply chains. Mechanical damages caused during transit may significantly diminish the quality of fresh produce which may also result in a substantial wastage. Bananas are one of the staple fruit crops and the most sold supermarket produce in Australia. It is also the largest horticultural industry in the state of Queensland where 95% of the total production of bananas are cultivated. This results in significantly lengthy interstate supply chains where fruits are exposed to prolonged vibration and shocks. This paper is focused on determining the shock and vibration levels experienced by packaged bananas during transit from the farm gate to the retail market. Tri-axis acceleration data were captured by custom made accelerometer based data loggers which were set to a predetermined sampling rate of 400 Hz. The devices recorded data continuously for 96 Hours in the interstate journey of nearly 3000 Km from the growing fields in far north Queensland to the central distribution centre in Melbourne in Victoria. After the bananas were ripened at the ripening facility in Melbourne, the data loggers were used to capture the transport and handling conditions from the central distribution centre to three retail outlets within the outskirts of Melbourne. The quality of bananas were assessed before and after transport at each location along the supply chain. Time series vibration and shock data were used to determine the frequency and the severity of the transient shocks experienced by the packages. Frequency spectrogram was generated to determine the dominant frequencies within each segment of the post-harvest supply chain. Root Mean Square (RMS) acceleration levels were calculated to characterise the vibration intensity during transport. Data were further analysed by Fast Fourier Transform (FFT) and the Power Spectral Density (PSD) profiles were generated to determine the critical frequency ranges. It revealed the frequency range in which the escalated energy levels were transferred to the packages. It was found that the vertical vibration was the highest and the acceleration levels mostly oscillated between ± 1g during transport. Several shock responses were recorded exceeding this range which were mostly attributed to package handling. These detrimental high impact shocks may eventually lead to mechanical damages in bananas such as impact bruising, compression bruising and neck injuries which affect their freshness and visual quality. It was revealed that the frequency range between 0-5 Hz and 15-20 Hz exert an escalated level of vibration energy to the packaged bananas which may result in abrasion damages such as scuffing, fruit rub and blackened rub. Further research is indicated specially in the identified critical frequency ranges to minimise exposure of fruits to the harmful effects of vibration. Improving the handling conditions and also further study on package failure mechanisms when exposed to transient shock excitation will be crucial to improve the visual quality of bananas within the post-harvest supply chain in Australia.

Keywords: bananas, handling, post-harvest, supply chain, shocks, transport, vibration

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Authors: Chalise Kiran

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The prime idea of inclusive education is to mainstream every child in education. However, it will be challenging for implementation when there are policy and practice gaps. It will be even more challenging when children have disabilities. Generally, the focus will be on the policy gap, but the problem may not always be with policy. The proper practice could be a challenge in the countries like Nepal. In determining practice, the teachers’ perceptions toward inclusive will play a vital role. Nepal has categorized disability in 7 types (physical, visual, hearing, vision/hearing, speech, mental, and multiple). Out of these, hearing impairment is the study realm. In the context of a limited number of researches on children with disabilities and rare researches on CWHI and their education in Nepal, this study is a pioneering effort in knowing basically the problems and challenges of CWHI focused on inclusive education in the schools including gaps and barriers in its proper implementation. Philosophically, the paradigm of the study is post-positivism. In the post-positivist worldview, the quantitative approach with the description of the situation and inferential relationship are revealed out in the study. This is related to the natural model of objective reality. The data were collected from an individual survey with the teachers and head teachers of 35 schools in Nepal. The survey questionnaire was prepared and filled by the respondents from the schools where the CWHI study in 7 provincial 20 districts of Nepal. Through these considerations, the perceptions of CWHI focused inclusive education were explored in the study. The data were analyzed using both descriptive and inferential tools on which the Likert scale-based analysis was done for descriptive analysis, and chi-square mathematical tool was used to know the significant relationship between dependent variables and independent variables. The descriptive analysis showed that the majority of teachers have positive perceptions toward implementing CWHI focused inclusive education, and the majority of them have positive perceptions toward CWHI focused inclusive education, though there are some problems and challenges. The study has found out the major challenges and problems categorically. Some of them are: a large number of students in a single class; availability of generic textbooks for CWHI and no availability of textbooks to all students; less opportunity for teachers to acquire knowledge on CWHI; not adequate teachers in the schools; no flexibility in the curriculum; less information system in schools; no availability of educational consular; disaster-prone students; no child abuse control strategy; no disabled-friendly schools; no free health check-up facility; no participation of the students in school activities and in child clubs and so on. By and large, it is found that teachers’ age, gender, years of experience, position, employment status, and disability with him or her show no statistically significant relation to successfully implement CWHI focused inclusive education and perceptions to CWHI focused inclusive education in schools. However, in some of the cases, the set null hypothesis was rejected, and some are completely retained. The study has suggested policy implications, implications for educational authority, and implications for teachers and parents categorically.

Keywords: children with hearing impairment, disability, inclusive education, perception

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Authors: R. Pussinen, V. Jankovic, U. Herzberg, M. Cerrada-Gimenez, T. Huhtala, A. Nurmi, T. Ahtoniemi

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Targeted over-expression of human α-synuclein using viral-vector mediated gene delivery into the substantia nigra of rats and non-human primates has been reported to lead to dopaminergic cell loss and the formation of α-synuclein aggregates reminiscent of Lewy bodies. We have previously shown how AAV-mediated expression of α-synuclein is seen in the chronic phenotype of the rats over 16 week follow-up period. In the context of these findings, we attempted to further characterize this long term PD related functional and motor deficits as well as neurochemical and neuropathological changes in AAV-mediated α-synuclein transfection model in rats during chronic follow-up period. Different titers of recombinant AAV expressing human α-synuclein (A53T) were stereotaxically injected unilaterally into substantia nigra of Wistar rats. Rats were allowed to recover for 3 weeks prior to initial baseline behavioral testing with rotational asymmetry test, stepping test and cylinder test. A similar behavioral test battery was applied again at weeks 5, 9,12 and 15. In addition to traditionally used rat PD model tests, MotoRater test system, a high speed kinematic gait performance monitoring was applied during the follow-up period. Evaluation focused on animal gait between groups. Tremor analysis was performed on weeks 9, 12 and 15. In addition to behavioral end-points, neurochemical evaluation of dopamine and its metabolites were evaluated in striatum. Furthermore, integrity of the dopamine active transport (DAT) system was evaluated by using 123I- β-CIT and SPECT/CT imaging on weeks 3, 8 and 12 after AAV- α-synuclein transfection. Histopathology was examined from end-point samples at 3 or 12 weeks after AAV- α-synuclein transfection to evaluate dopaminergic cell viability and microglial (Iba-1) activation status in substantia nigra by using stereological analysis techniques. This study focused on the characterization and validation of previously published AAV- α-synuclein transfection model in rats but with the addition of novel end-points. We present the long term phenotype of AAV- α-synuclein transfected rats with traditionally used behavioral tests but also by using novel fine motor analysis techniques and tremor analysis which provide new insight to unilateral effects of AAV α-synuclein transfection. We also present data about neurochemical and neuropathological end-points for the dopaminergic system in the model and how well they correlate with behavioral phenotype.

Keywords: adeno-associated virus, alphasynuclein, animal model, Parkinson’s disease

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Authors: Sarah Lister, Pauline Palmer

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Research findings presented within this paper form part of a larger scale collaboration between academics at Manchester Metropolitan University and a technology company. The overarching aims of this project focus on developing a series of game-based resources to promote the teaching of aspects of mathematics through a second language (L2) in primary schools. This study explores the potential of game-based learning (GBL) as a dynamic way to engage and motivate learners, making learning fun and purposeful. The research examines the capacity of GBL resources to provide a meaningful and purposeful context for CLIL. GBL is a powerful learning environment and acts as an effective vehicle to promote the learning of mathematics through an L2. The fun element of GBL can minimise stress and anxiety associated with mathematics and L2 learning that can create barriers. GBL provides one of the few safe domains where it is acceptable for learners to fail. Games can provide a life-enhancing experience for learners, revolutionizing the routinized ways of learning through fusing learning and play. This study argues that playing games requires learners to think creatively to solve mathematical problems, using the L2 in order to progress, which can be associated with the development of higher-order thinking skills and independent learning. GBL requires learners to engage appropriate cognitive processes with increased speed of processing, sensitivity to environmental inputs, or flexibility in allocating cognitive and perceptual resources. At surface level, GBL resources provide opportunities for learners to learn to do things. Games that fuse subject content and appropriate learning objectives have the potential to make learning academic subjects more learner-centered, promote learner autonomy, easier, more enjoyable, more stimulating and engaging and therefore, more effective. Data includes observations of the children playing the games and follow up group interviews. Given that learning as a cognitive event cannot be directly observed or measured. A Cognitive Discourse Functions (CDF) construct was used to frame the research, to map the development of learners’ conceptual understanding in an L2 context and as a framework to observe the discursive interactions that occur learner to learner and between learner and teacher. Cognitively, the children were required to engage with mathematical content, concepts and language to make decisions quickly, to engage with the gameplay to reason, solve and overcome problems and learn through experimentation. The visual elements of the games supported the learning of new concepts. Children recognised the value of the games to consolidate their mathematical thinking and develop their understanding of new ideas. The games afforded them time to think and reflect. The teachers affirmed that the games provided meaningful opportunities for the learners to practise the language. The findings of this research support the view that using the game-based resources supported children’s grasp of mathematical ideas and their confidence and ability to use the L2. Engaging with the content and language through the games led to deeper learning.

Keywords: CLIL, gaming, language, mathematics

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Authors: Zubaidan Yushan, Hudayar Cıhan

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Turkiye and China are countries that have collective cultures, but they have different cultural backgrounds. They have different cultures, different religions, and different levels of economic development. The aim of this study is to test the moderation effect of caregiver bonding on the relationship between dating violence and coping strategies among unmarried emerging adults in China and Turkiye. Participants ages were 19 and 26 years (X=23.66, SD=3.66), unmarried emerging adults Turkish 171 participants (72.5% women, 24% men, 3.5% prefer not to say), Chinese 170 participants (71.8% women, 21.8% men, 6.5% prefer not to say). All participants had been in a relationship for more than six months. Participants completed The Conflict Tactics Scales—(CTS2), The Cope Inventory, and The Parental Bonding Instrument (PBI). Examining the dating violence and coping strategies of the participant's relationship through caregiver bonding moderation analysis was performed using the Jamovi. Significance was tested using the bootstrapping method with bias-corrected confidence estimates. The outcome variable for analysis was dating violence, and the predictor variable for the analysis was coping strategies. The moderator variable evaluated for the analysis was parent attachment. Before the analysis, the mean-centered scores of each variable and moderator were calculated. Furthermore, the moderation analysis was conducted separately for each outcome. The Moderation analysis results show that the sub-dimension of over-protection moderates psychological aggression perpetration and avoidance coping in China. The sub-dimension of care moderates injury victimization and avoidance management in Turkiye; also, over-protection moderates injury victimization and social support coping. Moreover, the sub-dimension of care moderates sexual coercion perpetration and avoidance coping. In the results, caregiver bonding moderates the relationship between coping strategies and dating violence, which may be explained by the fact that our ways of coping with problems are learned, and people are influenced by their parents when they face problems. Therefore, problem-solving is permanently fixed, and each person has his or her fixed solution, which leads to a habit of using solutions to problems. However, sometimes, these solutions become the justification for the injured or abusive person. The quality of the attachment between parents can regulate this state. The results are somewhat similar to and slightly different from those in the previous literature. These mixed results indicate the need for further exploration. Many other factors, such as alcohol, drug violence, and pathological problems, maybe the reasons for these differences. In addition, diverse factors such as the study environment and the applied measurement scales may also affect the results.

Keywords: caregiver bonding, coping strategies, dating violence, emerging adulthood, cross-cultural, comparison

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Authors: Le Jiang, Chua Jinxing

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Introduction: The recent outbreak of Ebola virus disease in the west Africa has drawn global concern. With a high fatality rate and direct human-to-human transmission, it has spread between countries and caused great damages for patients and family who are affected. Being the designated hospital to manage epidemic outbreak in Singapore, Tan Tock Seng Hospital (TTSH) is facing great challenges in preparation and managing of potential outbreak of emerging infectious disease such as Ebola virus disease. Aim: We conducted an infection control drill in TTSH emergency department to assess the readiness of healthcare and allied health workers in managing suspected Ebola patients. It also helps to review current Ebola clinical protocol and work instruction to ensure more smooth and safe practice in managing Ebola patients in TTSH emergency department. Result: General preparedness level of staffs involved in managing Ebola virus disease in TTSH emergency department is not adequate. Knowledge deficits of staffs on Ebola personal protective equipment gowning and degowning process increase the risk of potential cross contamination in patient care. Loopholes are also found in current clinical protocol, such as unclear instructions and inaccurate information, which need to be revised to promote better staff performance in patient management. Logistic issues such as equipment dysfunction and inadequate supplies can lead to ineffective communication among teams and causing harm to patients in emergency situation. Conclusion: The infection control drill identified the need for more well-structured and clear clinical protocols to be in place to promote participants performance. In addition to quality protocols and guidelines, systemic training and annual refresher for all staffs in the emergency department are essential to prepare staffs for the outbreak of Ebola virus disease. Collaboration and communication with allied health staffs are also crucial for smooth delivery of patient care and minimising the potential human suffering, properties loss or injuries caused by disease. Therefore, more clinical drills with collaboration among various departments involved are recommended to be conducted in the future to monitor and assess readiness of TTSH emergency department in managing Ebola virus disease.

Keywords: ebola, emergency department, infection control drill, Tan Tock Seng Hospital

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Authors: Nina Ivanova

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More than one third of the population and animals are infected with parasitic helminths. It is especially difficult to cure the larval forms of parasites. The larvae of Hymenolepis nana invade the villi of the intestinal mucosa. Toxocara larvae can live in the liver, heart, lungs, brain, eyes, and pancreas. Commercial antiparasitic drugs cannot guarantee a 100% cure after a single course of treatment, because parasite larvae invade the villi of the intestinal mucosa and the anthelmintics do not reach and kill cestode larvae. The aim of this work was to conduct a study of liposomal antihelminthics on the laboratory animals under the certification received from the Committee on Bioethics and Deontology. It has been checked: 1) anthelmintic activity of the liposomal form of fenasal in experimental hymenolepidosis of white mice (larval stage - Hymenolepis nana). 2) anthelmintic activity of the liposomal form of albendazole in experimental toxocariasis of white mice (in the lungs at the stage of larval migration). Since some helminths cause hemolysis of erythrocytes as we used a mixture of polar lipids developed by us with antihemolytic activity to obtain liposomes Fenasal and albendazole were included in the liposome membrane in the ratio of anthelmintic: lipids 1:10. . The average size of liposomes was 180 nm, and the concentration of lipids in liposomes was 1%. The researches were carried out on white male mice who were infected with Hymenolepis Nana invasional eggs in a peroral way with a doze of 100 eggs per animal. On the 5th day after infection, a liposomal fenasal and commercial fenasal were administered orally for comparison. The animals were observed for 15 days. Before the introduction of liposomes and on the 3rd, 5th, 15th day after the administration of the drug, studies were carried out on the presence of helminths in the organs of animals. The liposomal fenasal, when administered orally, had an anthelmintic effect on Hymenolepis Nana cysticercoids at a dose of 25 mg/kg. The percentage of efficiency was 90.06, 91.36 96.85% on days 3, 5, 15, respectively. For comparison, the commercial activity was at a dose of 200 mg/ml, which is 8 times higher than the dose of liposomal fenasal. To evaluate the anthelmintic effect of the liposomal form of albendazole in experimental toxocariasis of white mice (toxascaris in the lungs at the stage of larval migration), studies were also carried out on white mice. The animals were infected with invasive eggs of Toxocara canis, orally, at a dose of 100 eggs per animal. On the 5th day after infection, the liposomal albendazole was administered orally. The efficacy of the study dosage form was determined by counting Larva mirgans larvae in the lungs. The results obtained showed that the liposomal albendazole had the greatest anthelmintic effect on Toxocara larvae at a dose of 2.0 mg/kg, which was 3.75 times less than the therapeutic one. At the same time, the percentage of efficiency was 93.75% on the 3rd day, and 98.66% on the 5th day.

Keywords: hymenolepis, Toxocara, larvae, liposomes

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Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

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Authors: Sanjay Shukla

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Excessive use of antibiotics is a main problem in the treatment of wounds and other chronic infections and antibiotic treatment is frequently non-curative, thus alternative treatment is necessary. Phage therapy is considered one of the most effective approaches to treat multi-drug resistant bacterial pathogens. Infections caused by Staphylococcus aureus are very efficiently controlled with phage cocktails, containing a different individual phages lysate infecting a majority of known pathogenic S. aureus strains. The aim of current study was to investigate the efficiency of a purified phage cocktail for prophylactic as well as therapeutic application in mouse model and in large animals with chronic septic infection of wounds. A total of 150 sewage samples were collected from various livestock farms. These samples were subjected for the isolation of bacteriophage by double agar layer method. A total of 27 sewage samples showed plaque formation by producing lytic activity against S. aureus in double agar overlay method out of 150 sewage samples. In TEM recovered isolates of bacteriophages showed hexagonal structure with tail fiber. In the bacteriophage (ØVS) had an icosahedral symmetry with the head size 52.20 nm in diameter and long tail of 109 nm. Head and tail were held together by connector and can be classified as a member of the Myoviridae family under the order of Caudovirale. Recovered bacteriophage had shown the antibacterial activity against the S. aureus in vitro. Cocktail (ØVS1, ØVS5, ØVS9 and ØVS 27) of phage lysate were tested to know in vivo antibacterial activity as well as the safety profile. Result of mice experiment indicated that the bacteriophage lysate was very safe, did not show any appearance of abscess formation which indicates its safety in living system. The mice were also prophylactically protected against S. aureus when administered with cocktail of bacteriophage lysate just before the administration of S. aureus which indicates that they are good prophylactic agent. The S. aureus inoculated mice were completely recovered by bacteriophage administration with 100% recovery which was very good as compere to conventional therapy. In present study ten chronic cases of wound were treated with phage lysate and follow up of these cases was done regularly up to ten days (at 0, 5 and 10 d). Result indicated that the six cases out of ten showed complete recovery of wounds within 10 d. The efficacy of bacteriophage therapy was found to be 60% which was very good as compared to the conventional antibiotic therapy in chronic septic wounds infections. Thus, the application of lytic phage in single dose proved to be innovative and effective therapy for treatment of septic chronic wounds.

Keywords: phage therapy, phage lysate, antimicrobial resistance, S. aureus

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Authors: Nadhiya N. Subramony, Jenifer Vaughan, Lesley E. Scott

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In South Africa, the World Health Organisation estimated 454000 new cases of Mycobacterium tuberculosis (M.tb) infection (MTB) in 2015. Disseminated tuberculosis arises from the haematogenous spread and seeding of the bacilli in extrapulmonary sites. The gold standard for the detection of MTB in bone marrow is TB culture which has an average turnaround time of 6 weeks. Histological examinations of trephine biopsies to diagnose MTB also have a time delay owing mainly to the 5-7 day processing period prior to microscopic examination. Adding to the diagnostic delay is the non-specific nature of granulomatous inflammation which is the hallmark of MTB involvement of the bone marrow. A Ziehl-Neelson stain (which highlights acid-fast bacilli) is therefore mandatory to confirm the diagnosis but can take up to 3 days for processing and evaluation. Owing to this delay in diagnosis, many patients are lost to follow up or remain untreated whilst results are awaited, thus encouraging the spread of undiagnosed TB. The Xpert® MTB/RIF (Cepheid, Sunnyvale, CA) is the molecular test used in the South African national TB program as the initial diagnostic test for pulmonary TB. This study investigates the optimisation and performance of the Xpert® MTB/RIF on bone marrow aspirate specimens (BMA), a first since the introduction of the assay in the diagnosis of extrapulmonary TB. BMA received for immunophenotypic analysis as part of the investigation into disseminated MTB or in the evaluation of cytopenias in immunocompromised patients were used. Processing BMA on the Xpert® MTB/RIF was optimised to ensure bone marrow in EDTA and heparin did not inhibit the PCR reaction. Inactivated M.tb was spiked into the clinical bone marrow specimen and distilled water (as a control). A volume of 500mcl and an incubation time of 15 minutes with sample reagent were investigated as the processing protocol. A total of 135 BMA specimens had sufficient residual volume for Xpert® MTB/RIF testing however 22 specimens (16.3%) were not included in the final statistical analysis as an adequate trephine biopsy and/or TB culture was not available. Xpert® MTB/RIF testing was not affected by BMA material in the presence of heparin or EDTA, but the overall detection of MTB in BMA was low compared to histology and culture. Sensitivity of the Xpert® MTB/RIF compared to both histology and culture was 8.7% (95% confidence interval (CI): 1.07-28.04%) and sensitivity compared to histology only was 11.1% (95% CI: 1.38-34.7%). Specificity of the Xpert® MTB/RIF was 98.9% (95% CI: 93.9-99.7%). Although the Xpert® MTB/RIF generates a faster result than histology and TB culture and is less expensive than culture and drug susceptibility testing, the low sensitivity of the Xpert® MTB/RIF precludes its use for the diagnosis of MTB in bone marrow aspirate specimens and warrants alternative/additional testing to optimise the assay.

Keywords: bone marrow aspirate , extrapulmonary TB, low sensitivity, Xpert® MTB/RIF

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Authors: Isaac Martin, Abigail Lark, Sandra Morales, Eric W. Alton, Jane C. Davies

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Objectives: The cystic fibrosis (CF) lung is a unique microbiological niche, wherein harmful bacteria persist for many years despite antibiotic therapy. Pseudomonas aeruginosa (Pa), the major culprit leading to lung decline and increased mortality, thrives in the lungs of patients with CF due to several factors that have been linked with poor antibiotic performance. Our group is investigating alternative therapies including bacteriophage cocktails with which we have previously demonstrated efficacy against planktonic organisms. In this study, we explored the effects of a 4-phage cocktail on Pa grown in two different conditions, intended to mirror the CF lung: a) alongside standard antibiotic treatment in pre-formed biofilms (structures formed by Pa-secreted exopolysaccharides which provide both physical and cell division barriers to antimicrobials and host defenses and b) in an acidic environment postulated to be present in the CF airway due both to the primary defect in bicarbonate secretion and secondary effects of inflammation. Methods: 16 Pa strains from CF patients at the Royal Brompton Hospital were selected based on sensitivity to a) ceftazidime/ tobramycin and b) the phage cocktail in a conventional plaque assay. To assess efficacy of phage in biofilms, 96 well plates with Pa (5x10⁷ CFU/ ml) were incubated in static conditions, allowing adherent bacterial colonies to form for 24 hr. Ceftazidime and tobramycin (both at 2 × MIC) were added, +/- bacteriophage (4x10⁸ PFU/mL) for a further 24 hr. Cell viability and biomass were estimated using fluorescent resazurin and crystal violet assays, respectively. To evaluate the effect of pH, strains were grown planktonically in shaking 96 well plates at pH 6.0, 6.6, 7.0 and 7.5 with tobramycin or phage, at varying concentrations. Cell viability was quantified by fluorescent resazurin assay. Results: For the biofilm assay, treatment groups were compared with untreated controls and expressed as percent reduction in cell viability and biomass. Addition of the 4-phage cocktail resulted in a 1.3-fold reduction in cell viability and 1.7-fold reduction in biomass (p < 0.001) when compared to standard antibiotic treatment alone. Notably, there was a 50 ± 15% reduction in cell viability and 60 ± 12% reduction in biomass (95% CI) for the 4 biofilms demonstrating the most resistance to antibiotic treatment. 83% of strains tested (n=6) showed decreased bacterial killing by tobramycin at acidic pHs (p < 0.01). However, 25% of strains (n=12) showed improved phage killing at acidic pHs (p < 0.05), with none showing the pattern of reduced efficacy at acidic pH demonstrated by tobramycin. Conclusion: The 4-phage anti-Pa cocktail tested against Pa performs well in pre-formed biofilms and in acidic environments; two conditions intended to mimic the CF lung. To our knowledge, these are the first data looking at the effects of subtle pH changes on phage-mediated bacterial killing in the context of Pa infection. These findings contribute to a growing body of evidence supporting the use of nebulised lytic bacteriophage as a treatment in the context of lung infection.

Keywords: biofilm, cystic fibrosis, pH, Pseudomonas aeruginosa, lytic bacteriophage

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Authors: Shelley Jones

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Assumptions abound that education for girls will, as a matter of course, lead to their economic empowerment as women; yet. little is known about the ways in which schooling for girls, who traditionally/historically would not have had opportunities for post-primary, or perhaps even primary education – such as the participants in this study based in rural Uganda - in reality, impacts their economic situations. There is a need forlongitudinal studies in which women share experiences, understandings, and reflections of their lives that can inform our knowledge of this. In response, this paper reports on stage four of a longitudinal case study (2004-2018) focused on education and empowerment for girls and women in rural Uganda, in which 13 of the 15 participants from the original study participated. This paper understands empowerment as not simply increased opportunities (e.g., employment) but also real gains in power, freedoms that enable agentive action, and authentic and viable choices/alternatives that offer ‘exit options’ from unsatisfactory situations. As with the other stages, this study used a critical, postmodernist, global feminist ethnographic methodology, multimodal and qualitative data collection. Participants participated in interviews, focus group discussions, and a two-day workshop, which explored their understandings of how/if they understood post-primary education to have contributed to their economic empowerment. A constructivist grounded theory approach was used for data analysis to capture major themes. Findings indicate that although all participants believe that post-primary education provided them with economic opportunities they would not have had otherwise, the parameters of their economic empowerment were severely constrained by historic and extant sociocultural, economic, political, and institutional structures that continue to disempower girls and women, as well as additional financial responsibilities that they assumed to support others. Even though the participants had post-primary education, and they were able to obtain employment or operate their own businesses that they would not likely have been able to do without post-primary education, the majority of the participants’ incomes were not sufficient to elevate them financially above the extreme poverty level, especially as many were single mothers and the sole income earners in their households. Furthermore, most deemed their working conditions unsatisfactory and their positions precarious; they also experienced sexual harassment and abuse in the labour force. Additionally, employment for the participants resulted in a double work burden: long days at work, surrounded by many hours of domestic work at home (which, even if they had spousal partners, still fell almost exclusively to women). In conclusion, although the participants seem to have experienced some increase in economic empowerment, largely due to skills, knowledge, and qualifications gained at the post-primary level, numerous barriers prevented them from maximizing their capabilities and making significant gains in empowerment. There is need, in addition to providing education (primary, secondary, and tertiary) to girls, to address systemic gender inequalities that mitigate against women’s empowerment, as well as opportunities and freedom for women to come together and demand fair pay, reasonable working conditions, and benefits, freedom from gender-based harassment and assault in the workplace, as well as advocate for equal distribution of domestic work as a cultural change.

Keywords: girls' post-primary education, women's empowerment, uganda, employment

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Authors: Md. Wasiul Islam, Md. Jamius Shams Sowrov

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The Sundarbans is the largest single tract of mangrove forest in the world. This is located in the southwest corner of Bangladesh. This is a unique ecosystem which is a great breeding and nursing ground for a great biodiversity. It supports the livelihood of about 3.5 million coastal dwellers and also protects the coastal belt and inland areas from various natural calamities. Historically, the management of the Sundarbans was controlled by the Bangladesh Forest Department following top-down approach without the involvement of local communities. Such fence and fining-based blue-print approach was not effective to protect the forest which caused Sundarbans to degrade severely in the recent past. Fifty percent of the total tree cover has been lost in the last 30 years. Therefore, local multi-stakeholder based bottom-up co-management approach was introduced at some of the parts of the Sundarbans in 2006 to improve the biodiversity status by enhancing the protection level of the forest. Various co-management organizations were introduced under co-management approach where the local community people could actively involve in various activities related to the management and welfare of the Sundarbans including the decision-making process to achieve the goal. From this backdrop, the objective of the study was to assess the performance of co-management organizations to facilitate sustainable management of the Sundarbans mangrove forests. The qualitative study followed face-to-face interview to collect data using two sets of semi-structured questionnaires. A total of 40 respondents participated in the research that was from eight villagers under two forest ranges. 32 representatives from the local communities as well as 8 official representatives involved in co-management approach were interviewed using snowball sampling technique. The study shows that the co-management approach improved governance system of the Sundarbans through active participation of the local community people and their interactions with the officials via the platform of co-management organizations. It facilitated accountability and transparency system to some extent through following some formal and informal rules and regulations. It also improved the power structure of the management process by fostering local empowerment process particularly the women. Moreover, people were able to learn from their interactions with and within the co-management organizations as well as interventions improved environmental awareness and promoted social learning. The respondents considered good governance as the most important factor for achieving the goal of sustainable management and biodiversity conservation of the Sundarbans. The success of co-management planning process also depends on the active and functional participation of different stakeholders including the local communities where co-management organizations were considered as the most functional platform. However, the governance system was also facing various challenges which resulted in barriers to the sustainable management of the Sundarbans mangrove forest. But still there were some members involved in illegal forest operations and created obstacles against sustainable management of the Sundarbans. Respondents recommended greater patronization from the government, financial and logistic incentives for alternative income generation opportunities with effective participatory monitoring and evaluation system to improve sustainable management of the Sundarbans.

Keywords: Bangladesh, co-management approach, co-management organizations, governance, Sundarbans, sustainable management

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Authors: Rupinder Bakshi, Geeta Walia, Anita Gupta

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Introduction: Urinary tract infections (UTI) are considered to be one of the most common bacterial infections with an estimated annual global incidence of 150 million. Antimicrobial drug resistance is one of the major threats due to widespread usage of uncontrolled antibiotics. Materials and Methods: A total number of 9149 urine samples were collected from R.H Patiala and processed in the Department of Microbiology G.M.C Patiala. Urine samples were inoculated on MacConkey’s and blood agar plates by using calibrated loop delivering 0.001 ml of sample and incubated at 37 °C for 24 hrs. The organisms were identified by colony characters, gram’s staining and biochemical reactions. Antimicrobial susceptibility of the isolates was determined against various antimicrobial agents (Hi – Media Mumbai India) by Kirby-Bauer disk diffusion method on Muller Hinton agar plates. Results: Maximum patients were in the age group of 21-30 yrs followed by 31-40 yrs. Males (34%) are less prone to urinary tract infections than females (66%). Out of 9149 urine sample, the culture was positive in 25% (2290) samples. Esch. coli was the most common isolate 60.3% (n = 1378) followed by Klebsiella pneumoniae 13.5% (n = 310), Proteus spp. 9% (n = 209), Staphylococcus aureus 7.6 % (n = 173), Pseudomonas aeruginosa 3.7% (n = 84), Citrobacter spp. 3.1 % (70), Staphylococcus saprophyticus 1.8 % (n = 142), Enterococcus faecalis 0.8%(n=19) and Acinetobacter spp. 0.2%(n=5). Gram negative isolates showed higher sensitivity towards, Piperacillin +Tazobactum (67%), Amikacin (80%), Nitrofurantoin (82%), Aztreonam (100%), Imipenem (100%) and Meropenam (100%) while gram positive showed good response towards Netilmicin (69%), Nitrofurantoin (79%), Linezolid (98%), Vancomycin (100%) and Teicoplanin (100%). 465 (23%) isolates were resistant to Penicillins, 1st generation and 2nd generation Cehalosporins which were further tested by double disk approximation test and combined disk method for ESBL production. Out of 465 isolates, 375 were ESBLs consisting of n 264 (70.6%) Esch.coli and 111 (29.4%) Klebsiella pneumoniae. Susceptibility of ESBL producers to Imipenem, Nitrofurantoin and Amikacin were found to be 100%, 76%, and 75% respectively. Conclusion: Uropathogens are increasingly showing resistance to many antibiotics making empiric management of outpatients UTIs challenging. Ampicillin, Cotrimoxazole, and Ciprofloxacin should not be used in empiric treatment. Nitrofurantoin could be used in lower urinary tract infection. Knowledge of uropathogens and their antimicrobial susceptibility pattern in a geographical region will help inappropriate and judicious antibiotic usage in a health care setup.

Keywords: Urinary Tract Infection, UTI, antibiotic susceptibility pattern, ESBL

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Authors: Georgia Kremmyda, Angelos Georgoulas, Yiannis Koumpouros, James T. Mottram

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There is a growing interest in enhancing the creativity and problem-solving ability of engineering students by expanding their engagement to complex, interdisciplinary problems such as environmental issues, resilience to man-made and natural disasters, global health matters, water needs, increased energy demands, and other global humanitarian challenges. Tackling societal challenges requires knowledgeable and erudite engineers who can handle, combine, transform and create innovative, affordable and sustainable solutions. This view simultaneously complements and challenges current conceptions of an emerging educational movement that, almost without exception, are underpinned by calls for competitive economic growth and technological development. This article reveals a taxonomy of humanitarian attributes to be enabled to professional engineers, through reformed curricula and innovative pedagogies, which once implemented and integrated efficiently in higher engineering education, they will provide students and educators with opportunities to explore interdependencies and connections between resources, sustainable design, societal needs, and the natural environment and to critically engage with implicit and explicit facets of disciplinary identity. The research involves carrying out a study on (a) current practices, best practices and barriers in knowledge organisation, content, and hierarchy in graduate engineering programmes, (b) best practices associated with teaching and research in engineering education around the world, (c) opportunities inherent in general reforms of graduate engineering education and inherent in integrating the humanitarian context throughout engineering education programmes, and, (d) an overarching taxonomy of professional attributes for tackling humanitarian challenges. Research methods involve state-of-the-art literature review on engineering education and pedagogy to resource thematic findings on current status in engineering education worldwide, and qualitative research through three practice dialogue workshops, run in Asia (Vietnam, Indonesia and Bangladesh) involving a variety of national, international and local stakeholders (industries; NGOs, governmental organisations). Findings from this study provide evidence on: (a) what are the professional engineering attributes (skills, experience, knowledge) needed for tackling humanitarian challenges; (b) how we can integrate other disciplines and professions to engineering while defining the professional attributes of engineers who are capable of tackling humanitarian challenges. The attributes will be linked to those discipline(s) and profession(s) that are more likely to enforce the attributes (removing the assumption that engineering education as it stands at the moment can provide all attributes), and; (c) how these attributes shall be supplied; what kind of pedagogies or training shall take place beyond current practices. Acknowledgment: The study is currently in progress and is being undertaken in the framework of the project ENHANCE - ENabling Humanitarian Attributes for Nurturing Community-based Engineering (project No: 598502-EEP-1-2018-1-UK-EPPKA2-CBHE-JP (2018-2582/001-001), funded by the Erasmus + KA2 Cooperation for innovation and the exchange of good practices – Capacity building in the field of Higher Education.

Keywords: professional engineering attributes, engineering education, taxonomy, humanitarian challenges, humanitarian engineering

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Authors: Drishti Sharma, Mona Duggal

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Background: WhatsApp can serve as a cost-effective, scalable, convenient, and popular medium for public health management related communication in the developing world where the existing system of communication is top-down and slow. The product supports sending and receiving a variety of media: text, photos, videos, documents, and location, as well as voice/video calls. With growing number of users of smartphones and improving access and penetration of internet, the scope of information technology remains immense in resolving the hurdles faced by traditional public health system. Poor infrastructure, gap in digital literacy, faulty documentation, strict organizational hierarchy and slow movement of information across desks and offices- all these, make WhatsApp an efficient prospect to complement the existing system for communication, feedback and leadership for public health system in India. Objective: This study investigates the benefits, challenges and limitations associated with WhatsApp usage as a public health management tool. Methods: The study was conducted within the Chandigarh Union Territory. We used a qualitative approach and conducted individual semi-structured interviews and group interviews (n = 10). Participants included medical officers (n 20), Program managers (n = 4), academicians (n=2) and administrators (n=2). Thematic and content qualitative analyses were conducted. Message log of the WhatsApp group of one of the health program was assessed. Results: Medical Officers said that WhatsApp helped them remain in touch with the program officer. They could easily give feedback and highlight those challenges which needed immediate intervention from the program managers, hence they felt supported. Also, the application helped them share pictures of their activities (meetings and field activities) with the group which they thought inspired others and gave themselves immense satisfaction. Also, it helped build stronger relationships and better coordination among themselves, the same being important in team events. For program managers, it had become a portal for coordinating large scale campaigns. Its reach and the fact that the feedback is real-time make WhatsApp ideal for district level events. Though the easy informal connectivity made them answerable to their staff but it also provided them with flexibility in operations. It turned out to be an important portal for sharing outcome and goals related feedback (both positive and negative) to the team. To be sure, using WhatsApp for the purpose of public health program presents considerable challenges, including technological barriers, organizational challenges, gender issues, confidentiality concerns and unplanned aftereffects. Nevertheless, its advantages in a low-cost setting make it an efficient alternative. Conclusion: WhatsApp has become an integral part of our lives. Use of this app for public health program management within closed groups looks promising and useful. At the same time, addressing the challenges involved would make its usage safer.

Keywords: communication, mobile technology, public health management, WhatsApp

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Authors: Sascha E. Oswald, Jan Busch

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The in-situ dechlorination of contamination by chlorinated solvents in groundwater via zero-valent iron (nZVI) is potentially an efficient and prompt remediation method. A key requirement is that nZVI has to be introduced in the subsurface in a way that substantial quantities of the contaminants are actually brought into direct contact with the nZVI in the aquifer. Thus it could be a more flexible and precise alternative to permeable reactive barrier techniques using granular iron. However, nZVI are often limited by fast agglomeration and sedimentation in colloidal suspensions, even more so in the aquifer sediments, which is a handicap for the application to treat source zones or contaminant plumes. Colloid-supported nZVI show promising characteristics to overcome these limitations and Carbo-Iron Colloids is a newly developed composite material aiming for that. The nZVI is built onto finely ground activated carbon of about a micrometer diameter acting as a carrier for it. The Carbo-Iron Colloids are often suspended with a polyanionic stabilizer, and carboxymethyl cellulose is one with good properties for that. We have investigated the transport behavior of Carbo-Iron Colloids (CIC) on different scales and for different conditions to assess its mobility in aquifer sediments as a key property for making its application feasible. The transport properties were tested in one-dimensional laboratory columns, a two-dimensional model aquifer and also an injection experiment in the field. Those experiments were accompanied by non-invasive tomographic investigations of the transport and filtration processes of CIC suspensions. The laboratory experiments showed that a larger part of the CIC can travel at least scales of meters for favorable but realistic conditions. Partly this is even similar to a dissolved tracer. For less favorable conditions this can be much smaller and in all cases a particular fraction of the CIC injected is retained mainly shortly after entering the porous medium. As field experiment a horizontal flow field was established, between two wells with a distance of 5 meters, in a confined, shallow aquifer at a contaminated site in North German lowlands. First a tracer test was performed and a basic model was set up to define the design of the CIC injection experiment. Then CIC suspension was introduced into the aquifer at the injection well while the second well was pumped and samples taken there to observe the breakthrough of CIC. This was based on direct visual inspection and total particle and iron concentrations of water samples analyzed in the laboratory later. It could be concluded that at least 12% of the CIC amount injected reached the extraction well in due course, some of it traveling distances larger than 10 meters in the non-uniform dipole flow field. This demonstrated that these CIC particles have a substantial mobility for reaching larger volumes of a contaminated aquifer and for interacting there by their reactivity with dissolved contaminants in the pore space. Therefore they seem suited well for groundwater remediation by in-situ formation of reactive barriers for chlorinated solvent plumes or even source removal.

Keywords: carbo-iron colloids, chlorinated solvents, in-situ remediation, particle transport, plume treatment

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Authors: Alan Walsh, Peter Walker

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Differences in commercial, professional and personal cultural traditions between western consultants and project sponsors in the Gulf Cooperation Council (GCC) region are potentially significant in the workplace, and this can impact on project outcomes. These cultural differences can, for example, result in conflict amongst senior managers, which can negatively impact the megaproject. New entrants to the GCC often experience ‘culture shock’ as they attempt to integrate into their unfamiliar environments. Megaprojects are unique ventures with individual project characteristics, which need to be considered when managing their associated risks. Megaproject research to date has mostly ignored the significance of the absence of cultural congruence in the GCC, which is surprising considering that there are large volumes of megaprojects in various stages of construction in the GCC. An initial step to dealing with cultural issues is to acknowledge culture as a significant risk factor (SRF). This paper seeks to understand the criticality for western consultants to address these risks. It considers the cultural barriers that exist between GCC sponsors and western consultants and examines the cultural distance between the key actors. Initial findings suggest the presence to a certain extent of ethnocentricity. Other cultural clashes arise out of a lack of appreciation of the customs, practices and traditions of ‘the Other’, such as the need for avoiding public humiliation and the hierarchal significance rankings. The concept and significance of cultural shock as part of the integration process for new arrivals are considered. Culture shock describes the state of anxiety and frustration resulting from the immersion in a culture distinctly different from one's own. There are potentially substantial project risks associated with underestimating the process of cultural integration. This paper examines two distinct but intertwined issues: the societal and professional culture differences associated with expatriate assignments. A case study examines the cultural congruences between GCC sponsors and American, British and German consultants, over a ten-year cycle. This provides indicators as to which nationalities encountered the most profound cultural issues and the nature of these. GCC megaprojects are typically intensive fast track demanding ventures, where consultant turnover is high. The study finds that building trust-filled relationships is key to successful project team integration and therefore, to successful megaproject execution. Findings indicate that both professional and social inclusion processes have steep learning curves. Traditional risk management practice is to approach any uncertainty in a structured way to mitigate the potential impact on project outcomes. This research highlights cultural risk as a significant factor in the management of GCC megaprojects. These risks arising from high staff turnover typically include loss of project knowledge, delays to the project, cost and disruption in replacing staff. This paper calls for cultural risk to be recognised as an SRF, as the first step to developing risk management strategies, and to reduce staff turnover for western consultants in GCC megaprojects.

Keywords: western consultants in megaprojects, national culture impacts on GCC megaprojects, significant risk factors in megaprojects, professional culture in megaprojects

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