Search results for: open defecation free

Authors: Dina Ibrahim Abouelamaiem, Ana Jorge Sobrido, Magdalena Titirici, Paul R. Shearing, Daniel J. L. Brett

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Global warming and scarcity of fossil fuels have had a radical impact on the world economy and ecosystem. The urgent need for alternative energy sources has hence elicited an extensive research for exploiting efficient and sustainable means of energy conversion and storage. Among various electrochemical systems, supercapacitors attracted significant attention in the last decade due to their high power supply, long cycle life compared to batteries and simple mechanism. Recently, the performance of these devices has drastically improved, as tuning of nanomaterials provided efficient charge and storage mechanisms. Carbon materials, in various forms, are believed to pioneer the next generation of supercapacitors due to their attractive properties that include high electronic conductivities, high surface areas and easy processing and functionalization. Cellulose has eco-friendly attributes that are feasible to replace man-made fibers. The carbonization of cellulose yields carbons, including activated carbon and graphite fibers. Activated carbons successively are the most exploited candidates for supercapacitor electrode materials that can be complemented with pseudocapacitive materials to achieve high energy and power densities. In this work, the optimum functionalization conditions of cellulose have been investigated for supercapacitor electrode materials. The precursor was treated with potassium hydroxide (KOH) at different KOH/cellulose ratios prior to the carbonization process in an inert nitrogen atmosphere at 850 °C. The chalky products were washed, dried and characterized with different techniques including transmission electron microscopy (TEM), x-ray tomography and nitrogen adsorption-desorption isotherms. The morphological characteristics and their effect on the electrochemical performances were investigated in two and three-electrode systems. The KOH/cellulose ratios of 0.5:1 and 1:1 exhibited the highest performances with their unique hierarchal porous network structure, high surface areas and low cell resistances. Both samples acquired the best results in three-electrode systems and coin cells with specific gravimetric capacitances as high as 187 F g-1 and 20 F g-1 at a current density of 1 A g-1 and retention rates of 72% and 70%, respectively. This is attributed to the morphology of the samples that constituted of a well-balanced micro-, meso- and macro-porosity network structure. This study reveals that the electrochemical performance doesn’t solely depend on high surface areas but also an optimum pore size distribution, specifically at low current densities. The micro- and meso-pore contribution to the final pore structure was found to dominate at low KOH loadings, reaching ‘equilibrium’ with macropores at the optimum KOH loading, after which macropores dictate the porous network. The wide range of pore sizes is detrimental for the mobility and penetration of electrolyte ions in the porous structures. These findings highlight the influence of various morphological factors on the double-layer capacitances and high performance rates. In addition, they open a platform for the investigation of the optimized conditions for double-layer capacitance that can be coupled with pseudocapacitive materials to yield higher energy densities and capacities.

Keywords: carbon, electrochemical performance, electrodes, KOH/cellulose optimized ratio, morphology, supercapacitor

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Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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Authors: Mamert Mbonimpa, Ousseynou Kanteye, Élysée Tshibangu Ngabu, Rachid Amrou, Abdelkabir Maqsoud, Tikou Belem

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The management of mine wastes (waste rocks and tailings) containing sulphide minerals such as pyrite and pyrrhotite represents the main environmental challenge for the mining industry. Indeed, acid mine drainage (AMD) can be generated when these wastes are exposed to water and air. AMD is characterized by low pH and high concentrations of heavy metals, which are toxic to plants, animals, and humans. It affects the quality of the ecosystem through water and soil pollution. Different techniques involving soil materials can be used to control AMD generation, including impermeable covers (compacted clays) and oxygen barriers. The latter group includes covers with capillary barrier effects (CCBE), a multilayered cover that include the moisture retention layer playing the role of an oxygen barrier. Once AMD is produced at a mine site, it must be treated so that the final effluent at the mine site complies with regulations and can be discharged into the environment. Active neutralization with lime is one of the treatment methods used. This treatment produces sludge that is usually stored in sedimentation ponds. Other sludge management alternatives have been examined in recent years, including sludge co-disposal with tailings or waste rocks, disposal in underground mine excavations, and storage in technical landfill sites. Considering the ability of AMD neutralization sludge to maintain an alkaline to neutral pH for decades or even centuries, due to the excess alkalinity induced by residual lime within the sludge, valorization of sludge in specific applications could be an interesting management option. If done efficiently, the reuse of sludge could free up storage ponds and thus reduce the environmental impact. It should be noted that mixtures of sludge and soils could potentially constitute usable materials in CCBE for the rehabilitation of acid-generating mine sites, while sludge alone is not suitable for this purpose. The high sludge water content (up to 300%), even after sedimentation, can, however, constitute a geotechnical challenge. Adding lime to the mixtures can reduce the water content and improve the geotechnical properties. The objective of this paper is to investigate the impact of the sludge content (30, 40 and 50%) in sand-sludge mixtures (SSM) on their hydrogeotechnical properties (compaction, shrinkage behaviour, saturated hydraulic conductivity, and water retention curve). The impact of lime addition (dosages from 2% to 6%) on the moisture content, dry density after compaction and saturated hydraulic conductivity of SSM was also investigated. Results showed that sludge adding to sand significantly improves the saturated hydraulic conductivity and water retention capacity, but the shrinkage increased with sludge content. The dry density after compaction of lime-treated SSM increases with the lime dosage but remains lower than the optimal dry density of the untreated mixtures. The saturated hydraulic conductivity of lime-treated SSM after 24 hours of cure decreases by 3 orders of magnitude. Considering the hydrogeotechnical properties obtained with these mixtures, it would be possible to design CCBE whose moisture retention layer is made of SSM. Physical laboratory models confirmed the performance of such CCBE.

Keywords: mine waste, AMD neutralization sludge, sand-sludge mixture, hydrogeotechnical properties, mine site reclamation, CCBE

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Authors: Chuanxiang Cheng, Tiantian Min, Jin Yue

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Antimicrobial active packaging enables extensive biological effects to improve food safety. However, the efficacy of antimicrobial packaging hinges on factors including the diffusion rate of the active agent toward the food surface, the initial content in the antimicrobial agent, and the targeted food shelf life. Among the possibilities of antimicrobial packaging design, an interesting approach involves the incorporation of volatile antimicrobial agents into the packaging material. In this case, the necessity for direct contact between the active packaging material and the food surface is mitigated, as the antimicrobial agent exerts its action through the packaging headspace atmosphere towards the food surface. However, it still remains difficult to achieve controlled and precise release of bioactive compounds to the specific target location with required quantity in food packaging applications. Remarkably, the development of stimuli-responsive materials for electrospinning has introduced the possibility of achieving controlled release of active agents under specific conditions, thereby yielding enduring biological effects. Relative humidity (RH) for the storage of food categories such as meat and aquatic products typically exceeds 90%. Consequently, high RH can be used as an abiotic trigger for the release of active agents to prevent microbial growth. Hence, a novel RH - responsive polyvinyl alcohol/chitosan (PVA/CS) composite nanofibrous film incorporated with 4-terpineol/β-cyclodextrin inclusion complexes (4-TA@β-CD ICs) was engineered by electrospinning that can be deposited as a functional packaging materials. The characterization results showed the thermal stability of the films was enhanced after the incorporation due to the hydrogen bonds between ICs and polymers. Remarkably, the 4 wt% 4-TA@β-CD ICs/PVA/CS film exhibited enhanced crystallinity, moderate hydrophilic (Water contact angle of 81.53°), light barrier property (Transparency of 1.96%) and water resistance (Water vapor permeability of 3.17 g mm/m2 h kPa). Moreover, this film also showed optimized mechanical performance with a Young’s modulus of 11.33 MPa, a tensile strength of 19.99 MPa and an elongation at break of 4.44 %. Notably, the antioxidant and antibacterial properties of this packaging material were significantly improved. The film demonstrated the half-inhibitory concentrations (IC50) values of 87.74% and 85.11% for scavenging 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2, 2′-azinobis (3-ethylbenzothiazoline-6-sulfonic) (ABTS) free radicals, respectively, in addition to an inhibition efficiency of 65% against Shewanella putrefaciens, the characteristic bacteria in aquatic products. Most importantly, the film achieved controlled release of 4-TA under high 98% RH by inducing the plasticization of polymers caused by water molecules, swelling of polymer chains, and destruction of hydrogen bonds within the cyclodextrin inclusion complex. Consequently, low relative humidity is suitable for the preservation of nanofibrous film, while high humidity conditions typical in fresh food packaging environments effectively stimulated the release of active compounds in the film. This film with a long-term antimicrobial effect successfully extended the shelf life of Litopenaeus vannamei shrimp to 7 days at 4 °C. This attractive design could pave the way for the development of new food packaging materials.

Keywords: controlled release, electrospinning, nanofibrous film, relative humidity–responsive, shrimp preservation

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Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai

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Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.

Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics

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Authors: C. Bel, J. Nevado, F. Ciceri, M. Ropacki, T. Hoffmann, P. Lapunzina, C. Buesa

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Background: The Phelan-McDermid syndrome (PMS) is a genetic disorder caused by the deletion of the terminal region of chromosome 22 or mutation of the SHANK3 gene. Shank3 disruption in mice leads to dysfunction of synaptic transmission, which can be restored by epigenetic regulation with both Lysine Specific Demethylase 1 (LSD1) inhibitors. PMS subjects result in a variable degree of intellectual disability, delay or absence of speech, autistic spectrum disorders symptoms, low muscle tone, motor delays and epilepsy. Vafidemstat is an LSD1 inhibitor in Phase II clinical development with a well-established and favorable safety profile, and data supporting the restoration of memory and cognition defects as well as reduction of agitation and aggression in several animal models and clinical studies. Therefore, vafidemstat has the potential to become a first-in-class precision medicine approach to treat PMS patients. Aims: The goal of this research is to perform an observational trial to psychometrically characterize individuals carrying deletions in SHANK3 and build a foundation for subsequent precision psychiatry clinical trials with vafidemstat. Methodology: This study is characterizing the clinical profile of 20 to 40 subjects, > 16-year-old, with genotypically confirmed PMS diagnosis. Subjects will complete a battery of neuropsychological scales, including the Repetitive Behavior Questionnaire (RBQ), Vineland Adaptive Behavior Scales, Escala de Observación para el Diagnostico del Autismo (Autism Diagnostic Observational Scale) (ADOS)-2, the Battelle Developmental Inventory and the Behavior Problems Inventory (BPI). Results: By March 2021, 19 patients have been enrolled. Unsupervised hierarchical clustering of the results obtained so far identifies 3 groups of patients, characterized by different profiles of cognitive and behavioral scores. The first cluster is characterized by low Battelle age, high ADOS and low Vineland, RBQ and BPI scores. Low Vineland, RBQ and BPI scores are also detected in the second cluster, which in contrast has high Battelle age and low ADOS scores. The third cluster is somewhat in the middle for the Battelle, Vineland and ADOS scores while displaying the highest levels of aggression (high BPI) and repeated behaviors (high RBQ). In line with the observation that female patients are generally affected by milder forms of autistic symptoms, no male patients are present in the second cluster. Dividing the results by gender highlights that male patients in the third cluster are characterized by a higher frequency of aggression, whereas female patients from the same cluster display a tendency toward higher repetitive behavior. Finally, statistically significant differences in deletion sizes are detected comparing the three clusters (also after correcting for gender), and deletion size appears to be positively correlated with ADOS and negatively correlated with Vineland A and C scores. No correlation is detected between deletion size and the BPI and RBQ scores. Conclusions: Precision medicine may open a new way to understand and treat Central Nervous System disorders. Epigenetic dysregulation has been proposed to be an important mechanism in the pathogenesis of schizophrenia and autism. Vafidemstat holds exciting therapeutic potential in PMS, and this study will provide data regarding the optimal endpoints for a future clinical study to explore vafidemstat ability to treat shank3-associated psychiatric disorders.

Keywords: autism, epigenetics, LSD1, personalized medicine

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Authors: Shatarupa Thakurta Roy

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Along the limelight of mainstream academic practices in Indian art, exist a significant lot of habitual art practices that are mutually susceptible in their contemporary forms. Narrative folk paintings of regional India has successfully dispersed to its audience social messages through pulsating pictures and orations. The paper consists of images from narrative scroll paintings on ‘Ramayana’ theme from various neighboring states as well as districts in India, describing their subtle differences in style of execution, method, and use of material. Despite sharing commonness in the choice of subject matter, habitual and ceremonial Indian folk art in its formative phase thrived within isolated locations to yield in remarkable variety in the art styles. The differences in style took place district wise, cast wise and even gender wise. An open flow is only evident in the contemporary expressions as a result of substantial changes in social structures, mode of communicative devices, cross-cultural exposures and multimedia interactivities. To decipher the complex nature of popular cultural taste of contemporary India it is important to categorically identify its root in vernacular symbolism. The realization of modernity through European primitivism was rather elevated as a perplexed identity in Indian cultural margin in the light of nationalist and postcolonial ideology. To trace the guiding factor that has still managed to obtain ‘Indianness’ in today’s Indian art, researchers need evidences from the past that are yet to be listed in most instances. They are commonly created on ephemeral foundations. The artworks are also found in endangered state and hence, not counted much friendly for frequent handling. The museums are in dearth of proper technological guidelines to preserve them. Even though restoration activities are emerging in the country, the existing withered and damaged artworks are in threat to perish. An immediacy of digital achieving is therefore envisioned as an alternative to save this cultural legacy. The method of this study is, two folded. It primarily justifies the richness of the evidences by conducting categorical aesthetic analysis. The study is supported by comments on the stylistic variants, thematic aspects, and iconographic identities alongside its anthropological and anthropomorphic significance. Further, it explores the possible ways of cultural preservation to ensure cultural sustainability that includes technological intervention in the form of digital transformation as an altered paradigm for better accessibility to the available recourses. The study duly emphasizes on visual description in order to culturally interpret and judge the rare visual evidences following Feldman’s four-stepped method of formal analysis combined with thematic explanation. A habitual design that emerges and thrives within complex social circumstances may experience change placing its principle philosophy at risk by shuffling and altering with time. A tradition that respires in the modern setup struggles to maintain timeless values that operate its creative flow. Thus, the paper hypothesizes the survival and further growth of this practice within the dynamics of time and concludes in realization of the urgency to transform the implicitness of its knowledge into explicit records.

Keywords: aesthetic, identity, implicitness, paradigm

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Authors: Ankit Khurana

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The sufficient heat storage capacity or ability to dissipate heat is the most decisive parameter to have an effective and efficient functioning of Friction-based Brake Disc systems. The primary aim of the research was to analyse the effect of multiple coatings on lightweight disk rotors surface which not only alleviates the mass of vehicle & also, augments heat transfer. This research is projected to aid the automobile fraternity with an enunciated view over the thermal aspects in a braking system. The results of the project indicate that with the advent of modern coating technologies a brake system’s thermal curtailments can be removed and together with forced convection, heat transfer processes can see a drastic improvement leading to increased lifetime of the brake rotor. Other advantages of modifying the surface of a lightweight rotor substrate will be to reduce the overall weight of the vehicle, decrease the risk of thermal brake failure (brake fade and fluid vaporization), longer component life, as well as lower noise and vibration characteristics. A mathematical model was constructed in MATLAB which encompassing the various thermal characteristics of the proposed coatings and substrate materials required to approximate the heat flux values in a free and forced convection environment; resembling to a real-time braking phenomenon which could easily be modelled into a full cum scaled version of the alloy brake rotor part in ABAQUS. The finite element of a brake rotor was modelled in a constrained environment such that the nodal temperature between the contact surfaces of the coatings and substrate (Wrought Aluminum alloy) resemble an amalgamated solid brake rotor element. The initial results obtained were for a Plasma Electrolytic Oxidized (PEO) substrate wherein the Aluminum alloy gets a hard ceramic oxide layer grown on its transitional phase. The rotor was modelled and then evaluated in real-time for a constant ‘g’ braking event (based upon the mathematical heat flux input and convective surroundings), which reflected the necessity to deposit a conducting coat (sacrificial) above the PEO layer in order to inhibit thermal degradation of the barrier coating prematurely. Taguchi study was then used to bring out certain critical factors which may influence the maximum operating temperature of a multi-coated brake disc by simulating brake tests: a) an Alpine descent lasting 50 seconds; b) an Autobahn stop lasting 3.53 seconds; c) a Six–high speed repeated stop in accordance to FMVSS 135 lasting 46.25 seconds. Thermal Barrier coating thickness and Vane heat transfer coefficient were the two most influential factors and owing to their design and manufacturing constraints a final optimized model was obtained which survived the 6-high speed stop test as per the FMVSS -135 specifications. The simulation data highlighted the merits for preferring Wrought Aluminum alloy 7068 over Grey Cast Iron and Aluminum Metal Matrix Composite in coherence with the multiple coating depositions.

Keywords: lightweight brakes, surface modification, simulated braking, PEO, aluminum

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Authors: Priyanka Kumari

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Menstrual hygiene is an important aspect in the life of young girls. Menstrual Hygiene Management (MHM) is defined as ‘Women and adolescent girls using a clean material to absorb or collect menstrual blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required and having access to facilities to dispose of used menstrual management materials. This paper aims to investigate the prevalence of hygienic menstrual practices and socio-demographic correlates of hygienic menstrual practices among women aged 15-24 in India. Data from the 2015–2016 National Family Health Survey–4 for 244,500 menstruating women aged 15–24 were used. The methods have been categorized into two, women who use sanitary napkins, locally prepared napkins and tampons considered as a hygienic method and those who use cloth, any other method and nothing used at all during menstruation considered as an unhygienic method. Women’s age, year of schooling, religion, place of residence, caste/tribe, marital status, wealth index, type of toilet facility used, region, the structure of the house and exposure to mass media are taken as an independent variables. Bivariate analysis was carried out with selected background characteristics to analyze the socio-economic and demographic factors associated with the use of hygienic methods during menstruation. The odds for the use of the hygienic method were computed by employing binary logistic regression. Almost 60% of the women use cloth as an absorbent during menstruation to prevent blood stains from becoming evident. The hygienic method, which includes the use of locally prepared napkins, sanitary napkins and tampons, is 16.27%, 41.8% and 2.4%. The proportion of women who used hygienic methods to prevent blood stains from becoming evident was 57.58%. Multivariate analyses reveal that education of women, wealth and marital status are found to be the most important positive factors of hygienic menstrual practices. The structure of the house and exposure to mass media also have a positive impact on the use of menstrual hygiene practices. In contrast, women residing in rural areas belonging to scheduled tribes are less likely to use hygienic methods during their menstruation. Geographical regions are also statistically significant with the use of hygienic methods during menstruation. This study reveals that menstrual hygiene is not satisfactory among a large proportion of adolescent girls. They need more education about menstrual hygiene. A variety of factors affect menstrual behaviors; amongst these, the most influential is economic status, educational status and residential status, whether urban or rural. It is essential to design a mechanism to address and access healthy menstrual knowledge. It is important to encourage policies and quality standards that promote safe and affordable options and dynamic markets for menstrual products. Materials that are culturally acceptable, contextually available and affordable. Promotion of sustainable, environmentally friendly menstrual products and their disposal as it is a very important aspect of sustainable development goals. We also need to educate the girls about the services which are provided by the government, like a free supply of sanitary napkins to overcome reproductive tract infections. Awareness regarding the need for information on healthy menstrual practices is very important. It is essential to design a mechanism to address and access healthy menstrual practices. Emphasis should be given to the education of young girls about the importance of maintaining hygiene during menstruation to prevent the risk of reproductive tract infections.

Keywords: adolescent, menstruation, menstrual hygiene management, menstrual hygiene

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Authors: Ajay Ivan

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This paper focuses on the cultural politics of health-promotional and disease-preventive pedagogic practices in the context of the national tobacco control programme in India. Tobacco consumption is typically problematised as a paradox: tobacco poses objective health risks such as cancer and heart disease, but its production, sale and export contribute significantly to state revenue. A blanket ban on tobacco products, therefore, is infeasible though desirable. Instead, initiatives against tobacco use have prioritised awareness creation and behaviour change to reduce its demand. This paper argues that public health communication is not, as commonly assumed, an apolitical and neutral transmission of disease-preventive information. Drawing on Michel Foucault’s concept of governmentality, it examines such campaigns as techniques of disciplining people rather than coercing them to give up tobacco use, which would be both impractical and counter-productive. At the level of the population, these programmes constitute a security mechanism that reduces risks without eliminating them, so as to ensure an optimal level of public health without hampering the economy. Anti-tobacco pedagogy thus aligns with a contemporary paradigm of health that emphasises risk-assessment and lifestyle management as tools of governance, using pedagogic techniques to teach people how to be healthy. The paper analyses the pictorial health warnings on tobacco packets and anti-tobacco advertisements in movie theatres mandated by the state, along with awareness-creation messages circulated by anti-tobacco advocacy groups in India, to show how they discursively construct tobacco and its consumption as a health risk. Smoking is resignified from a pleasurable and sociable practice to a deadly addiction that jeopardises the health of those who smoke and those who passively inhale the smoke. While disseminating information about the health risks of tobacco, these initiatives employ emotional and affective techniques of persuasion to discipline tobacco users. They incite fear of death and of social ostracism to motivate behaviour change, complementing their appeals to reason. Tobacco is portrayed as a grave moral danger to the family and a detriment to the vitality of the nation, such that using it contradicts one’s duties as a parent or citizen. Awareness programmes reproduce prevailing societal assumptions about health and disease, normalcy and deviance, and proper and improper conduct. Pedagogy thus functions as an apparatus of public health governance, recruiting subjects as volunteers in their own regulation and aligning their personal goals and aspirations to the objectives of tobacco control. The paper links this calculated management of subjectivity and the self-responsibilisation of the pedagogic subject to a distinct mode of neoliberal civic governance in contemporary India. Health features prominently in this mode of governance that serves the biopolitical obligation of the state as laid down in Article 39 of the Constitution, which includes a duty to ensure the health of its citizens. Insofar as the health of individuals is concerned, the problem is how to balance this duty of the state with the fundamental right of the citizen to choose how to live. Public health pedagogy, by directing the citizen’s ‘free’ choice without unduly infringing upon it, offers a tactical solution.

Keywords: public health communication, pedagogic power, tobacco control, neoliberal governance

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Authors: M. Doudi, M. H. Pazandeh, L. Rahimzadeh Torabi

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Bedsores are pressure ulcers that occur on the skin or tissue due to being immobile and lying in bed for extended periods. Bedsores have the potential to progress into open ulcers, increasing the possibility of variety of bacterial infection. Acinetobacter baumannii, a pathogen of considerable clinical importance, exhibited a significant correlation with Bedsores (pressure ulcers) infections, thereby manifesting a wide spectrum of antibiotic resistance. The emergence of drug resistance has led researchers to focus on alternative methods, particularly phage therapy, for tackling bacterial infections. Phage therapy has emerged as a novel therapeutic approach to regulate the activity of these agents. The management of bacterial infections greatly benefits from the clinical utilization of bacteriophages as a valuable antimicrobial intervention. The primary objective of this investigation consisted of isolating and discerning potent bacteriophage capable of targeting multi drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria obtained from pressure ulcers. In present study, analyzed and isolated A. baumannii strains obtained from a cohort of patients suffering from pressure ulcers at Taleghani Hospital in Ahvaz, Iran. An approach that included biochemical and molecular identification techniques was used to determine the taxonomic classification of bacterial isolates at the genus and species levels. The molecular identification process was facilitated by using the 16S rRNA gene in combination with universal primers 27 F, and 1492 R. Bacteriophage was obtained through the isolation process conducted on treatment plant sewage located in Isfahan, Iran. The main goal of this study was to evaluate different characteristics of phage, such as their appearance, range of hosts they can infect, how quickly they can enter a host, their stability at varying temperatures and pH levels, their effectiveness in killing bacteria, the growth pattern of a single phage stage, mapping of enzymatic digestion, and identification of proteomics patterns. The findings demonstrated that an examination was conducted on a sample of 50 specimens, wherein 15 instances of A. baumannii were identified. These microorganisms are the predominant Gram-negative agents known to cause wound infections in individuals suffering from bedsores. The study's findings indicated a high prevalence of antibiotic resistance in the strains isolated from pressure ulcers, excluding the clinical strains that exhibited responsiveness to colistin.According to the findings obtained from assessments of host range and morphological characteristics of bacteriophage VbɸAB-1, it can be concluded that this phage possesses specificity towards A. Baumannii BAH_Glau1001 was classified as a member of the Plasmaviridae family. The bacteriophage mentioned earlier showed the strongest antibacterial effect at a temperature of 18 °C and a pH of 6.5. Through the utilization of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis on protein fragments, it was established that the bacteriophage VbɸAB-1 exhibited a size range between 50 and 75 kilodaltons (KDa). The numerous research findings on the effectiveness of phages and the safety studies conducted suggest that the phages studied in this research can be considered as a practical solution and recommended approach for controlling and treating stubborn pathogens in burn wounds among hospitalized patients.

Keywords: acinetobacter baumannii, extremely drug- resistant, phage therapy, surgery wound

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Authors: L. Calcagni, A. Battisti, M. Hensel, D. S. Hensel

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Since the beginning of the 21st century, we have seen a dynamic growth of water-based (WB) architecture, mainly due to the increasing threat of floods caused by sea level rise and heavy rains, all correlated with climate change. At the same time, the shortage of land available for urban development also led architects, engineers, and policymakers to reclaim the seabed or to build floating structures. Furthermore, the drive to produce energy from renewable resources has expanded the sector of offshore research, mining, and energy industry which seeks new types of WB structures. In light of these considerations, the time is ripe to consider floating architecture as a full-fledged building typology. Currently, there is no universally recognized academic definition of a floating building. Research on floating architecture lacks a proper, commonly shared vocabulary and typology distinction. Moreover, there is no global international legal framework for urban development on water, and there is no structured performance based building design (PBBD) approach for floating architecture in most countries, let alone national regulatory systems. Thus, first of all, the research intends to overcome the semantic and typological issues through the conceptualization of floating architecture, laying the proto-ontological conditions for floating development, and secondly to identify the parameters to be considered in the definition of a specific PBBD framework, setting the scene for national planning strategies. The theoretical overview and re-semanticization process involve the attribution of a new meaning to the term floating architecture. This terminological work of semantic redetermination is carried out through a systematic literature review and involves quantitative and historical research as well as logical argumentation methods. As it is expected that floating urban development is most likely to take place as an extension of coastal areas, the needs and design criteria are definitely more similar to those of the urban environment than to those of the offshore industry. Therefore, the identification and categorization of parameters –looking towards the potential formation of a PBBD framework for floating development– takes the urban and architectural guidelines and regulations as the starting point, taking the missing aspects, such as hydrodynamics (i.e. stability and buoyancy) from the offshore and shipping regulatory frameworks. This study is carried out through an evidence-based assessment of regulatory systems that are effective in different countries around the world, addressing on-land and on-water architecture as well as offshore and shipping industries. It involves evidence-based research and logical argumentation methods. Overall, inhabiting water is proposed not only as a viable response to the problem of rising sea levels, thus as a resilient frontier for urban development, but also as a response to energy insecurity, clean water, and food shortages, environmental concerns, and urbanization, in line with Blue Economy principles and the Agenda 2030. This review shows how floating architecture is to all intents and purposes, an urban adaptation measure and a solution towards self-sufficiency and energy-saving objectives. Moreover, the adopted methodology is, to all extents, open to further improvements and integrations, thus not rigid and already completely determined. Along with new designs and functions that will come into play in the practice field, eventually, life on water will seem no more unusual than life on land, especially by virtue of the multiple advantages it provides not only to users but also to the environment.

Keywords: adaptation measures, building typology, floating architecture, performance based building design, rising sea levels

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Authors: Manuel I. Capel, Antonio Tomeu, Alberto Salguero

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Tumor growth from a transformed cancer-cell up to a clinically apparent mass spans through a range of spatial and temporal magnitudes. Through computer simulations, Cellular Automata (CA) can accurately describe the complexity of the development of tumors. Tumor development prognosis can now be made -without making patients undergo through annoying medical examinations or painful invasive procedures- if we develop appropriate CA-based software tools. In silico testing mainly refers to Computational Biology research studies of application to clinical actions in Medicine. To establish sound computer-based models of cellular behavior, certainly reduces costs and saves precious time with respect to carrying out experiments in vitro at labs or in vivo with living cells and organisms. These aim to produce scientifically relevant results compared to traditional in vitro testing, which is slow, expensive, and does not generally have acceptable reproducibility under the same conditions. For speeding up computer simulations of cellular models, specific literature shows recent proposals based on the CA approach that include advanced techniques, such the clever use of supporting efficient data structures when modeling with deterministic stochastic cellular automata. Multiparadigm and multiscale simulation of tumor dynamics is just beginning to be developed by the concerned research community. The use of stochastic cellular automata (SCA), whose parallel programming implementations are open to yield a high computational performance, are of much interest to be explored up to their computational limits. There have been some approaches based on optimizations to advance in multiparadigm models of tumor growth, which mainly pursuit to improve performance of these models through efficient memory accesses guarantee, or considering the dynamic evolution of the memory space (grids, trees,…) that holds crucial data in simulations. In our opinion, the different optimizations mentioned above are not decisive enough to achieve the high performance computing power that cell-behavior simulation programs actually need. The possibility of using multicore and GPU parallelism as a promising multiplatform and framework to develop new programming techniques to speed-up the computation time of simulations is just starting to be explored in the few last years. This paper presents a model that incorporates parallel processing, identifying the synchronization necessary for speeding up tumor growth simulations implemented in Java and C++ programming environments. The speed up improvement that specific parallel syntactic constructs, such as executors (thread pools) in Java, are studied. The new tumor growth parallel model is proved using implementations with Java and C++ languages on two different platforms: chipset Intel core i-X and a HPC cluster of processors at our university. The parallelization of Polesczuk and Enderling model (normally used by researchers in mathematical oncology) proposed here is analyzed with respect to performance gain. We intend to apply the model and overall parallelization technique presented here to solid tumors of specific affiliation such as prostate, breast, or colon. Our final objective is to set up a multiparadigm model capable of modelling angiogenesis, or the growth inhibition induced by chemotaxis, as well as the effect of therapies based on the presence of cytotoxic/cytostatic drugs.

Keywords: cellular automaton, tumor growth model, simulation, multicore and manycore programming, parallel programming, high performance computing, speed up

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Authors: Rachid Essamoud, Abdelkrim Afenzar, Ahmed Belqadi

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During the Early Mesozoic, the northwestern part of the African continent was affected by initial fracturing associated with the early stages of the opening of the Central Atlantic (Atlantic Rift). During this rifting phase, the Moroccan Meseta experienced an extensive tectonic regime. This extension favored the formation of a set of rift-type basins, including the Mohammedia-Benslimane-ElGara-Berrechid basin. Thus, it is essential to know the nature of the deposits in this basin and their evolution over time as well as their relationship with the basaltic effusion of the Central Atlantic Magmatic Province (CAMP). These deposits are subdivided into two large series: The Lower clay-salt series attributed to the Triassic and the Upper clay-salt series attributed to the Liassic. The two series are separated by the Upper Triassic-Lower Liassic basaltic complex. The detailed sedimentological analysis made it possible to characterize four mega-sequences, fifteen types of facies and eight architectural elements and facies associations in the Triassic series. A progressive decrease observed in paleo-slope over time led to the evolution of the paleoenvironment from a proximal system of alluvial fans to a braided fluvial style, then to an anastomosed system. These environments eventually evolved into an alluvial plain associated with a coastal plain where playa lakes, mudflats and lagoons had developed. The pure and massive halitic facies at the top of the series probably indicate an evolution of the depositional environment towards a shallow subtidal environment. The presence of these evaporites indicates a climate that favored their precipitation, in this case, a fairly hot and humid climate. The sedimentological analysis of the supra-basaltic part shows that during the Lower Liassic, the paleopente after basaltic effusion remained weak with distal environments. The faciological analysis revealed the presence of four major sandstone, silty, clayey and evaporitic lithofacies organized in two mega-sequences: the sedimentation of the first rock-salt mega-sequence took place in a brine depression system free, followed by saline mudflats under continental influences. The upper clay mega-sequence displays facies documenting sea level fluctuations from the final transgression of the Tethys or the opening Atlantic. Saliferous sedimentation is therefore favored from the Upper Triassic, but experienced a sudden rupture by the emission of basaltic flows which are interstratified in the azoic salt clays of very shallow seas. This basaltic emission which belongs to the CAMP would come from a fissural volcanism probably carried out through transfer faults located in the NW and SE of the basin. Their emplacement is probably subaquatic to subaerial. From a chronological and paleogeographic point of view, this main volcanism, dated between the Upper Triassic and the Lower Liassic (180-200 MA), is linked to the fragmentation of Pangea and managed by a progressive expansion triggered in the West in close relation with the initial phases of Central Atlantic rifting and seems to coincide with the major mass extinction at the Triassic-Jurassic boundary.

Keywords: Basalt, CAMP, Liassic, sedimentology, Triassic, Morocco

Procedia PDF Downloads 48

Authors: Sudeshna Chandra, Christian Gäbler, Christian Schliebe, Heinrich Lang

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Highly branched dendrimers provide structural homogeneity, controlled composition, comparable size to biomolecules, internal porosity and multiple functional groups for conjugating reactions. Electro-active dendrimers containing multiple redox units have generated great interest in their use as electrode modifiers for development of biosensors. The electron transfer between the redox-active dendrimers and the biomolecules play a key role in developing a biosensor. Ferrocenes have multiple and electrochemically equivalent redox units that can act as electron “pool” in a system. The ferrocenyl-terminated polyamidoamine dendrimer is capable of transferring multiple numbers of electrons under the same applied potential. Therefore, they can be used for dual purposes: one in building a film over the electrode for immunosensors and the other for immobilizing biomolecules for sensing. Electrochemical immunosensor, thus developed, exhibit fast and sensitive analysis, inexpensive and involve no prior sample pre-treatment. Electrochemical amperometric immunosensors are even more promising because they can achieve a very low detection limit with high sensitivity. Detection of the cancer biomarkers at an early stage can provide crucial information for foundational research of life science, clinical diagnosis and prevention of disease. Elevated concentration of biomarkers in body fluid is an early indication of some type of cancerous disease and among all the biomarkers, IgG is the most common and extensively used clinical cancer biomarkers. We present an IgG (=immunoglobulin) electrochemical immunosensor using a newly synthesized redox-active ferrocenyl dendrimer of generation 2 (G2Fc) as glassy carbon electrode material for immobilizing the antibody. The electrochemical performance of the modified electrodes was assessed in both aqueous and non-aqueous media using varying scan rates to elucidate the reaction mechanism. The potential shift was found to be higher in an aqueous electrolyte due to presence of more H-bond which reduced the electrostatic attraction within the amido groups of the dendrimers. The cyclic voltammetric studies of the G2Fc-modified GCE in 0.1 M PBS solution of pH 7.2 showed a pair of well-defined redox peaks. The peak current decreased significantly with the immobilization of the anti-goat IgG. After the immunosensor is blocked with BSA, a further decrease in the peak current was observed due to the attachment of the protein BSA to the immunosensor. A significant decrease in the current signal of the BSA/anti-IgG/G2Fc/GCE was observed upon immobilizing IgG which may be due to the formation of immune-conjugates that blocks the tunneling of mass and electron transfer. The current signal was found to be directly related to the amount of IgG captured on the electrode surface. With increase in the concentration of IgG, there is a formation of an increasing amount of immune-conjugates that decreased the peak current. The incubation time and concentration of the antibody was optimized for better analytical performance of the immunosensor. The developed amperometric immunosensor is sensitive to IgG concentration as low as 2 ng/mL. Tailoring of redox-active dendrimers provides enhanced electroactivity to the system and enlarges the sensor surface for binding the antibodies. It may be assumed that both electron transfer and diffusion contribute to the signal transformation between the dendrimers and the antibody.

Keywords: ferrocenyl dendrimers, electrochemical immunosensors, immunoglobulin, amperometry

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Authors: Olga V. Chervyakova, Elmira T. Tailakova, Vitaliy M. Strochkov, Kulyaisan T. Sultankulova, Nurlan T. Sandybayev, Lev G. Nemchinov, Rosemarie W. Hammond

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Sheep pox is a highly contagious infection that OIE regards to be one of the most dangerous animal diseases. It causes enormous economic losses because of death and slaughter of infected animals, lower productivity, cost of veterinary and sanitary as well as quarantine measures. To control spread of sheep pox infection the attenuated vaccines are widely used in the Republic of Kazakhstan and other Former Soviet Union countries. In spite of high efficiency of live vaccines, the possible presence of the residual virulence, potential genetic instability restricts their use in disease-free areas that leads to necessity to exploit new approaches in vaccine development involving recombinant DNA technology. Vaccines on the basis of recombinant proteins are the newest generation of prophylactic preparations. The main advantage of these vaccines is their low reactogenicity and this fact makes them widely used in medical and veterinary practice for vaccination of humans and farm animals. The objective of the study is to produce recombinant immunogenic proteins for development of the high-performance means for sheep pox prophylaxis. The SPV proteins were chosen for their homology with the known immunogenic vaccinia virus proteins. Assay of nucleotide and amino acid sequences of the target SPV protein genes. It has been shown that four proteins SPPV060 (ortholog L1), SPPV074 (ortholog H3), SPPV122 (ortholog A33) and SPPV141 (ortholog B5) possess transmembrane domains at N- or C-terminus while in amino acid sequences of SPPV095 (ortholog А 4) and SPPV117 (ortholog А 27) proteins these domains were absent. On the basis of these findings the primers were constructed. Target genes were amplified and subsequently cloned into the expression vector рЕТ26b(+) or рЕТ28b(+). Six constructions (pSPPV060ΔТМ, pSPPV074ΔТМ, pSPPV095, pSPPV117, pSPPV122ΔТМ and pSPPV141ΔТМ) were obtained for expression of the SPV genes under control of T7 promoter in Escherichia coli. To purify and detect recombinant proteins the amino acid sequences were modified by adding six histidine molecules at C-terminus. Induction of gene expression by IPTG was resulted in production of the proteins with molecular weights corresponding to the estimated values for SPPV060, SPPV074, SPPV095, SPPV117, SPPV122 and SPPV141, i.e. 22, 30, 20, 19, 17 and 22 kDa respectively. Optimal protocol of expression for each gene that ensures high yield of the recombinant protein was identified. Assay of cellular lysates by western blotting confirmed expression of the target proteins. Recombinant proteins bind specifically with antibodies to polyhistidine. Moreover all produced proteins are specifically recognized by the serum from experimentally SPV-infected sheep. The recombinant proteins SPPV060, SPPV074, SPPV117, SPPV122 and SPPV141 were also shown to induce formation of antibodies with virus-neutralizing activity. The results of the research will help to develop a new-generation high-performance means for specific sheep pox prophylaxis that is one of key moments in animal health protection. The research was conducted under the International project ISTC # K-1704 “Development of methods to construct recombinant prophylactic means for sheep pox with use of transgenic plants” and under the Grant Project RK MES G.2015/0115RK01983 "Recombinant vaccine for sheep pox prophylaxis".

Keywords: prophylactic preparation, recombinant protein, sheep pox virus, subunit vaccine

Procedia PDF Downloads 223

Authors: Mumtaz Mooncey, Alexander Jolly, Megan Fisher, Kerry Robinson, Robert Lloyd, Dave Fielding

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Introduction: The integration of the WingFactors in-situ simulation programme has transformed the education landscape at the Whittington Health NHS Trust. To date, there have been a total of 90 simulations - 19 aimed at Paediatric trainees, including 2 Child and Adolescent Mental Health (CAMHS) scenarios. The opportunity for joint debriefs provided by clinical faculty and airline pilots, has created a new exciting avenue to explore human factors within psychiatry. Through the use of real clinical environments and primed actors; the benefits of high fidelity simulation, interdisciplinary and interprofessional learning has been highlighted. The use of in-situ simulation within Psychiatry is a newly emerging concept and its success here has been recognised by unanimously positive feedback from participants and acknowledgement through nomination for the Health Service Journal (HSJ) Award (Best Education Programme 2021). Methodology: The first CAMHS simulation featured a collapsed patient in the toilet with a ligature tied around her neck, accompanied by a distressed parent. This required participants to consider:; emergency physical management of the case, alongside helping to contain the mother and maintaining situational awareness when transferring the patient to an appropriate clinical area. The second simulation was based on a 17- year- old girl attempting to leave the ward after presenting with an overdose, posing potential risk to herself. The safe learning environment enabled participants to explore techniques to engage the young person and understand their concerns, and consider the involvement of other members of the multidisciplinary team. The scenarios were followed by an immediate ‘hot’ debrief, combining technical feedback with Human Factors feedback from uniformed airline pilots and clinicians. The importance of psychological safety was paramount, encouraging open and honest contributions from all participants. Key learning points were summarized into written documents and circulated. Findings: The in-situ simulations demonstrated the need for practical changes both in the Emergency Department and on the Paediatric ward. The presence of airline pilots provided a novel way to debrief on Human Factors. The following key themes were identified: -Team-briefing (‘Golden 5 minutes’) - Taking a few moments to establish experience, initial roles and strategies amongst the team can reduce the need for conversations in front of a distressed patient or anxious relative. -Use of checklists / guidelines - Principles associated with checklist usage (control of pace, rigor, team situational awareness), instead of reliance on accurate memory recall when under pressure. -Read-back - Immediate repetition of safety critical instructions (e.g. drug / dosage) to mitigate the risks associated with miscommunication. -Distraction management - Balancing the risk of losing a team member to manage a distressed relative, versus it impacting on the care of the young person. -Task allocation - The value of the implementation of ‘The 5A’s’ (Availability, Address, Allocate, Ask, Advise), for effective task allocation. Conclusion: 100% of participants have requested more simulation training. Involvement of airline pilots has led to a shift in hospital culture, bringing to the forefront the value of Human Factors focused training and multidisciplinary simulation. This has been of significant value in not only physical health, but also mental health simulation.

Keywords: human factors, in-situ simulation, inter-professional, multidisciplinary

Procedia PDF Downloads 86

Authors: Monika Dmitrzak-Weglarz, Aleksandra Rajewska-Rager, Maria Skibinska, Natalia Lepczynska, Piotr Sibilski, Joanna Pawlak, Pawel Kapelski, Joanna Hauser

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Epidermal growth factor (EGF) is a well-known neurotrophic factor that involves in neuronal growth and synaptic plasticity. The proteomic research provided in order to identify novel candidate biological markers for mood disorders focused on elevated EGF serum level in patients during depression episode. However, the EGF association with mood disorder spectrum among adolescents and young adults has not been studied extensively. In this study, we aim to investigate the serum levels of EGF in adolescents and young adults during hypo/manic, depressive episodes and in remission compared to healthy control group. In our study, we involved 80 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorder spectrum, and 35 healthy volunteers matched by age and gender. Diagnoses were established according to DSM-IV-TR criteria using structured clinical interviews: K-SADS for child and adolescents, and SCID for young adults. Clinical and biological evaluations were made at baseline and euthymic mood (at 3th or 6th month of treatment and after 1 and 2 years). The Young Mania Rating Scale and Hamilton Rating Scale for Depression were used for assessment. The study protocols were approved by the relevant ethics committee. Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human EGF (cat. no DY 236) DuoSet ELISA kit was used (R&D Systems). Serum EGF levels were analysed with following variables: age, age under 18 and above 18 years old, sex, family history of affective disorders, drug-free vs. medicated. Shapiro-Wilk test was used to test the normality of the data. The homogeneity of variance was calculated with Levene’s test. EGF levels showed non-normal distribution and the homogeneity of variance was violated. Non-parametric tests: Mann-Whitney U test, Kruskall-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient was applied in the analyses The statistical significance level was set at p<0.05. Elevated EGF level at baseline (p=0.001) and at month 24 (p=0.02) was detected in study subjects compared with controls. Increased EGF level in women at month 12 (p=0.02) compared to men in study group have been observed. Using Wilcoxon signed rank test differences in EGF levels were detected: decrease from baseline to month 3 (p=0.014) and increase comparing: month 3 vs. 24 (p=0.013); month 6 vs. 12 (p=0.021) and vs. 24 (p=0.008). EGF level at baseline was negatively correlated with depression and mania occurrence at 24 months. EGF level at 24 months was positively correlated with depression and mania occurrence at 12 months. No other correlations of EGF levels with clinical and demographical variables have been detected. The findings of the present study indicate that EGF serum level is significantly elevated in the study group of patients compared to the controls. We also observed fluctuations in EGF levels during two years of disease observation. EGF seems to be useful as an early marker for prediction of diagnosis, course of illness and treatment response in young patients during first episode od mood disorders, which requires further investigation. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: biological marker, epidermal growth factor, mood disorders, prediction

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Authors: Francesca Crivellari, Nicholas Mavrogiannis, Zachary Gagnon

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Portable diagnostic methods have become increasingly important for a number of different purposes: point-of-care screening in developing nations, environmental contamination studies, bio/chemical warfare agent detection, and end-user use for commercial health monitoring. The cheapest and most portable methods currently available are paper-based – lateral flow and dipstick methods are widely available in drug stores for use in pregnancy detection and blood glucose monitoring. These tests are successful because they are cheap to produce, easy to use, and require minimally invasive sampling. While adequate for their intended uses, in the realm of blood-borne pathogens and numerous cancers, these paper-based methods become unreliable, as they lack the nM/pM sensitivity currently achieved by clinical diagnostic methods. Clinical diagnostics, however, utilize techniques involving surface plasmon resonance (SPR) and enzyme-linked immunosorbent assays (ELISAs), which are expensive and unfeasible in terms of portability. To develop a better, competitive biosensor, we must reduce the cost of one, or increase the sensitivity of the other. Electric fields are commonly utilized in microfluidic devices to manipulate particles, biomolecules, and cells. Applications in this area, however, are primarily limited to interfaces formed between immiscible interfaces. Miscible, liquid-liquid interfaces are common in microfluidic devices, and are easily reproduced with simple geometries. Here, we demonstrate the use of electrical fields at liquid-liquid electrical interfaces, known as fluidic dielectrophoresis, (fDEP) for biodetection in a microfluidic device. In this work, we apply an AC electric field across concurrent laminar streams with differing conductivities and permittivities to polarize the interface and induce a discernible, near-immediate, frequency-dependent interfacial tilt. We design this aqueous electrical interface, which becomes the biosensing “substrate,” to be intelligent – it “moves” only when a target of interest is present. This motion requires neither labels nor expensive electrical equipment, so the biosensor is inexpensive and portable, yet still capable of sensitive detection. Nanoparticles, due to their high surface-area-to-volume ratio, are often incorporated to enhance detection capabilities of schemes like SPR and fluorimetric assays. Most studies currently investigate binding at an immobilized solid-liquid or solid-gas interface, where particles are adsorbed onto a planar surface, functionalized with a receptor to create a reactive substrate, and subsequently flushed with a fluid or gas with the relevant analyte. These typically involve many preparation and rinsing steps, and are susceptible to surface fouling. Our microfluidic device is continuously flowing and renewing the “substrate,” and is thus not subject to fouling. In this work, we demonstrate the ability to electrokinetically detect biomolecules binding to functionalized nanoparticles at liquid-liquid interfaces using fDEP. In biotin-streptavidin experiments, we report binding detection limits on the order of 1-10 pM, without amplifying signals or concentrating samples. We also demonstrate the ability to detect this interfacial motion, and thus the presence of binding, using impedance spectroscopy, allowing this scheme to become non-optical, in addition to being label-free.

Keywords: biodetection, dielectrophoresis, microfluidics, nanoparticles

Procedia PDF Downloads 366

Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the country. The elevated death and disease among ex-slaves were attributable to the unavailability of healthcare. To address the paucity of healthcare services, the College, an institution with the mission of educating minority professionals and serving the under served population, was established in 1876. This study was designed to assess if the College has accomplished its mission of serving under served communities and contributed to the elimination of health disparities in the United States. The study objective was to quantify the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities, which, in turn, was significantly associated with a health professional shortage score partly designated by the U.S. Department of Health and Human Services. Various statistical methods were used to analyze the alumni data in years 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates into the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t test was performed to detect the significant mean differences for clustering and criterion variables between Disadvantaged and Non-disadvantaged Communities, which confirms the “content” validity of cluster analysis model. Chi-square test was used to assess if the proportion of cluster groups (Disadvantaged vs Non-disadvantaged Communities) were consistent with that of practicing specialties (primary care vs. non-primary care). Finally, the partial least squares (PLS) path model was constructed to explore the “construct” validity of analytics model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving disadvantaged community. The social ecological theory along with statistical models mentioned was used to establish the relationship between medical and dental graduates (primary care professionals serving disadvantaged communities) and their social environments (socioeconomic status, adverse health outcome, health professional shortage score). Based on social ecological framework, it was hypothesized that the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities could be quantified. Also, primary care professionals serving disadvantaged communities related to a health professional shortage score can be measured. Adverse health outcome (adult obesity rate, age-adjusted premature mortality rate, and percent of people diagnosed with diabetes) could be affected by the latent variable, namely socioeconomic status (unemployment rate, poverty rate, percent of children who were in free lunch programs, and percent of uninsured adults). The study results indicated that approximately 83% (3,192/3,864) of the College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. In addition, the PLS path modeling demonstrated that primary care professionals serving disadvantaged community was significantly associated with socioeconomic status and adverse health outcome (p < .001). In summary, the majority of medical and dental graduates from the College provide primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcomes, which demonstrate that the College has fulfilled its mission.

Keywords: disadvantaged community, K-means cluster analysis, PLS path modeling, primary care

Procedia PDF Downloads 527

Authors: Farwa Rizvi, Joanne Williams, Humaira Maheen, Elizabeth Hoban

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There is an increase in risky sexual behavior and unsafe sex in adolescent girls and young women aged 15 to 24 years in Cambodia, which negatively affects their reproductive health by increasing the risk of contracting sexually transmitted infections and unintended pregnancies. Risky sexual behavior includes ‘having sex at an early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs, and unprotected sexual behaviors’. A systematic review of quantitative research conducted in Cambodia was undertaken, using the theoretical framework of the Social Ecological Model to identify the personal, social and cultural factors associated with risky sexual behavior and unsafe sex in young Cambodian women. PRISMA guidelines were used to search databases including Medline Complete, PsycINFO, CINAHL Complete, Academic Search Complete, Global Health, and Social Work Abstracts. Additional searches were conducted in Science Direct, Google Scholar and in the grey literature sources. A risk-of-bias tool developed explicitly for the systematic review of cross-sectional studies was used. Summary item on the overall risk of study bias after the inter-rater response showed that the risk-of-bias was high in two studies, moderate in one study and low in one study. The search strategy included a combination of subject terms and free text terms. The medical subject headings (MeSH) terms included were; contracept* or ‘birth control’ or ‘family planning’ or pregnan* or ‘safe sex’ or ‘protected intercourse’ or ‘unprotected intercourse’ or ‘protected sex’ or ‘unprotected sex’ or ‘risky sexual behaviour*’ or ‘abort*’ or ‘planned parenthood’ or ‘unplanned pregnancy’ AND ( barrier* or obstacle* or challenge* or knowledge or attitude* or factor* or determinant* or choic* or uptake or discontinu* or acceptance or satisfaction or ‘needs assessment’ or ‘non-use’ or ‘unmet need’ or ‘decision making’ ) AND Cambodia*. Initially, 300 studies were identified by using key words and finally, four quantitative studies were selected based on the inclusion criteria. The four studies were published between 2010 and 2016. The study participants ranged in age from 10-24 years, single or married, with 3 to 10 completed years of education. The mean age at sexual debut was reported to be 18 years. Using the perspective of the Social Ecological Model, risky sexual behavior was associated with individual-level factors including young age at sexual debut, low education, unsafe sex under the influence of alcohol and substance abuse, multiple sexual partners or transactional sex. Family level factors included living away from parents, orphan status and low levels of family support. Peer and partner level factors included peer delinquency and lack of condom use. Low socioeconomic status at the society level was also associated with risky sexual behaviour. There is scant research on sexual and reproductive health of adolescent girls and young women in Cambodia. Individual, family and social factors were significantly associated with risky sexual behaviour. More research is required to inform potential preventive strategies and policies that address young women’s sexual and reproductive health.

Keywords: adolescents, high-risk sex, sexual activity, unplanned pregnancies

Procedia PDF Downloads 217

Authors: Daniele Lerede, Gianvito Colucci, Matteo Nicoli, Laura Savoldi

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The European Green Deal is the first internationally agreed set of measures to contrast climate change and environmental degradation. Besides the main target of reducing emissions by at least 55% by 2030, it sets the target of accompanying European countries through an energy transition to make the European Union into a modern, resource-efficient, and competitive net-zero emissions economy by 2050, decoupling growth from the use of resources and ensuring a fair adaptation of all social categories to the transformation process. While the general purpose to allow the realization of the purposes of the Green Deal already dates back to 2019, strategies and policies keep being developed coping with recent circumstances and achievements. However, general long-term measures like the Circular Economy Action Plan, the proposals to shift from fossil natural gas to renewable and low-carbon gases, in particular biomethane and hydrogen, and to end the sale of gasoline and diesel cars by 2035, will all have significant effects on energy supply and demand evolution across the next decades. The interactions between energy supply and demand over long-term time frames are usually assessed via energy system models to derive useful insights for policymaking and to address technological choices and research and development. TEMOA-Europe is a newly developed energy system optimization model instance based on the minimization of the total cost of the system under analysis, adopting a technologically integrated, detailed, and explicit formulation and considering the evolution of the system in partial equilibrium in competitive markets with perfect foresight. TEMOA-Europe is developed on the TEMOA platform, an open-source modeling framework totally implemented in Python, therefore ensuring third-party verification even on large and complex models. TEMOA-Europe is based on a single-region representation of the European Union and EFTA countries on a time scale between 2005 and 2100, relying on a set of assumptions for socio-economic developments based on projections by the International Energy Outlook and a large technological dataset including 7 sectors: the upstream and power sectors for the production of all energy commodities and the end-use sectors, including industry, transport, residential, commercial and agriculture. TEMOA-Europe also includes an updated hydrogen module considering its production, storage, transportation, and utilization. Besides, it can rely on a wide set of innovative technologies, ranging from nuclear fusion and electricity plants equipped with CCS in the power sector to electrolysis-based steel production processes and steel in the industrial sector – with a techno-economic characterization based on public literature – to produce insightful energy scenarios and especially to cope with the very long analyzed time scale. The aim of this work is to examine in detail the scheme of measures and policies for the realization of the purposes of the Green Deal and to transform them into a set of constraints and new socio-economic development pathways. Based on them, TEMOA-Europe will be used to produce and comparatively analyze scenarios to assess the consequences of Green Deal-related measures on the future evolution of the energy mix over the whole energy system in an economic optimization environment.

Keywords: European Green Deal, energy system optimization modeling, scenario analysis, TEMOA-Europe

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Authors: A. Calabrese, V. F. Uricchio, D. di Noia, S. Favale, C. Caiati, G. P. Maggi, G. Donvito, D. Diacono, S. Tangaro, A. Italiano, E. Riezzo, M. Zippitelli, M. Toriello, E. Celiberti, D. Festa, A. Colaianni

Abstract:

Climate change has a severe impact on human health. There is a vast literature demonstrating temperature increase is causally related to cardiovascular problem and represents a high risk for human health, but there are not study that improve a solution. In this work, it is studied how the clime influenced the human parameter through the analysis of climatic conditions in an area of the Apulia Region: Capurso Municipality. At the same time, medical personnel involved identified a set of variables useful to define an index describing health condition. These scientific studies are the base of an innovative alert system, IPPOCRATE, whose aim is to asses climate risk and share information to population at risk to support prevention and mitigation actions. IPPOCRATE is an e-health system, it is designed to provide technological support to analysis of health risk related to climate and provide tools for prevention and management of critical events. It is the first integrated system of prevention of human risk caused by climate change. IPPOCRATE calculates risk weighting meteorological data with the vulnerability of monitored subjects and uses mobile and cloud technologies to acquire and share information on different data channels. It is composed of four components: Multichannel Hub. Multichannel Hub is the ICT infrastructure used to feed IPPOCRATE cloud with a different type of data coming from remote monitoring devices, or imported from meteorological databases. Such data are ingested, transformed and elaborated in order to be dispatched towards mobile app and VoIP phone systems. IPPOCRATE Multichannel Hub uses open communication protocols to create a set of APIs useful to interface IPPOCRATE with 3rd party applications. Internally, it uses non-relational paradigm to create flexible and highly scalable database. WeHeart and Smart Application The wearable device WeHeart is equipped with sensors designed to measure following biometric variables: heart rate, systolic blood pressure and diastolic blood pressure, blood oxygen saturation, body temperature and blood glucose for diabetic subjects. WeHeart is designed to be easy of use and non-invasive. For data acquisition, users need only to wear it and connect it to Smart Application by Bluetooth protocol. Easy Box was designed to take advantage from new technologies related to e-health care. EasyBox allows user to fully exploit all IPPOCRATE features. Its name, Easy Box, reveals its purpose of container for various devices that may be included depending on user needs. Territorial Registry is the IPPOCRATE web module reserved to medical personnel for monitoring, research and analysis activities. Territorial Registry allows to access to all information gathered by IPPOCRATE using GIS system in order to execute spatial analysis combining geographical data (climatological information and monitored data) with information regarding the clinical history of users and their personal details. Territorial Registry was designed for different type of users: control rooms managed by wide area health facilities, single health care center or single doctor. Territorial registry manages such hierarchy diversifying the access to system functionalities. IPPOCRATE is the first e-Health system focused on climate risk prevention.

Keywords: climate change, health risk, new technological system

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Authors: Anushka Naidoo, Veron Ramsuran, Maxwell Chirehwa, Paolo Denti, Kogieleum Naidoo, Helen McIlleron, Nonhlanhla Yende-Zuma, Ravesh Singh, Sinaye Ngcapu, Nesri Padayatachi

Abstract:

Background: Despite efforts to introduce new drugs and shorter drug regimens for drug-susceptible tuberculosis (TB), the standard first-line treatment has not changed in over 50 years. Rifampicin, isoniazid, and pyrazinamide are critical components of the current standard treatment regimens. Some studies suggest that microbiologic failure and acquired drug resistance are primarily driven by low drug concentrations that result from pharmacokinetic (PK) variability independent of adherence to treatment. Wide between-patient pharmacokinetic variability for rifampin, isoniazid, and pyrazinamide has been reported in prior studies. There may be several reasons for this variability. However, genetic variability in genes coding for drug metabolizing and transporter enzymes have been shown to be a contributing factor for variable tuberculosis drug exposures. Objective: We describe the pharmacokinetics of first-line TB drugs rifampicin, isoniazid, and pyrazinamide and assess the effect of genetic variability in relevant selected drug metabolizing and transporter enzymes on pharmacokinetic parameters of isoniazid and rifampicin. Methods: We conducted the randomized-controlled Improving retreatment success TB trial in Durban, South Africa. The drug regimen included rifampicin, isoniazid, and pyrazinamide. Drug concentrations were measured in plasma, and concentration-time data were analysed using nonlinear-mixed-effects models to quantify the effects of relevant covariates and single nucleotide polymorphisms (SNP’s) of drug metabolizing and transporter genes on rifampicin, isoniazid and pyrazinamide exposure. A total of 25 SNP’s: four NAT2 (used to determine acetylator status), four SLCO1B1, three Pregnane X receptor (NR1), six ABCB1 and eight UGT1A, were selected for analysis in this study. Genotypes were determined for each of the SNP’s using a TaqMan® Genotyping OpenArray™. Results: Among fifty-eight patients studied; 41 (70.7%) were male, 97% black African, 42 (72.4%) HIV co-infected and 40 (95%) on efavirenz-based ART. Median weight, fat-free mass (FFM), and age at baseline were 56.9 kg (interquartile range, IQR: 51.1-65.2), 46.8 kg (IQR: 42.5-50.3) and 37 years (IQR: 31-42), respectively. The pharmacokinetics of rifampicin and pyrazinamide was best described using one-compartment models with first-order absorption and elimination, while for isoniazid two-compartment disposition was used. The median (interquartile range: IQR) AUC (h·mg/L) and Cmax (mg/L) for rifampicin, isoniazid, and pyrazinamide were; 25.62 (23.01-28.53) and 4.85 (4.36-5.40), 10.62 (9.20-12.25) and 2.79 (2.61-2.97), 345.74 (312.03-383.10) and 28.06 (25.01-31.52), respectively. Eighteen percent of patients were classified as rapid acetylators, and 34% and 43% as slow and intermediate acetylators, respectively. Rapid and intermediate acetylator status based on NAT 2 genotype resulted in 2.3 and 1.6 times higher isoniazid clearance than slow acetylators. We found no effects of the SLCO1B1 genotypes on rifampicin pharmacokinetics. Conclusion: Plasma concentrations of rifampicin, isoniazid, and pyrazinamide were low overall in our patients. Isoniazid clearance was high overall and as expected higher in rapid and intermediate acetylators resulting in lower drug exposures. In contrast to reports from previous South African or Ugandan studies, we did not find any effects of the SLCO1B1 or other genotypes tested on rifampicin PK. However, our findings are in keeping with more recent studies from Malawi and India emphasizing the need for geographically diverse and adequately powered studies. The clinical relevance of the low tuberculosis drug concentrations warrants further investigation.

Keywords: rifampicin, isoniazid pharmacokinetics, genetics, NAT2, SLCO1B1, tuberculosis

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Authors: Ikele Chika Bright, Mgbenka Bernard Obialo, Ikele Chioma Faith

Abstract:

Icthyophthiriasis is a prevalent protozoan (ectoparasite) mostly affecting cultured and aquarium fishes. The majority of the chemotherapeutants lack efficacy for completely eliminating Ich parasite without affecting the environment and they are not safe for human health. The present work is focused on the evaluating different immersion treatments of African catfish (Clarias gariepinus) infected with ichthyophthiriasis and treated with a non-chemical and environmental friendly parasiticides Moringa oleifera. A total number of 800 apparently healthy parasites free (examined) post juvenile catfish were obtained from a reputable farm, disinfected with potassium permanganate in a quarantine tank to remove any possible external parasites. The fish were further challenged with approximately 44,000 infective stages of theronts which were obtained through serial passages by cohabitation. Seven groups (A-G) of post Juvenile were used for the experiment which was carried out into three stages; Dips (60minutes), short term treatment (24-96h) and prolong bath treatment (0-15 days). The concentrations selected were dependent on the outcome of the LC50 of the plant material from which dose-dependent factors were used to select various concentrations of the treatment. In Dips treatment, group D-G were treated with 1,500mg/L, 2500mg/L., 3500mg/L and 4500mg/L, short-term treatment was treated with 150mg/L, 250mg/L, 350mg/L and 450mg/L and prolong bath was treated with 15mg/L, 25mg/L, 35mg/L and 45mg/L of the plant extract whereas group A, B and C were normal control, Ich- infested not treated and Ich- infested treated with standard drug (Acriflavin), respectively. The various types of treatment applied with corresponding concentrations showed almost complete elimination of the adult parasites (trophonts) both in the gills and the body smear, thereby making M. oleifera a potential parasiticides. There were serious pathological alterations in the skin and gills which are usually the main point for Ich parasites invasion but no significant morphological characteristics was noted among the treated groups subjected to different immersion treatment patterns. Epitheliocystis, aneurysm, oedema, hemorrhage, and localization of the adult parasite in the gills were the overall common observations made in the gills whereas degeneration of muscle fibre, dermatitis, hemorrhage, oedema, abscess formation and keratinisation were observed in the skin. However, there are no pathological changes in the control group. Moreover, biochemical parameters such as urea, creatinine, albumin., globulin, total protein, ALT, AST), blood chemistry (sodium, chloride, potassium, bicarbonate), antioxidants (CAT, SOD, GPx, LPO), enzymatic activities (myeloperoxidase, thioreadoxin reductase), Inflammatory response (C-reactive protein), Stress markers (lactate dehydrogenase), heamatological parameters (RBC, PCV, WBC, HB and differential count), lipid profile (total cholesterol, tryglycerides , high density lipoprotein and low density lipoprotein) all showed various significant (P<0.05) and no significant (P>0.05) responses among the Ich-infested fish treated under three immersion treatments. It is suggested that M. oleifera may serve as an alternatives to chemotherapeutants for control of Ichthyophthiriasis in African catfish Clarias gariepinus.

Keywords: Icthyophthirius multifilis, immersion treatment, pathophysiology, African catfish

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Authors: Eric Spruth, Lindsey Herbert, Danielle DiCristofano, Isis Violet Spruth, Drake Von Spruth

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Turning dreams into reality, the lifelong passion of Mr. Spruth and the company is to transform garbage-filled courtyards into flourishing flower and vegetable gardens, bringing light, hope, and wellness to not just the space but to the populations served within these public and private spaces. As an Expressive Art Therapist at Cook County Jail, Eric Spruth has implemented gardening projects, mobile radish carts, plant fostering systems, and large-scale murals. Lindsey Herbert, the Manager of Operations and Events at the International Museum of Surgical Science, supports gardening projects with Mr. Spruth along the front lawn of the museum, which will eventually accumulate into a community wellness garden. Mr. Spruth and Ms. Herbert both have dedicated efforts towards fostering awareness of hope and help and accountability for physical and mental wellbeing. Medicinal plants can rightfully be called one of nature’s wonderful healing tools with therapeutic powers. They can inhibit and kill bacteria, lower blood pressure, blood cholesterol, and blood sugar, prevent blood clotting, boost the immune system, and serve as a digestive aid. Some plants have the ability to stimulate the lymphatic system, which expedites the removal of waste products from the body to fight off evil toxins. Many plants are considered effective antioxidants to protect cells against free radical damage, serving to prevent some forms of cancer, heart disease, strokes, and viral infections. Garlic alone can provide us with over two hundred unusual chemicals that have the capability of protecting the human body from a wide variety of diseases. Besides the medicinal qualities of plants, plant and vegetable gardens also have an echoing effect on non-participants to look at something beautiful rather than a concrete courtyard or an unkempt lawn in front of a beautiful building. Plants also purify spaces and affect mood with color therapy. Collective gardening can foster a sense of community and purpose. Additionally, by recognizing the ever-evolving planet with global warming, horticulture therapy teaches important lessons in responsibility, accountability, and sustainability. Growing local food provides an opportunity to be involved in your own mental and physical health and gives you a chance for your own self-resilience, combating depression and a lack of nutrition. In adolescents, the process of watering and caring for plants can teach important life lessons that transcend beyond the garden by providing knowledge on how to care for yourself and how to be an active member of society. It also gives a sense of purpose and pride in transforming a small seed into a plant that can be consumed or enjoyed by others. Mr. Spruth and Ms. Herbert recognize the importance of bringing more green spaces to urban areas, both to serve a nutritional benefit and provide a beautiful transformation to underutilized areas. Gardens can bring beauty, wellness, and hope to dark spaces and provide immeasurable benefits for all.

Keywords: growth, hope, mental health, sustainability, transformation, wellness

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Authors: Naoko Ono, Junko Kato

Abstract:

According to the Ministry of Justice, 9,044,000 foreigners visited Japan in 2010. The number of foreign residents in Japan was over 2,134,000 at the end of 2010. Further, medical tourism has emerged as a new area of business. Against this background, language barriers put the health of foreigners in Japan at risk, because they have difficulty in accessing health care and communicating with medical professionals. Medical interpreting training is urgently needed in response to language problems resulting from the rapid increase in the number of foreign workers in Japan over recent decades. Especially, there is a growing need in medical settings in Japan to speak international languages for communication, with Tokyo selected as the host city of the 2020 Summer Olympics. Due to the limited number of practical activities on medical interpreting, it is difficult for learners to acquire the interpreting skills. In order to eliminate the shortcoming, a web-based English-Japanese medical interpreting training system was developed. We conducted a literature review to identify learning contents, core competencies for medical interpreters by using Pubmed, PsycINFO, Cochrane Library, and Google Scholar. Selected papers were investigated to find core competencies in medical interpreting. Eleven papers were selected through literature review indicating core competencies for medical interpreters. Core competencies in medical interpreting abstracted from the literature review, showed consistency in previous research whilst the content of the programs varied in domestic and international training programs for medical interpreters. Results of the systematic review indicated five core competencies: (a) maintaining accuracy and completeness; (b) medical terminology and understanding the human body; (c) behaving ethically and making ethical decisions; (d) nonverbal communication skills; and (e) cross-cultural communication skills. We developed an e-leaning program for training medical interpreters. A Web-based Medical Interpreter Training Program which cover these competencies was developed. The program included the following : online word list (Quizlet), allowing student to study online and on their smartphones; self-study tool (Quizlet) for help with dictation and spelling; word quiz (Quizlet); test-generating system (Quizlet); Interactive body game (BBC);Online resource for understanding code of ethics in medical interpreting; Webinar about non-verbal communication; and Webinar about incompetent vs. competent cultural care. The design of a virtual environment allows the execution of complementary experimental exercises for learners of medical interpreting and introduction to theoretical background of medical interpreting. Since this system adopts a self-learning style, it might improve the time and lack of teaching material restrictions of the classroom method. In addition, as a teaching aid, virtual medical interpreting is a powerful resource for the understanding how actual medical interpreting can be carried out. The developed e-learning system allows remote access, enabling students to perform experiments at their own place, without being physically in the actual laboratory. The web-based virtual environment empowers students by granting them access to laboratories during their free time. A practical example will be presented in order to show capabilities of the system. The developed web-based training program for medical interpreters could bridge the gap between medical professionals and patients with limited English proficiency.

Keywords: e-learning, language education, moodle, medical interpreting

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Authors: Farhana Alam Bhuiyan, Saad Khan, Tanveer Hassan, Jhalok Ranjon Talukder, Syeda Farjana Ahmed, Rahil Roodsaz, Els Rommes, Sabina Faiz Rashid

Abstract:

Breaking the shame’ is a 3 year (2015-2018) qualitative implementation research project which investigates several aspects of sexual and reproductive health and rights (SRHR) issues for adolescents living in Bangladesh. Scope of learning SRHR issues for adolescents is limited here due to cultural and religious taboos. This study adds to the ongoing discussions around adolescent’s SRHR needs and aims to, 1) understand the overall SRHR needs of urban and rural unmarried female and male adolescents and the challenges they face, 2) explore existing gaps in the content of SRHR curriculum and 3) finally, addresses some critical knowledge gaps by developing and implementing innovative SRHR educational materials. 18 in-depth interviews (IDIs) and 10 focus-group discussions (FGDs) with boys and 21 IDIs and 14 FGDs with girls of ages 13-19, from both urban and rural setting took place. Curriculum materials from two leading organizations, Unite for Body Rights (UBR) Alliance Bangladesh and BRAC Adolescent Development Program (ADP) were also reviewed, with discussions with 12 key program staff. This paper critically analyses the relevance of some of the SRHR topics that are covered, the challenges with existing pedagogic approaches and key sexuality issues that are not covered in the content, but are important for adolescents. Adolescents asked for content and guidance on a number of topics which remain missing from the core curriculum, such as emotional coping mechanisms particularly in relationships, bullying, impact of exposure to porn, and sexual performance anxiety. Other core areas of concern were effects of masturbation, condom use, sexual desire and orientation, which are mentioned in the content, but never discussed properly, resulting in confusion. Due to lack of open discussion around sexuality, porn becomes a source of information for the adolescents. For these reasons, several myths and misconceptions regarding SRHR issues like body, sexuality, agency, and gender roles still persist. The pedagogical approach is very didactic, and teachers felt uncomfortable to have discussions on certain SRHR topics due to cultural taboos or shame and stigma. Certain topics are favored- such as family planning, menstruation- and presented with an emphasis on biology and risk. Rigid formal teaching style, hierarchical power relations between students and most teachers discourage questions and frank conversations. Pedagogy approaches within classrooms play a critical role in the sharing of knowledge. The paper also describes the pilot approaches to implementing new content in SRHR curriculum. After a review of findings, three areas were selected as critically important, 1) myths and misconceptions 2) emotional management challenges, and 3) how to use condom, that have come up from adolescents. Technology centric educational materials such as web page based information platform and you tube videos are opted for which allow adolescents to bypass gatekeepers and learn facts and information from a legitimate educational site. In the era of social media, when information is always a click away, adolescents need sources that are reliable and not overwhelming. The research aims to ensure that adolescents learn and apply knowledge effectively, through creating the new materials and making it accessible to adolescents.

Keywords: adolescents, Bangladesh, media, sexuality education, unmet needs

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Authors: M. Doudi, M. H. Pazandeh, L. Rahimzadeh Torabi

Abstract:

Bedsores are pressure ulcers that occur on the skin or tissue due to being immobile and lying in bed for extended periods. Bedsores have the potential to progress into open ulcers, increasing the possibility of a variety of bacterial infections. Acinetobacter baumannii, a pathogen of considerable clinical importance, exhibited a significant correlation with Bedsores (pressure ulcers) infections, thereby manifesting a wide spectrum of antibiotic resistance. The emergence of drug resistance has led researchers to focus on alternative methods, particularly phage therapy, for tackling bacterial infections. Phage therapy has emerged as a novel therapeutic approach to regulate the activity of these agents. The management of bacterial infections greatly benefits from the clinical utilization of bacteriophages as a valuable antimicrobial intervention. The primary objective of this investigation consisted of isolating and discerning potent bacteriophage capable of targeting multi-drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria obtained from pressure ulcers. The present study analyzed and isolated A. baumannii strains obtained from a cohort of patients suffering from pressure ulcers at Taleghani Hospital in Ahvaz, Iran. An approach that included biochemical and molecular identification techniques was used to determine the taxonomic classification of bacterial isolates at the genus and species levels. The molecular identification process was facilitated by using the 16S rRNA gene in combination with universal primers 27 F and 1492 R. Bacteriophage was obtained through the isolation process conducted on treatment plant sewage located in Isfahan, Iran. The main goal of this study was to evaluate different characteristics of phage, such as their appearance, the range of hosts they can infect, how quickly they can enter a host, their stability at varying temperatures and pH levels, their effectiveness in killing bacteria, the growth pattern of a single phage stage, mapping of enzymatic digestion, and identification of proteomics patterns. The findings demonstrated that an examination was conducted on a sample of 50 specimens, wherein 15 instances of A. baumannii were identified. These microorganisms are the predominant Gram-negative agents known to cause wound infections in individuals suffering from bedsores. The study's findings indicated a high prevalence of antibiotic resistance in the strains isolated from pressure ulcers, excluding the clinical strains that exhibited responsiveness to colistin. According to the findings obtained from assessments of host range and morphological characteristics of bacteriophage VbɸAB-1, it can be concluded that this phage possesses specificity towards A. Baumannii BAH_Glau1001 was classified as a member of the Podoviridae family. The bacteriophage mentioned earlier showed the strongest antibacterial effect at a temperature of 18 °C and a pH of 6.5. Through the utilization of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis on protein fragments, it was established that the bacteriophage VbɸAB-1 exhibited a size range between 50 and 75 kilodaltons (KDa). The numerous research findings on the effectiveness of phages and the safety studies conducted suggest that the phages studied in this research can be considered as a practical solution and recommended approach for controlling and treating stubborn pathogens in burn wounds among hospitalized patients. The findings of our research indicated that isolated phages could be an effective antimicrobial and an appreciate candidate for prophylaxis against pressure ulcers.

Keywords: acinetobacter baumannii, extremely drug-resistant, phage therapy, surgery wound

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Authors: B. M. Moda, L. F. Secco

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Through free and fair elections and others less democratic processes, Latin America has been gradually turning into a right-wing political region. In order to understand these recent changes, this paper aims to discuss the origin and the traits of the pink wave in the subcontinent, the reasons for its current rollback and future projections for left-wing in the region. The methodology used in this paper will be descriptive and analytical combined with secondary sources mainly from the social and political sciences fields. The canons of the Washington Consensus was implemented by the majority of the Latin American governments in the 80s and 90s under the social democratic and right-wing parties. The neoliberal agenda caused political, social and economic dissatisfaction bursting into a new political configuration for the region. It started in 1998 when Hugo Chávez took the office in Venezuela through the Fifth Republic Movement under the socialist flag. From there on, Latin America was swiped by the so-called ‘pink wave’, term adopted to define the rising of self-designated left-wing or center-left parties with a progressive agenda. After Venezuela, countries like Chile, Brazil, Argentina, Uruguay, Bolivia, Equator, Nicaragua, Paraguay, El Salvador and Peru got into the pink wave. The success of these governments was due a post-neoliberal agenda focused on cash transfers programs, increasing of public spending, and the straightening of national market. The discontinuation of the preference for the left-wing started in 2012 with the coup against Fernando Lugo in Paraguay. In 2015, the chavismo in Venezuela lost the majority of the legislative seats. In 2016, an impeachment removed the Brazilian president Dilma Rousself from office who was replaced by the center-right vice-president Michel Temer. In the same year, Mauricio Macri representing the right-wing party Proposta Republicana was elected in Argentina. In 2016 center-right and liberal, Pedro Pablo Kuczynski was elected in Peru. In 2017, Sebastián Piñera was elected in Chile through the center-right party Renovación Nacional. The pink wave current rollback points towards some findings that can be arranged in two fields. Economically, the 2008 financial crisis affected the majority of the Latin American countries and the left-wing economic policies along with the end of the raw materials boom and the subsequent shrinking of economic performance opened a flank for popular dissatisfaction. In Venezuela, the 2014 oil crisis reduced the revenues for the State in more than 50% dropping social spending, creating an inflationary spiral, and consequently loss of popular support. Politically, the death of Hugo Chavez in 2013 weakened the ‘socialism of the twenty first century’ ideal, which was followed by the death of Fidel Castro, the last bastion of communism in the subcontinent. In addition, several cases of corruption revealed during the pink wave governments made the traditional politics unpopular. These issues challenge the left-wing to develop a future agenda based on innovation of its economic program, improve its legal and political compliance practices, and to regroup its electoral forces amid the social movements that supported its ascension back in the early 2000s.

Keywords: Latin America, political parties, left-wing, right-wing, pink wave

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