Search results for: in vivo assessment.

Authors: Gampel Alexander, Mazzuchi Thomas, Sarkani Shahram

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The cybersecurity landscape is constantly evolving, and organizations must adapt to the changing threat environment to protect their assets. The implementation of the NIST Risk Management Framework (RMF) has become critical in ensuring the security and safety of industrial control and automation systems. However, cybersecurity professionals are facing challenges in implementing RMF, leading to systems operating without authorization and being non-compliant with regulations. The current approach to RMF implementation based on business practices is limited and insufficient, leaving organizations vulnerable to cyberattacks resulting in the loss of personal consumer data and critical infrastructure details. To address these challenges, this research proposes a Model-Based Systems Engineering (MBSE) approach to implementing cybersecurity controls and assessing risk through the RMF process. The study emphasizes the need to shift to a modeling approach, which can streamline the RMF process and eliminate bloated structures that make it difficult to receive an Authorization-To-Operate (ATO). The study focuses on the practical application of MBSE in industrial control and automation systems to improve the security and safety of operations. It is concluded that MBSE can be used to solve the implementation challenges of the NIST RMF process and improve the security of industrial control and automation systems. The research suggests that MBSE provides a more effective and efficient method for implementing cybersecurity controls and assessing risk through the RMF process. The future work for this research involves exploring the broader applicability of MBSE in different industries and domains. The study suggests that the MBSE approach can be applied to other domains beyond industrial control and automation systems.

Keywords: authorization-to-operate (ATO), industrial control systems (ICS), model-based system’s engineering (MBSE), risk management framework (RMF)

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Authors: Zaka Nisa, Farooq Sher

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Adverse drug reactions (ADRs) underreporting is a great challenge to Pharmacovigilance. Health care professionals have to consider ADR reporting as their professional obligation, an effective system of ADR reporting is important to improve patient health care and safety. The present study is designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by health care professionals (physicians and pharmacists) in public and private hospitals of Pakistan. A pretested questionnaire was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude, and practice related to ADR reporting. The data was analyzed using the SPSS statistical software, the factors which encourage and discourage respondents in reporting ADRs were determined. Most of the respondents have shown a positive attitude towards ADR reporting. The response rate was 95.32%. Of the 367 questionnaires, including 333 (86.5%) physicians and 34 (8.8%) pharmacists with the mean age 28.34 (SD= 6.69), most of the respondents showed poor ADR reporting knowledge (83.1%). The majority of respondents (78.2%) showed positive attitude towards ADR reporting and only (12.3%) hospitals have good ADR reporting practice. Knowledge of respondents in public hospitals (8.6%) was less as compare to those in the private hospitals (29.7%) (P < 0.001). Attitude of respondents in private hospitals was more positive (92.4%) than those in public hospitals (68.8%) (P < 0.001). No significant difference was observed in practicing of ADR reporting in public (11.8%) and private hospitals (13.1%) (P value 0.89). Seriousness of ADR, unusualness of reaction, new drug involvement and confidence in diagnosis of ADR were the factors which encourage respondents to report ADR, however, lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patients was more important than reporting ADR, legal liability issues were the factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However positive attitude was seen regarding ADR reporting. There is a need of educational training for health care professionals as well as genuine and continuous efforts are required by Government and health authorities to ensure the proper implementation of ADR reporting system in all of the hospitals.

Keywords: adverse drugs reactions (ADR), pharmacovigilance, spontaneous ADR reporting, knowledge of ADR, attitude of health care profesionals, practice of ADR reporting

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Authors: Muhammad Tayyab Afzal, Muhammad Arslan, Mirza Muhammad Waqar

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One of the key components of the water cycle is evapotranspiration (ET), which represents water consumption by vegetated and non-vegetated surfaces. Conventional techniques for measurements of ET are point based and representative of the local scale only. Satellite remote sensing data with large area coverage and high temporal frequency provide representative measurements of several relevant biophysical parameters required for estimation of ET at regional scales. The objective is of this research is to exploit satellite data in order to estimate evapotranspiration. This study uses Surface Energy Balance System (SEBS) model to calculate daily actual evapotranspiration (ETa) in Larkana District, Sindh Pakistan using Landsat TM data for clouds-free days. As there is no flux tower in the study area for direct measurement of latent heat flux or evapotranspiration and sensible heat flux, therefore, the model estimated values of ET were compared with reference evapotranspiration (ETo) computed by FAO-56 Penman Monteith Method using meteorological data. For a country like Pakistan, agriculture by irrigation in the river basins is the largest user of fresh water. For the better assessment and management of irrigation water requirement, the estimation of consumptive use of water for agriculture is very important because it is the main consumer of water. ET is yet an essential issue of water imbalance due to major loss of irrigation water and precipitation on cropland. As large amount of irrigated water is lost through ET, therefore its accurate estimation can be helpful for efficient management of irrigation water. Results of this study can be used to analyse surface conditions, i.e. temperature, energy budgets and relevant characteristics. Through this information we can monitor vegetation health and suitable agricultural conditions and can take controlling steps to increase agriculture production.

Keywords: SEBS, remote sensing, evapotranspiration, ETa

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Authors: Wen-Ting Wang, Wei-An Tsai, Rong-Hong Hsieh

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Long term taking high fat diet can lead to over production of energy, result in accumulation of body fat, dyslipidemia and increased lipid metabolism in the body. Over metabolism of lipid results in excessive reactive oxygen species and oxidative stress, may also cause mitochondrial dysfunction and cell death. Krill oil, fish oil and linseed oil are good sources of n-3 polyunsaturated fatty acids (PUFA). The present study investigated the effect of high fat diet and various oil rich of n-3 fatty acids on mitochondrial function and cell membrane composition. Six-weeks old male Spraque-Dawley rats were randomly divided into 8 groups including: control group, high fat diet group, low dosage and high dosage krill oil group, low dosage and high dosage fish oil group, and low dosage and high dosage linseed oil group. After 12 weeks of experimental period, the low dosage krill oil, fish oil group and linseed oil group with different dosage prevented mitochondrial dysfunction caused by high fat diet. The supplementation of different oils increased plasma, erythrocyte and mitochondrial n-3/n-6 ratio and further increased the proportion of PUFA in erythrocyte and mitochondrial membrane. It also decreased serum triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) concentration. However, there was no significant change in serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), biomarker of liver function, glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and plasma malonadialdehyde (MDA) concentration when compared with high fat diet group. The supplementation of different sources of n-3 PUFA can maintain mitochondrial function and modulate cell membrane fatty acid composition in high fat diet conditions, and there is a positive relationship between mitochondrial function and mitochondrial membrane composition.

Keywords: fish oil, linseed oil, mitochondria, n-3 PUFA

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Authors: Gulnaz Erkomaishvili

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Introduction. One of the most important issues of state economic policy in the 21st century is the problem of environmental protection. The Georgian government considers the green economy as one of the most important means of sustainable economic development and takes the initiative to implement voluntary measures to promote sustainable development. In this context, it is important to promote the development of ecosystem services, clean production, environmental education and green jobs.The development of the green economy significantly reduces the inefficient use of natural resources, waste generation, emissions into the atmosphere and the discharge of untreated water into bodies of water.It is, therefore, an important instrument in the environmental orientation of sustainable development. Objectives.The aim of the paper is to analyze the current status of the green economy in Georgia and identify effective ways to improve the environmental, economic policy of sustainable development. Methodologies: This paper uses general and specific methods, in particular, analysis, synthesis, induction, deduction, scientific abstraction, comparative and statistical methods, as well as experts’ evaluation. bibliographic research of scientific works and reports of organizations was conducted; Publications of the National Statistics Office of Georgia are used to determine the regularity between analytical and statistical estimations. Also, theoretical and applied research of international organizations and scientist-economists are used. Contributions: The country should implement such an economic policy that ensures the transition to a green economy, in particular, revising water, air and waste laws, strengthening existing environmental management tools and introcing new tools (including economic tools). Perfecting the regulatory legal framework of the environmental impact assessment system, which includes the harmonization of Georgian legislation with the requirements of the European Union. To ensure the protection and rational use of Georgia's forests, emphasis should be placed on sustainable forestry, protection and restoration of forests.

Keywords: green economy, environmental protection, environmental protection economic policy, environmental protection policy challanges

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Authors: I. Gusti Agung Aditya Surya Wibawa, Andri Syafriya, Beiruny Syam

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Gumai Formation which acts as regional seal for Talang Akar Formation becomes one of the most prolific reservoir in South Sumatra Basin and the primary exploration target in this area. Marine conditions were eventually established during the continuation of transgression sequence leads an open marine facies deposition in Early Miocene. Marine clastic deposits where calcareous shales, claystone and siltstones interbedded with fine-grained calcareous and glauconitic sandstones are the domination of lithology which targeted as the hydrocarbon reservoir. All this time, the main objective of PetroChina’s exploration and production in Betara area is only from Lower Talang Akar Formation. Successful testing in some exploration wells which flowed gas & condensate from Gumai Formation, opened the opportunity to optimize new reservoir objective in Betara area. Limitation of conventional wireline logs data in Gumai interval is generating technical challenge in term of geological approach. A utilization of Gas While Drilling indicator initiated with the objective to determine the next Gumai reservoir candidate which capable to increase Jabung hydrocarbon discoveries. This paper describes how Gas While Drilling indicator is processed to generate potential and non-potential zone by cut-off analysis. Validation which performed by correlation and comparison with well logs, Drill Stem Test (DST), and Reservoir Performance Monitor (RPM) data succeed to observe Gumai reservoir in Betara Complex. After we integrated all of data, we are able to generate a Betara Complex potential map and overlaid with reservoir characterization distribution as a part of risk assessment in term of potential zone presence. Mud log utilization and geophysical data information successfully covered the geological challenges in this study.

Keywords: Gumai, gas while drilling, classification, reservoir, potential

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Authors: Norzaliza Md. Nor, Sh-Hussain Salleh, Mahyar Hamedi, Hadrina Hussain, Wahab Abdul Rahman

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Motivational factor is mainly the students’ desire to involve in learning process. However, it also depends on the goal towards their involvement or non-involvement in academic activity. Even though, the students’ motivation might be in the same level, but the basis of their motivation may differ. In this study, it focuses on the intrinsic motivational factor which student enjoy learning or feeling of accomplishment the activity or study for its own sake. The intrinsic motivational factor of students in learning mathematics and science has found as difficult to be achieved because it depends on students’ interest. In the Program for International Student Assessment (PISA) for mathematics and science, Malaysia is ranked as third lowest. The main problem in Malaysian educational system, students tend to have extrinsic motivation which they have to score in exam in order to achieve a good result and enrolled as university students. The use of electroencephalogram (EEG) signals has found to be scarce especially to identify the students’ intrinsic motivational factor in learning science and mathematics. In this research study, we are identifying the correlation between precursor emotion and its dynamic emotion to verify the intrinsic motivational factor of students in learning mathematics and science. The 2-D Affective Space Model (ASM) was used in this research in order to identify the relationship of precursor emotion and its dynamic emotion based on the four basic emotions, happy, calm, fear and sad. These four basic emotions are required to be used as reference stimuli. Then, in order to capture the brain waves, EEG device was used, while Mel Frequency Cepstral Coefficient (MFCC) was adopted to be used for extracting the features before it will be feed to Multilayer Perceptron (MLP) to classify the valence and arousal axes for the ASM. The results show that the precursor emotion had an influence the dynamic emotions and it identifies that most students have no interest in mathematics and science according to the negative emotion (sad and fear) appear in the EEG signals. We hope that these results can help us further relate the behavior and intrinsic motivational factor of students towards learning of mathematics and science.

Keywords: EEG, MLP, MFCC, intrinsic motivational factor

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Authors: Pinna Beatrice., Laini Alex, Negro Giovanni, Burgazzi Gemma, Viaroli Pierluigi, Vezza Paolo

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Habitat models rarely consider macroinvertebrates as ecological targets in rivers. Available approaches mainly focus on single macroinvertebrate species, not addressing the ecological needs and functionality of the entire community. This research aimed to provide an approach to model the habitat of the macroinvertebrate community. The approach is based on the recently developed Flow-T index, together with a Random Forest (RF) regression, which is employed to apply the Flow-T index at the meso-habitat scale. Using different datasets gathered from both field data collection and 2D hydrodynamic simulations, the model has been calibrated in the Trebbia river (2019 campaign), and then validated in the Trebbia, Taro, and Enza rivers (2020 campaign). The three rivers are characterized by a braiding morphology, gravel riverbeds, and summer low flows. The RF model selected 12 mesohabitat descriptors as important for the macroinvertebrate community. These descriptors belong to different frequency classes of water depth, flow velocity, substrate grain size, and connectivity to the main river channel. The cross-validation R² coefficient (R²𝒸ᵥ) of the training dataset is 0.71 for the Trebbia River (2019), whereas the R² coefficient for the validation datasets (Trebbia, Taro, and Enza Rivers 2020) is 0.63. The agreement between the simulated results and the experimental data shows sufficient accuracy and reliability. The outcomes of the study reveal that the model can identify the ecological response of the macroinvertebrate community to possible flow regime alterations and to possible river morphological modifications. Lastly, the proposed approach allows extending the MesoHABSIM methodology, widely used for the fish habitat assessment, to a different ecological target community. Further applications of the approach can be related to flow design in both perennial and non-perennial rivers, including river reaches in which fish fauna is absent.

Keywords: ecological flows, macroinvertebrate community, mesohabitat, river habitat modeling

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Authors: Afaf Manzoor, Abdul Hameed

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Children with hearing impairment face several challenges in accessing primary and secondary education in general and higher education in particular in Pakistan. A large number of these children are excluded from formal education system through segregated special institutions. The enrollment rate of these children at school level is very low and it continues decreasing as they move on the ladder of education. Negligible number of students with hearing impairment gets any chance to be enrolled at tertiary or higher education institutes. The segregated system of education at primary and secondary level makes it even more difficult to adjust in an inclusive classroom at a higher level not only for students with hearing impairment but for their teachers and peers as well. A false belief of teachers and parents about low academic profile of students with hearing impairment is one of the major challenges to overcome for their participation at higher education. This case study was conducted to document an innovative step taken by the Department of Special Education Needs, University of Management & Technology, Lahore Pakistan. The prime objective of this study was to assess the satisfaction level of students with hearing impairment in BS 4 Years and MA Special Education programs at Lahore campus. Structured interviews were of 40 students with hearing impairment to assess the satisfaction on service delivery (admission process, classroom pedagogy, content, assessment/results, access to other services centers i.e. library, cafeteria, hostel, co-curricular activities) and campus life. Their peers without disabilities were also interviewed to assess their acceptance level. The findings of the study revealed positive results about their educational as well as social inclusion in the university. The students also shared their fears at the time of admission and how fear eventually faded out with the passage of time due to the proper academic support system. The findings of the study will be shared in detail with the audience during the presentation.

Keywords: students with hearing impairment, higher education, inclusive education, marginalization

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Authors: Apoorva Bamal, Agnieszka Indiana Olbert

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Floods are known to be one of the most devastating hydro-climatic events, impacting a wide range of stakeholders in terms of environmental, social and economic losses. With difference in inundation durations and level of impact, flood hazards are of different degrees and strength. Amongst various set of domains being impacted by floods, environmental degradation in terms of water quality deterioration is one of the majorly effected but less highlighted domains across the world. The degraded water quality is caused by numerous natural and anthropogenic factors that are both point and non-point sources of pollution. Therefore, it is essential to understand the nature and source of the water pollution due to flooding. The major impact of floods is not only on the physico-chemical water quality parameters, but also on the biological elements leading to a vivid influence on the aquatic ecosystem. This deteriorated water quality is impacting many water categories viz. agriculture, drinking water, aquatic habitat, and miscellaneous services requiring an appropriate water quality to survive. This study identifies, reviews, evaluates and assesses multiple researches done across the world to determine the impact of floods on water quality. With a detailed statistical analysis of top relevant researches, this study is a synopsis of the methods used in assessment of impact of floods on water quality in different geographies, and identifying the gaps for further abridgement. As per majority of the studies, different flood magnitudes have varied impact on the water quality parameters leading to either increased or decreased values as compared to the recommended values for various categories. There is also an evident shift of the biological elements in the impacted waters leading to a change in its phenology and inhabitants of the specified water body. This physical, chemical and biological water quality degradation by floods is dependent upon its duration, extent, magnitude and flow direction. Therefore, this research provides an overview into the multiple impacts of floods on water quality, along with a roadmap of way forward to an efficient and uniform linkage of floods and impacted water quality dynamics.

Keywords: floods, statistical analysis, water pollution, water quality

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Authors: Ramin Zargarbashi, Hamid Rabie, Behnam Panjavi, Hooman Kamran, Seyedarad Mosalamiaghili, Zohre Erfani, Seyed Peyman Mirghaderi, Maryam Salimi

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Background: Posterior shoulder dislocation is one of the disabling complications of brachial plexus birth injury (BPBI), and various treatment options, including capsule and surrounding muscles release for open reduction, humeral derotational osteotomy, and tendon transfers, have been recommended to manage it. In the present study, we aimed to determine the clinical outcome of open reduction with soft tissue release, tendon transfer, and glenoid osteotomy inpatients with BPBI and posterior shoulder dislocation or subluxation. Methods: From 2018 to 2020, 33 patients that underwent open reduction, glenoid osteotomy, and tendon transfer were included. The glenohumeral deformity was classified according to the Waters radiographic classification. Functional assessment was performed using the Mallet grading system before and at least two years after the surgery. Results: The patients were monitored for 26.88± 5.47 months. Their average age was 27.5±14 months. Significant improvement was seen in the overall Mallet score (from 13.5 to 18.91 points) and its segments, including hand to mouth, hand to the neck, global abduction, global external rotation, abduction degree, and external rotation degree. Hand-to-back score and the presence of trumpet sign were significantly decreased in the post-operation phase (all p values<0.001). The above-mentioned variables significantly changed for both infantile and non-infantile dislocations. Conclusion: Our study demonstrated that open reduction along with glenoid osteotomy improves retroversion, and muscle strengthening with different muscle transfers is an effective technique for BPBI.

Keywords: birth injuries, nerve injury, brachial plexus birth palsy, Erb palsy, tendon transfer

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Authors: Vivianne Aggestam

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Purpose: Organic dairy products have steadily increased with consumer popularity in recent years in Sweden, permitting more transport activities. The main aim of this study was to compare the transport costs and the environmental emissions made by the organic and conventional dairy production in Sweden. The objective was to evaluate differences and environmental impacts of transport between the two different production systems, allowing a more transparent understanding of the real impact of transport within the supply chain. Methods: A partial attributional Life Cycle Assessment has been conducted based on a comprehensive survey of Swedish farmers, dairies and consumers regarding their transport needs and costs. Interviews addressed the farmers and dairies. Consumers were targeted through an online survey. Results: Higher transport inputs from conventional dairy transportation are mainly via feed and soil management on farm level. The regional organic milk brand illustrate less initial transport burdens on farm level, however, after leaving the farm, it had equal or higher transportation requirements. This was mainly due to the location of the dairy farm and shorter product expiry dates, which requires more frequent retail deliveries. Organic consumers tend to use public transport more than private vehicles. Consumers using private vehicles for shopping trips primarily bought conventional products for which price was the main deciding factor. Conclusions: Organic dairy products that emphasise its regional attributes do not ensure less transportation and may therefore not be a more “climate smart” option for the consumer. This suggests that the idea of localism needs to be analysed from a more systemic perspective. Fuel and regional feed efficiency can be further implemented, mainly via fuel type and the types of vehicles used for transport.

Keywords: supply chains, distribution, transportation, organic food productions, conventional food production, agricultural fossil fuel use

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Authors: S. P. Rana

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Objectives: For the manufacture of a very thin strip or a strip with a high-quality finish, the stainless steel sheet that is called billet is re-rolled in re-rolling mill to make stainless steel sheet of 18 gauges. The rolls of re-rolling mill exert tremendous pressure over the sheet and there is likely chance of breaking of stainless steel strip from the sheet. The objective of the study was to minimise the number of accidents in steel re-rolling mills due to ejection of stainless steel strip and to minimize the pollution caused by the pickling process used in these units. Methods: Looking into the high rate of frequency and severity of accidents as well as pollution hazard in re-rolling and pickling mills, it becomes essential to make necessary arrangements for prevention of accidents in such type of industry. The author carried out survey/inspections of a large number of re-rolling and pickling mills and allied units. During the course of inspection, the working of these steel re-rolling and pickling mills was closely studied and monitored. A number of accidents involving re-rolling mills were investigated and subsequently remedial measures to prevent the occurrence of such accidents were suggested. Assessment of occupational safety and health system of these units was carried out and compliance level of the statutory requirements was checked. The workers were medically examined and monitored to ascertain their health conditions. Results: Proper use of safety gadgets by workers, machine guarding and regular training brought down the risk to an acceptable level and discharged effluent pollution was brought down to permissible limits. The fatal accidents have been reduced by 83%. Conclusions: Effective enforcement and implementation of the directions/suggestions given to the managements of such units brought down the no. of accidents to a rational level. The number of fatal accidents has reduced by 83% during the study period. The effective implementation of pollution control device curtailed the pollution level to an acceptable level.

Keywords: re-rolling mill, hazard, accident, health hazards

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Authors: Nagwa E. Abd Elazim, Maha S. El-naggar, Rania H. Mohamed, Sara M. Awad

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Background: Radiodermatitis is a common side effect of radiation therapy for breast cancer. However, there is no current consensus about effective standard therapy for the prevention and management of radiation dermatitis. Topical ectoine has demonstrated efficacy in the treatment of atopic dermatitis owing to its anti-inflammatory activity. Objective: To evaluate the efficacy of topical ectoine in comparison to traditional topical dexpanthenol treatment in the management of acute radiodermatitis in breast cancer patients undergoing adjuvant radiotherapy. Methods: Fifty patients were randomized to use either dexpanthenol 0.5% cream (25 patients), or ectoin 7% cream (25 patients), applied twice daily to the irradiated area during the radiation period and continued for 2 weeks after cessation of radiotherapy. Assessment of radiation skin toxicity using Common Terminology Criteria of Adverse Events (CTCAE) v4.0, radiation-associated symptoms, and adverse events were undertaken weekly during radiotherapy and 2 weeks after the end of radiotherapy. Results: Topical ectoine showed some clinical benefit over dexpanthenol, as shown by delayed time to onset (at week 3 versus week 2, respectively) and larger number of patients who reached grade 0 at the end of treatment (64% vs. 48%, respectively). The clinical symptoms of pain (p = 0.003) and itching (p = 0.001) attributable to radiation were less pronounced with ectoine than with dexpanthenol. Burning and hyperpigmentation were the most common side effects with ectoine. However, no significant difference between dexpanthenol and ectoine treatments was found in any of the side effects (p = 0.1). Conclusion: Ectoin was overall more effective in improving radiation dermatitis than topical dexpanthenol in breast cancer patients. Ectoin could be proposed as a preventive or curative treatment for patients undergoing postoperative irradiation for breast cancer. Further clinical studies with a larger number of patients are recommended for the confirmation of these preliminary results.

Keywords: breast cancer, dexapanthenol, ectoin, radiation dermatitis

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Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

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Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: endometrial cancer, FIGO grade, lymphadenectomy, tumor size

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Authors: Jonathan A. Akinwale, Ibukun J. Agotola

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There is a need to rethink how technology is being disseminated to end users in order to ensure wide adoption and utilisation. Aflasafe bio-control was developed to combat aflatoxin in maize to ensure food safety for the end users. This study was designed to assess how the pull mechanism is enhancing the utilisation of this proven technology among maize farmers in Oyo State, Nigeria. The study determines the awareness of farmers on Aflasafe, sources of purchase of Aflasafe, incentives towards the usage of Aflasafe, constraints to farmers’ utilisation and factors influencing farmers’ utilisation of Aflasafe bio-control measures. Respondents were selected using a multi-stage sampling procedure. Data were collected from respondents through interview schedule and analyzed using descriptive statistics (means, frequencies, and percentages) and inferential statistics (Pearson Product Moment Correlation and regression analysis). The result showed that 89% of the farmers indicated implementers as the outlet for the purchase of Aflasafe. Also, premium payment and provision of technical assistance were the highly ranked incentives to the utilisation of Aflasafe among the farmers. The study also revealed that the major constraints face by respondents were low access to credit facility, inadequate sources of purchase, and lack of storage facilities. A little above half (54%) of the farmers were found to have fully utilized Aflasafe in maize production. Pearson Product Moment Correlation (PPMC) analysis revealed that there was a significant correlation between incentives and utilisation of Aflasafe (r-value=0.274; p ≤ 0.01). The result of the regression analysis indicated maize production experience (β=0.572), output (β=0.531), years of formal education (β=0.404) and household size (β=0.391) as the leading factors influencing farmers utilisation of Aflasafe bio-control in maize production. The study, therefore, recommends that governments and non-governmental organisations should be interested in making Aflasafe available to the maize farmers either through loan provision or price subsidy.

Keywords: Aflasafe bio-control, maize production, production incentives, pull mechanism, utilisation

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Authors: Sherif Fayez Lewis Ghaly

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up to datefacupupdated planning has the mission of designing merchandise, plant life, procedures, enterprise, regions, and the development of a up to date. The requirements for up-to-date planning and the constructing of a updated have changed in recent years. everyday restructuring is turning inupupdated greater essential up-to-date hold the competitiveness of a manufacturing facilityupdated. restrictions in new regions, shorter existence cycles of product and manufacturing generation up-to-date a VUCA global (Volatility, Uncertainty, Complexity & Ambiguity) up-to-date greater frequent restructuring measures inside a manufacturing facilityupdated. A virtual up-to-date model is the making plans basis for rebuilding measures and up-to-date an fundamental up-to-date. short-time period rescheduling can now not be handled through on-web site inspections and manual measurements. The tight time schedules require 3177227fc5dac36e3e5ae6cd5820dcaa making plans fashions. updated the high variation fee of facup-to-dateries defined above, a method for rescheduling facupdatedries on the idea of a modern-day digital up to datery dual is conceived and designed for sensible software in updated restructuring projects. the point of interest is on rebuild approaches. The purpose is up-to-date preserve the planning basis (virtual up-to-date model) for conversions within a up to datefacupupdated updated. This calls for the application of a methodology that reduces the deficits of present techniques. The goal is up-to-date how a digital up to datery version may be up to date up to date during ongoing up to date operation. a method up-to-date on phoup to dategrammetry technology is presented. the focus is on developing a easy and fee-powerful up to date tune the numerous adjustments that arise in a manufacturing unit constructing in the course of operation. The method is preceded with the aid of a hardware and software assessment up-to-date become aware of the most cost effective and quickest version.

Keywords: building information modeling, digital factory model, factory planning, maintenance digital factory model, photogrammetry, restructuring

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Authors: Kate E Morris, Mark Sumner, Mark Taylor, Amanda Joynes, Yue Guo

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Garment durability, which encompasses physical and emotional factors, has been identified as a critical ingredient in producing clothing with increased lifespans, battling overconsumption, and subsequently tackling the catastrophic effects of climate change. Eco-design for Sustainable Products Regulation (ESPR) and Extended Producer Responsibility (EPR) schemes have been suggested and will be implemented across Europe and the UK which might require brands to declare a garment’s durability credentials to be able to sell in that market. There is currently no consistent method of measuring the overall durability of a garment. Measuring the physical durability of garments is difficult and current assessment methods lack objectivity and reliability or don’t reflect the complex nature of durability for different garment categories. This study presents a novel and reproducible methodology for testing and ranking the absolute durability of 5 commercially available garment types, Formal Trousers, Casual Trousers, Denim Jeans, Casual Leggings and Underwear. A total of 112 garments from 21 UK brands were assessed. Due to variations in end use, different factors were considered across the different garment categories when evaluating durability. A physical testing protocol was created, tailored to each category, to dictate the necessary test results needed to measure the absolute durability of the garments. Multiple durability factors were used to modulate the ranking as opposed to previous studies which only reported on single factors to evaluate durability. The garments in this study were donated by the signatories of the Waste Resource Action Programme’s (WRAP) Textile 2030 initiative as part of their strategy to reduce the environmental impact of UK fashion. This methodology presents a consistent system for brands and policymakers to follow to measure and rank various garment type’s physical durability. Furthermore, with such a methodology, the durability of garments can be measured and new standards for improving durability can be created to enhance utilisation and improve the sustainability of the clothing on the market.

Keywords: circularity, durability, garment testing, ranking

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Authors: Nasir Ashraf, Sajid Rahid Ahmad, Adeel Ahmad

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Pakistan is a major tea consumer country and ranked as the third largest importer of tea worldwide. Out of all beverage consumed in Pakistan, tea is the one with most demand for which tea import is inevitable. Being an agrarian country, Pakistan should cultivate its own tea and save the millions of dollars cost from tea import. So the need is to identify the most suitable areas with favorable weather condition and suitable soils where tea can be planted. This research is conducted over District Mansehra and District Abbottabad in Khyber Pakhtoonkhwah Province of Pakistan where the most favorable conditions for tea cultivation already exist and National Tea Research Institute has done successful experiments to cultivate high quality tea. High tech approach is adopted to meet the objectives of this research by using the remotely sensed data i.e. Aster DEM, Landsat8 Imagery. The Remote Sensing data was processed in Erdas Imagine, Envi and further analyzed in ESRI ArcGIS spatial analyst for final results and representation of result data in map layouts. Integration of remote sensing data with GIS provided the perfect suitability analysis. The results showed that out of all study area, 13.4% area is highly suitable while 33.44% area is suitable for tea plantation. The result of this research is an impressive GIS based outcome and structured format of data for the agriculture planners and Tea growers. Identification of suitable tea growing areas by using remotely sensed data and GIS techniques is a pressing need for the country. Analysis of this research lets the planners to address variety of action plans in an economical and scientific manner which can lead tea production in Pakistan to meet demand. This geomatics based model and approach may be used to identify more areas for tea cultivation to meet our demand which we can reduce by planting our own tea, and our country can be independent in tea production.

Keywords: agrarian country, GIS, geoinformatics, suitability analysis, remote sensing

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Authors: Ruichong Zhang, Fadi Sawaged, Lotfi Gargab

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This paper introduces a wave-based approach for system identification of high-rise building structures with a pair of seismic recordings, which can be used to evaluate structural integrity and detect damage in post-earthquake structural condition assessment. The fundamental of the approach is based on wave features of generalized impulse and frequency response functions (GIRF and GFRF), i.e., wave responses at one structural location to an impulsive motion at another reference location in time and frequency domains respectively. With a pair of seismic recordings at the two locations, GFRF is obtainable as Fourier spectral ratio of the two recordings, and GIRF is then found with the inverse Fourier transformation of GFRF. With an appropriate continuous model for the structure, a closed-form solution of GFRF, and subsequent GIRF, can also be found in terms of wave transmission and reflection coefficients, which are related to structural physical properties above the impulse location. Matching the two sets of GFRF and/or GIRF from recordings and the model helps identify structural parameters such as wave velocity or shear modulus. For illustration, this study examines ten-story Millikan Library in Pasadena, California with recordings of Yorba Linda earthquake of September 3, 2002. The building is modelled as piecewise continuous layers, with which GFRF is derived as function of such building parameters as impedance, cross-sectional area, and damping. GIRF can then be found in closed form for some special cases and numerically in general. Not only does this study reveal the influential factors of building parameters in wave features of GIRF and GRFR, it also shows some system-identification results, which are consistent with other vibration- and wave-based results. Finally, this paper discusses the effectiveness of the proposed model in system identification.

Keywords: wave-based approach, seismic responses of buildings, wave propagation in structures, construction

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Authors: Chao Ma

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In this paper, the evaluation criteria of authenticity evaluation system model are taken as the foundation so as to discuss the establishment problems about decentralization supervision system and mechanism of historical cultural town and village. The filtration of fitting towns and village's authenticity is conducted from the level, characteristic index and authentic assessment of evaluation model, thereby, supervising subject -interest related- coordinate organization can be taken as the venation in the management level, thus supervision mechanism of town and village's cultural inheritance can be combed, and the cultural inheritance management system and mechanism which is suitable to historical and cultural Chinese town and village will be provided. As the settlement with strong self-organizing characteristic, town and village don't recognize the management system as deeply as city. Therefore, it is necessary to establish town and village cultural evaluation system based on authenticity evaluation criteria. In this paper, authenticity evaluation system is established by taking this village's value evaluation criteria and protection as the cores, and the classification of participating options is beneficial to distribute local limited resources, protect hierarchically and accord with the local characters of town and village, build the evaluation system to run through the whole process of cultural inheritance, moreover, provide abundant information resources and make sure the value judgment criteria, thus supervision and management can be strengthened to effectively guard risk. By the above judgement and filtration of participating options, the management object with clear functions and supervision and coordination organization are established, thereby, the managerial logic of interest-related persons' decentralization can be clarified, evaluation system can be established, and the more targeted decentralization supervision system and mechanism of historical and cultural village will be built ultimately. Taking this method as a fundamental in cultural protection of town and village, not only can it be carried forward in the mass media, but also can cultivate the identity sense of indigenous people to come back historical and cultural villages, and resist the replacement of city culture.

Keywords: authenticity, rural culture, inheritance, supervision

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Authors: Farzaneh Tahmoorian, Bijan Samali, John Yeaman

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Road networks are expanding all over the world during the past few decades to meet the increasing freight volumes created by the population growth and industrial development. At the same time, the rate of generation of solid wastes in the society is increasing with the population growth, technological development, and changes in the lifestyle of people. Thus, the management of solid wastes has become an acute problem. Accordingly, there is a need for greater efficiency in the construction and maintenance of road networks, in reducing the overall cost, especially the utilization of natural materials such as aggregates. An efficient means to reduce construction and maintenance costs of road networks is to replace natural (virgin) materials by secondary, recycled materials. Recycling will also help to reduce pressure on landfills and demand for extraction of natural virgin materials thus ensuring sustainability. Application of solid wastes in asphalt layer reduces not only environmental issues associated with waste disposal but also the demand for virgin materials which will subsequently result in sustainability. Therefore, this research aims to investigate the feasibility of the application of some of the waste materials such as glass, construction and demolition wastes, etc. as alternative materials in pavement construction, particularly flexible pavements. To this end, various combination of different waste materials in certain percentages is considered in designing the asphalt mixture. One of the goals of this research is to determine the optimum percentage of all these materials in the mixture. This is done through a series of tests to evaluate the volumetric properties and resilient modulus of the mixture. The information and data collected from these tests are used to select the adequate samples for further assessment through advanced tests such as triaxial dynamic test and fatigue test, in order to investigate the asphalt mixture resistance to permanent deformation and also cracking. This paper presents the results of these investigations on the application of waste materials in asphalt mixture for production of a sustainable asphalt mix.

Keywords: asphalt, glass, pavement, recycled aggregate, sustainability

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Authors: Nurul Azmawati Mohamed, Zarini Ismail, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, K. Omar

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Choosing a career is one of the most important decisions in our life. A right career leads a person to grow with that career and achieve success through the decision. Thus, career suitability assessment is important to help individuals to understand how a variety of personal attributes can impact their potential success and satisfaction with different career options and work environments. Some career needs specific personality trait that relates to attributes of job requirements and commitments. For medicine, being caring, approachable, inquisitive, able to listen and understand patients’ pain, anxiety and sorrow are important. The aim of this study was to evaluate the career suitability of pre-clinical students. This was a cross sectional study conducted among pre-clinical medical students in Universiti Sains Islam Malaysia. 'Sidek Career Interest Inventory’ was used to assess the students’ suitability for the course. This instrument had been validated locally to suit the local social and cultural context. It assessed the students’ personality trait based on Holland’s theory and their interests. For students to pursue in the medical course, two main personality trait are believed to be essential namely investigative and social trait personalities. Some of the characteristics of investigative trait are analytical, rational, intellectual and curious, while the characteristics of social trait personality include empathy, friendly, understanding and accommodating. The score for each personality trait were categorized as low (0-3.99), moderate (4-6.99) and high (7-10). A total of 81 pre-clinical medical students were included in this study. About two third (93.8%) of them were female and all of them are from 20 to 21 of age. Approximately, half of the students (47.5%) scored high and another 46.3% scored moderate for investigative trait. For social trait, only 13.8% scored high while 31.3% scored moderate. Only 12.5% (10) students had high scores for both investigative and social traits. Most of the pre-clinical medical students scored high in the investigative sections, however their social values were inadequate (low scores). For them to become good medical doctors, they should be good in both investigative and social skills to enhance their suitability for this career. Therefore, there is a need to nurture these medical students with appropriate social values and soft skills.

Keywords: career suitability, career interest, medical students, personality trait

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Authors: Bisi Olawoyin

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The idea of knowledge sharing facilitated by the internet and complemented by a collaborative offline process in form of shared workshops called Makerspaces has become an attractive economic development agenda worldwide. Towards this end, Nigeria has established a number of Technology Incubation Centers (TICs) across the country with a view to using them as institutional mechanisms for commercializing Research and Development results; thus helping to promote venture creation and economic development. This study thus examines the impact of the nurturing by the TICs, on the performance of selected incubated enterprises that have grown into medium scale businesses in different sectors of the economy. The objective is to determine the extent to which the process of incubation has contributed to their growth in relation to similar businesses that developed outside the TICs. Six enterprises nurtured by TICs and six others outside, these were selected for the study. Data were collected in respect of the twelve enterprises covering their first five years of operation. Performances in terms of annual turnover, market share, and product range were analysed by scatter diagram plotted to show these variables against time and on comparative basis between TIC and non-TIC enterprises. Results showed an initial decline in performance for most of the incubatees in the first two years due to sluggish adjustment to withdrawal of subsidies enjoyed at the TICs. However, four of them were able to catch up with improved performance and surpass their non–TIC counterparts consistently from the third year. Analysis of year on year performance also showed average growth rate of 7% and 5 % respectively for TIC and non–TIC enterprises. The study, therefore, concludes that TICs have great role to play in nurturing new, innovative businesses but sees the need for government to address the provision of critical facilities especially electricity and utilities that constitute critical cost components for businesses. It must also address the issue of investment grants, loans including the development of technology/industrial parks that will serve to boost business survival.

Keywords: entrepreneurship, incubation, innovation, makerspaces

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Authors: Sónia Ribeiro, Diana Farinha, Elsa Pereira, Hélia Sales, Filipa Figueiredo, Rita Pontes, João Nunes

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Conventional plastic impacts on Planet, natural resources contamination, human health as well as animals are the most attractive environmental and health attention. The lack of treatment in the end-of-life (EOL) phase and uncontrolled discard allows plastic to be found everywhere in the world. Food waste is increasing significantly, with a final destination to landfills. To face these difficulties, new packaging solutions are needed with the objective of prolonging the shelf-life of products as well as equipment solutions for the development of the mentioned packaging. FLUI project thus presents relevance and innovation to reach a new level of knowledge and industrial development focused in Ecodesign. Industrial equipment field for the manufacture of new packaging solutions based on biodegradable plastics films to apply in the food sector. With lesser environmental impacts and new solutions that make it possible to prevent food waste, reduce the production e consequent poor disposal of plastic of fossil origin. It will be a paradigm shift at different levels, from industry to waste treatment stations, passing through commercial agents and consumers. It can be achieved through the life cycle assessment (LCA) and ecodesign of the products, which integrates the environmental concerns in the design of the product as well as through the entire life cycle. The FLUI project aims to build a piece of new bio-PLA extrusion equipment with the incorporation of bioactive extracts through the production of flexible mono- and multi-layer functional films (FLUI systems). The biofunctional and biodegradable films will prompt the extension of packaged products’ shelf-life, reduce food waste and contribute to reducing the consumption of non-degradable fossil plastics, as well as the use of raw material from renewable sources.

Keywords: food packing, bioplastics, ecodesign, circular economy

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Authors: Van Truong Pham

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Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.

Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index

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Authors: Isabel Carrero, Raquel Redondo, Carmen Valor

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An unclosed issue in sustainable consumption (SC) literature is the relationship between SC and well-being. This paper seeks to address three limitations in past research. First, well-being has been measured as a single-faceted construct. However, other authors have defended the need to broaden the well-being construct since it goes beyond the emotional experiences and life satisfaction. By examining the relationship between SC and the multifaceted construct of psychological well-being, past contradictory results may be reconciled. To illustrate, past studies have shown that sustainable consumers experience negative emotions when they become aware of the harm that human beings inflict on the planet but they realize they have limited power to solving the problem or when they find limited alternatives or useful information to make sustainable decisions. Thus, these experiences may negatively affect the dimension of well-being 'environmental mastery'. However, as past studies have demonstrated that sustainable consumers feel meaningful, their assessment of the dimension 'purpose in life' would be positive. Thus, we need to understand how SC impinge on the different facets of psychological well-being, in order to better understand the relationship between SC and well-being. Another limitation of past research is that most studies failed to distinguish among different pro-environmental actions under SC (i.e., boycotting, buycotting) among others. For instance, activists have been found to experience higher levels of well-being and sense of meaning than less committed sustainable consumers but also burnt-out and social rejection, which should affect negatively the dimension of 'positive relations'. Finally, the influence of gender has been overlooked in the literature of SC and well-being when it has been identified consistently as a moderator variable in SC. Therefore, this study aims to (1) investigate the effect of SC on the six facets of psychological well-being, (2) distinguish between conventional SC behaviors vs. activism to examine whether these behaviors influence psychological well-being differently (3) and test gender as a moderator variable. It does so by surveying 861 individuals. This paper contributes to existing literature by showing that the relationship between well-being and SC is more intricate than it has been presented in previous literature, as it depends on the facet, the type of behavior carried out and gender.

Keywords: activism, gender, psychological well-being, structural equation modelling, sustainable consumption

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Authors: Mircan Kaya

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A multi-disciplinary approach is required in any intervention project for historical monuments. Due to the complexity of their geometry, the variable and unpredictable characteristics of original materials used in their creation, heritage structures are peculiar. Their histories are often complex, and they require correct diagnoses to decide on the techniques of intervention. This approach should not only combine technical aspects but also historical research that may help discover phenomena involving structural issues, and acquire a knowledge of the structure on its concept, method of construction, previous interventions, process of damage, and its current state. In addition to the traditional techniques like bed joint reinforcement, the repairing, strengthening and restoration of historical buildings may require several other modern methods which may be described as innovative techniques like pre-stressing and post-tensioning, use of shape memory alloy devices and shock transmission units, shoring, drilling, and the use of stainless steel or titanium. Regardless of the method to be incorporated in the strengthening process, which can be traditional or innovative, it is crucial to recognize that structural strengthening is the process of upgrading the structural system of the existing building with the aim of improving its performance under existing and additional loads like seismic loads. This process is much more complex than dealing with a new construction, owing to the fact that there are several unknown factors associated with the structural system. Material properties, load paths, previous interventions, existing reinforcement are especially important matters to be considered. There are several examples of seismic strengthening with traditional and innovative techniques around the world, which will be discussed in this paper in detail, including their pros and cons. Ultimately, however, the main idea underlying the philosophy of a successful intervention with the most appropriate techniques of strengthening a historic monument should be decided by a proper assessment of the specific needs of the building.

Keywords: bed joint reinforcement, historical monuments, post-tensioning, pre-stressing, seismic strengthening, shape memory alloy devices, shock transmitters, tie rods

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Authors: P. V. Pramila , V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients esulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF 25, PEF,FEF 25-75, FEF50, and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF 25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects). It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV, multivariate adaptive regression splines pulmonary function test, random forest

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Authors: Ziyad S. Haidar

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Millions of teeth are removed annually, and dental extraction is one of the most commonly performed surgical procedures globally. Whether due to caries, periodontal disease or trauma, exodontia and the ensuing wound healing and bone remodeling processes of the resultant socket (hole in the jaw bone) usually result in serious deformities of the residual alveolar osseous ridge and surrounding soft tissues (reduced height/width). Such voluminous changes render the placement of a proper conventional bridge, denture or even an implant-supported prosthesis extremely challenging. Further, most extractions continue to be performed with no regard for preventing the onset of alveolar osteitis (also known as dry socket, a painful and difficult-to-treat/-manage condition post-exodontia). Hence, such serious resorptive morphological changes often result in significant facial deformities and a negative impact on the overall Quality of Life (QoL) of patients (and oral health-related QoL), alarming, particularly for the geriatric with compromised healing and in light of the thriving longevity statistics. Opportunity: Despite advances in tissue/wound grafting, serious limitations continue to exist, including efficacy and clinical outcome predictability, cost, treatment time, expertise and risk of immune reactions. For cases of dry sockets, specifically, the commercially-available and often-prescribed home remedies are highly lacking. Indeed, most are not recommended for use anymore. Alveogyl is a fine example. Hence, there is a great market demand and need for alternative solutions. Solution: Herein, SockGEL/PLUG (patent pending), an all-natural, drug-free and injectable stimuli-responsive hydrogel, was designed, formulated, characterized and evaluated as an osteogenic, angiogenic, anti-microbial and pain-soothing suture-free intra-alveolar dressing, safe and efficacious for use in several oro-dental and cranio-maxillo-facial interventional applications; for example: in fresh dental extraction sockets, immediately post-exodontia. It is composed of FDA-approved, biocompatible and biodegradable polymers, self-assembled electro-statically to formulate a scaffolding matrix to (a) prevent the onset of alveolar osteitis via securing the fibrin-clot in situ and protecting/sealing the socket from contamination/infection; and (b) endogenously promote/accelerate wound healing and bone remodeling to preserve the volume of the alveolus. Findings: The intrinsic properties of the SockGEL/PLUG hydrogel were evaluated physico-chemico-mechanically for safety (cell viability), viscosity, rheology, bio-distribution and essentially, capacity to induce wound healing and osteogenesis (small defect, in vivo) without any signaling cues from exogenous cells, growth factors or drugs. The performed animal model of cranial critical-sized and non-vascularized bone defects shall provide vitally critical insights into the role and mechanism of the employed natural bio-polymer blend and gel product in endogenous reparative regeneration of soft tissues and bone morphogenesis. Alongside, the fine-tuning of our modified formulation method will further tackle appropriateness, reproducibility, scalability, ease and speed in producing stable, biodegradable and sterilizable stimuli (thermo-sensitive and photo-responsive) matrices (3-dimensional interpenetrating yet porous polymeric network) suitable for an intra-socket application, and beyond. Conclusions and Perspective: Findings are anticipated to provide sufficient evidence to translate into pilot clinical trials and validate the bionanomaterial before engaging the market for feasibility, acceptance and cost-effectiveness studies. The SockGEL/PLUG platform is patent pending: SockGEL is a bio-inspired drug-free hydrogel; SockPLUG is a drug-loaded hydrogel designed for complex indications.

Keywords: hydrogel, injectable, dentistry, craniomaxillofacial complex, bioinspired, nanobiotechnology, biopolymer, sol-gel, stimuli-responsive, matrix, tissue engineering, regenerative medicine

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