Search results for: monitoring tool

Authors: Hela Ghali, Sihem Ben Fredj, Mohamed Ben Rejeb, Sawssen Layouni, Salwa Khefacha, Lamine Dhidah, Houyem Said Laatiri

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Background: Antimicrobial resistance is a growing threat to public health and motivates to improve prevention and control programs both at international (WHO) and national levels. Despite their low pathogenicity, vancomycin-resistant enterococci (VRE) are common nosocomial pathogens in several countries. The high potential for transmission of VRE between patients and the threat to send its resistance genes to other bacteria such as staphylococcus aureus already resistant to meticilin, justify strict control measures. Indeed, in Europe, the proportion of Enterococcus faecium responsible for invasive infections, varies from 1% to 35% in 2011 and less than 5% were resistant to vancomycin. In addition, it represents the second cause of urinary tract and wound infections and the third cause of nosocomial bacteremia in the United States. The nosocomial outbreaks of VRE have been mainly described in intensive care services, hematology-oncology and haemodialysis. An epidemic of VRE has affected our hospital and the objective of this work is to describe the measures put in place. Materials/Methods: Following the alert given by the service of plastic surgery concerning a patient carrier of VRE, a team of the prevention and healthcare security service (doctor + technician) made an investigation. A review of files was conducted to draw the synoptic table and the table of cases. Results: By contacting the microbiology laboratory, we have identified four other cases of VRE and who were hospitalized in Medical resuscitation department (2 cases, one of them was transferred to the Physical rehabilitation department), and Nephrology department (2 cases). The visit has allowed to detect several malfunctions in professional practice. A crisis cell has allowed to validate, coordinate and implement control measures following the recommendations of the Technical Center of nosocomial infections. In fact, the process was to technically isolate cases in their sector of hospitalization, to restrict the use of antibiotics, to strength measures of basic hygiene, and to make a screening by rectal swab for both cases and contacts (other patients and health staff). These measures have helped to control the situation and no other case has been reported for a month. 2 new cases have been detected in the intensive care unit after a month. However, these are short-term strategies, and other measures in the medium and long term should be taken into account in order to face similar outbreaks. Conclusion: The efforts to control the outbreak were not efficient since 2 new cases have been reported after a month. Therefore, a continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of VRE.

Keywords: hospitals, nosocomial infection, outbreak, vancomycin-resistant enterococci

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Authors: Alisa Salimova, Jiane Zuo, Christopher Homer

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The objective of this study is to analyse the North Canal riparian zone land use with the help of remote sensing analysis in ArcGis using 30 cloudless Landsat8 open-source satellite images from May to August of 2013 and 2017. Land cover, urban construction, heat island effect, vegetation cover, and water system change were chosen as the main parameters and further analysed to evaluate its impact on the North Canal water quality. The methodology involved the following steps: firstly, 30 cloudless satellite images were collected from the Landsat TM image open-source database. The visual interpretation method was used to determine different land types in a catchment area. After primary and secondary classification, 28 land cover types in total were classified. Visual interpretation method was used with the help ArcGIS for the grassland monitoring, US Landsat TM remote sensing image processing with a resolution of 30 meters was used to analyse the vegetation cover. The water system was analysed using the visual interpretation method on the GIS software platform to decode the target area, water use and coverage. Monthly measurements of water temperature, pH, BOD, COD, ammonia nitrogen, total nitrogen and total phosphorus in 2013 and 2017 were taken from three locations of the North Canal in Tongzhou district. These parameters were used for water quality index calculation and compared to land-use changes. The results of this research were promising. The vegetation coverage of North Canal riparian zone in 2017 was higher than the vegetation coverage in 2013. The surface brightness temperature value was positively correlated with the vegetation coverage density and the distance from the surface of the water bodies. This indicates that the vegetation coverage and water system have a great effect on temperature regulation and urban heat island effect. Surface temperature in 2017 was higher than in 2013, indicating a global warming effect. The water volume in the river area has been partially reduced, indicating the potential water scarcity risk in North Canal watershed. Between 2013 and 2017, urban residential, industrial and mining storage land areas significantly increased compared to other land use types; however, water quality has significantly improved in 2017 compared to 2013. This observation indicates that the Tongzhou Water Restoration Plan showed positive results and water management of Tongzhou district had been improved.

Keywords: North Canal, land use, riparian vegetation, river ecology, remote sensing

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Authors: Rizwan Ahmad, Soomin Chang, Daeun Kwon, Jeonghwan Kim

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Interests in an inorganic membrane are growing rapidly for industrial wastewater treatment due to its excellent chemical and thermal stability over polymeric membrane. Nevertheless, understanding of the membrane rejection and fouling rate caused by the deposit of contaminants on membrane surface and within membrane pores through inorganic porous membranes still requires much attention. Microfiltration alumina membranes were developed and applied for the industrial wastewater treatment to investigate rejection efficiency of organic contaminant and membrane fouling at various operational conditions. In this study, organic rejection and membrane fouling were investigated by using the alumina flat-tubular membrane developed for the treatment of industrial wastewaters. The flat-tubular alumina membranes were immersed in a fluidized membrane reactor added with granular activated carbon (GAC) particles. Fluidization was driven by recirculating a bulk industrial wastewater along membrane surface through the reactor. In the absence of GAC particles, for hazardous anionic dye contaminants, functional group characterized by the organic contaminant was found as one of the main factors affecting both membrane rejection and fouling rate. More fouling on the membrane surface led to the existence of dipolar characterizations and this was more pronounced at lower solution pH, thereby improving membrane rejection accordingly. Similar result was observed with a real metal-plating wastewater. Strong correlation was found that higher fouling rate resulted in higher organic rejection efficiency. Hydrophilicity exhibited by alumina membrane improved the organic rejection efficiency of the membrane due to the formation of hydrophilic fouling layer deposited on it. In addition, less surface roughness of alumina membrane resulted in less fouling rate. Regardless of the operational conditions applied in this study, fluidizing the GAC particles along the surface of alumina membrane was very effective to enhance organic removal efficiency higher than 95% and provide an excellent tool to reduce membrane fouling. Less than 0.1 bar as suction pressure was maintained with the alumina membrane at 25 L/m²hr of permeate set-point flux during the whole operational periods without performing any backwashing and chemical enhanced cleaning for the membrane.

Keywords: alumina membrane, fluidized membrane reactor, industrial wastewater, membrane fouling, rejection

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Authors: C. O. Igberi, M. U. Amadi

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This research paper on the impact of import restriction on rice production in Nigeria is aimed at finding/proffering valid solutions to the age long problem of rice self-sufficiency, through a better understanding of policy measures used in the past, in this case, the effectiveness of rice import restriction of the early 90’s. It tries to answer the questions of; import restriction boosting domestic rice production and the macroeconomic determining factors of Gross Domestic Rice Product (GDRP). The research probe is investigated through literature and analytical frameworks, such that time series data on the GDRP, Gross Fixed Capital Formation (GFCF), average foreign rice producers’ prices(PPF), domestic producers’ prices (PPN) and the labour force (LABF) are collated for analysis (with an import restriction dummy variable, POL1). The research objectives/hypothesis are analysed using; Cointegration, Vector Error Correction Model (VECM), Impulse Response Function (IRF) and Granger Causality Test(GCT) methodologies. Results show that in the short-run error correction specification for GDRP, a percentage (1%) deviation away from the long-run equilibrium in a current quarter is only corrected by 0.14% in the subsequent quarter. Also, the rice import restriction policy had no significant effect on the GDRP at this time. Other findings show that the policy period has, in fact, had effects on the PPN and LABF. The choice variables used are valid macroeconomic factors that explain the GDRP of Nigeria, as adduced from the IRF and GCT, and in the long-run. Policy recommendations suggest that the import restriction is not disqualified as a veritable tool for improving domestic rice production, rather better enforcement procedures and strict adherence to the policy dictates is needed. Furthermore, accompanying policies which drive public and private capital investment and accumulation must be introduced. Also, employment rate and labour substitution in the agricultural sector should not be drastically changed, rather its welfare and efficiency be improved.

Keywords: import restriction, gross domestic rice production, cointegration, VECM, Granger causality, impulse response function

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Authors: Su Yin Chiam, Zhipeng Ding, Guang Yang, Danny Jian Hang Tng, Peiyi Song, Geok Ing Ng, Ken-Tye Yong, Qing Xin Zhang

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Brain-machine interfaces (BMI) is a ground rich of exploration opportunities where manipulation of neural activity are used for interconnect with myriad form of external devices. These research and intensive development were evolved into various areas from medical field, gaming and entertainment industry till safety and security field. The technology were extended for neurological disorders therapy such as obsessive compulsive disorder and Parkinson’s disease by introducing current pulses to specific region of the brain. Nonetheless, the work to develop a real-time observing, recording and altering of neural signal brain-machine interfaces system will require a significant amount of effort to overcome the obstacles in improving this system without delay in response. To date, feature size of interface devices and the density of the electrode population remain as a limitation in achieving seamless performance on BMI. Currently, the size of the BMI devices is ranging from 10 to 100 microns in terms of electrodes’ diameters. Henceforth, to accommodate the single cell level precise monitoring, smaller and denser Nano-scaled nanowire electrode arrays are vital in fabrication. In this paper, we would like to showcase the fabrication of high aspect ratio of vertical silicon nanowire electrodes arrays using microelectromechanical system (MEMS) method. Nanofabrication of the nanowire electrodes involves in deep reactive ion etching, thermal oxide thinning, electron-beam lithography patterning, sputtering of metal targets and bottom anti-reflection coating (BARC) etch. Metallization on the nanowire electrode tip is a prominent process to optimize the nanowire electrical conductivity and this step remains a challenge during fabrication. Metal electrodes were lithographically defined and yet these metal contacts outline a size scale that is larger than nanometer-scale building blocks hence further limiting potential advantages. Therefore, we present an integrated contact solution that overcomes this size constraint through self-aligned Nickel silicidation process on the tip of vertical silicon nanowire electrodes. A 4 x 4 array of vertical silicon nanowires electrodes with the diameter of 290nm and height of 3µm has been successfully fabricated.

Keywords: brain-machine interfaces, microelectromechanical systems (MEMS), nanowire, nickel silicide

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Authors: Meryam Labyad, Karima Fakiri, Widad Lahmini, Ghizlane Draiss, Mohamed Bouskraoui, Nadia Ouzennou

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Background: Asthma is the most common chronic disease in children, affecting nearly 235 million people worldwide (OMS). In Morocco, asthma is much more common in children than in adults; the prevalence rate in children between 13 and 14 years of age is 20%.1 This pathology is marked by high morbidity, a significant impact on the quality of life and development of children 2 This requires a rigorous management strategy in order to achieve clinical control and reduce any risk to the patient 3 A search for aggravating factors is mandatory if a child has difficulty maintaining good asthma control. The objective of the present study is to describe asthma control during this confinement period in children aged 4 to 11 years followed by a pneumo-paediatric consultation. For children whose asthma is not controlled, a search for associations with promoting factors and adherence to treatment is also among the objectives of the study. Knowing the level of asthma control and influencing factors is a therapeutic priority in order to reduce hospitalizations and emergency care use. Objective: To assess asthma control and determine the factors influencing asthma levels in children with asthma during confinement following the COVID 19 pandemic. Method: Prospective cross-sectional study by questionnaire and structured interview among 66 asthmatic children followed in pediatric pneumology consultation at the CHU MED VI of Marrakech from 13/06/2020 to 13/07/2020, asthma control was assessed by the Childhood Asthma Control Test (C-ACT). Results: 66 children and their parents were included (mean age is 7.5 years), asthma was associated with allergic rhinitis (13.5% of cases), conjunctivitis (9% of cases), eczema (12% of cases), occurrence of infection (10.5% of cases). The period of confinement was marked by a decrease in the number of asthma attacks translated by a decrease in the number of emergency room visits (7.5%) of these asthmatic children, control was well controlled in 71% of the children, this control was significantly associated with good adherence to treatment (p<0.001), no infection (p<0.001) and no conjunctivitis (p=002) or rhinitis (p<0.001). This improvement in asthma control during confinement can be explained by the measures taken in the Kingdom to prevent the spread of COVID 19 (school closures, reduction in industrial activity, fewer means of transport, etc.), leading to a decrease in children's exposure to triggers, which justifies the decrease in the number of children having had an infection, allergic rhinitis or conjunctivitis during this period. In addition, the close monitoring of parents resulted in better therapeutic adherence (42.4% were fully observant). Confinement was positively perceived by 68% of the parents; this perception is significantly associated with the level of asthma control (p<0.001). Conclusion: Maintaining good control can be achieved through improved therapeutic adherence and avoidance of triggers, both of which were achieved during the containment period following the VIDOC pandemic 19.

Keywords: Asthma, control , COVID-19 , children

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Authors: Alan Lai, Wilson Yik

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With rapid urbanization, there has been a dramatic increase in global urban population in Asia and over half of population in Asia will live in urban regions in the near future. Facing with increasing exposure to climate-related stresses and shocks, most of the Asian cities will very likely to experience more frequent heat waves and flooding with rising sea levels, particularly the coastal cities will grapple for intense typhoons and storm surges. These climate changes have severe impacts in urban areas at the costs of infrastructure and population, for example, human health, wellbeing and high risks of dengue fever, malaria and diarrheal disease. With the increasing prominence of adaptation to climate changes, there have been changes in corresponding policies. Smaller cities have greater potentials for integrating the concept of resilience into their infrastructure as well as keeping pace with their rapid growths in population. It is therefore important to explore the potentials of Asian cities adapting to climate change and the opportunities of building climate resilience in urban planning and building design. Furthermore, previous studies have mainly attempted at exploiting the potential of resilience on a macro-level within urban planning rather than that on micro-level within the context of individual building. The resilience of individual building as a research field has not yet been much explored. Nonetheless, recent studies define that the resilience of an individual building is the one which is able to respond to physical damage and recover from such damage in a quickly and cost-effectively manner, while maintain its primary functions. There is also a need to develop an assessment tool to evaluate the resilience on building scale which is still largely uninvestigated as it should be regarded as a basic function of a building. Due to the lack of literature reporting metric for assessing building resilience with sustainability, the research will be designed as a case study to provide insight into the issue. The aim of this research project is to encourage and assist in developing neighborhood climate resilience design strategies for Hong Kong so as to bridge the gap between difference scales and that between theory and practice.

Keywords: resilience cities, building resilience, resilient buildings and infrastructure, climate resilience, hot and humid southeast area, high-density cities

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Authors: Pushkar Lal Sharma, Sanjana Singh, Umesh Kumar Sahu

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This paper helps to understand the need of Customer Relationship Management in Libraries and why Librarians should implement the marketing concept of Customer Relationship Management in their libraries. As like any industry, libraries too face growing challenges to continuously meet customer expectations, and attract and retain users in light of overflowing competition. The ability to understand customers, build relationships and market diverse services is essential when considering ways to expand service offerings and improve Return on Investment. Since Library is service oriented Enterprise, hence the Customer/User/ Reader/Patron are the most important element of Library & Information System to whom and for whom library offers various services. How to provide better and most efficient services to its users is the main concern of every Library & Information centre in the present era. The basic difference between Business Enterprise and Library Information System is that ‘in Business System ‘the efficiency is measured in terms of ’profit’ or ‘monetary gains’; whereas in a Library & Information System, the efficiency is measured in terms of ‘services’ and therefore the goals that are set in Business Enterprise are’ profit oriented’ whereas goals set in the Library & Information Centre are ‘Service-oriented’. With the explosion of information and advancement of technology readers have so many choices to get information rather than visiting a library. Everything is available at the click of a mouse, library customers have become more knowledgeable and demanding in an era marked by abundance of information resources and services. With this explosion of information in every field of knowledge and choice in selection of service, satisfying user has become a challenge now a day for libraries. Accordingly, Libraries have to build good relationship with its users by adopting Customer relationship Management. CRM refers to the methods and tools which help an organization to manage its relationship with its customers in an organized way. The Customer Relationship Management (CRM) combines business strategy and technology to identify, acquire and retain good customer relationship. The goal of CRM is to optimize management of customer information needs & interests and increase customer satisfaction and loyalty. Implementing CRM in Libraries can improve customer data and process management, customer loyalty, retention and satisfaction.

Keywords: customer relationship management, CRM, CRM tools, customer satisfaction

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Authors: Pauliasi Tony Fakahau

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This paper provides an overview of the impact of the revenue reform programme on vulnerable communities in the Kingdom of Tonga. Economic turmoil and mismanagement during the late 1990s forced the government to seek technical and financial assistance from the Asian Development Bank to undertake a comprehensive Economic and Public Sector Reform (EPSR) programme. The EPSR is a Western model recommended by donor agencies as the solution to Tonga’s economic challenges. The EPSR programme included public sector reform, private sector growth, and revenue generation. Tax reform was the main tool for revenue generation, which set out to strengthen tax compliance and administration as well as implement a value-added consumption tax. The EPSR is based on Western values and ideology but failed to recognise that Tongan cultural values are important to the local community. Two participant groups were interviewed. Participant group one consisted of 51 people representing vulnerable communities. Participant group two consisted of six people from the government and business sector who were from the elite of Tongan society. The Kakala Research Methodology provided the framework for the research, and the Talanoa Research Method was used to conduct semi-structured interviews in the homes of the first group and in the workplaces of the second group. The research found a heavy burden of the consumption tax on the purchasing power of participant group one (vulnerable participants), having an impact on nearly every financial transaction they made. Participant group ones’ main financial priorities were kavenga fakalotu (obligations to the church), kavenga fakafāmili (obligations to the family) and kavenga fakafonua (obligations to cultural events for the village, nobility, and royalty). The findings identified inequalities of the revenue reform, especially from consumption tax, for vulnerable people and communities compared to the elite of society. The research concluded that government and donor agencies need ameliorating policies to reduce the burden of tax on vulnerable groups more susceptible to the impact of revenue reform.

Keywords: tax reform, tonga vulnerable community revenue, revenue reform, public sector reform

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Authors: Tarek Duzan, Walid Esayed

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Fluid flow in porous media is attributed fundamentally to parameters that are controlled by depositional and post-depositional environments. After deposition, digenetic events can act negatively on the reservoir and reduce the effective porosity, thereby making the rock less permeable. Therefore, exploiting hydrocarbons from such resources requires partially altering the rock properties to improve the long-term production rate and enhance the recovery efficiency. In this study, we try to address, firstly, the phenomena of permeability reduction in tight sandstone reservoirs and illustrate the implemented procedures to investigate the problem roots; finally, benchmark the candidate solutions at the field scale and recommend the mitigation strategy for the field development plan. During the study, two investigations have been considered: subsurface analysis using ( PLT ) and Laboratory tests for four candidate wells of the interested reservoir. Based on the above investigations, it was obvious that the Production logging tool (PLT) has shown areas of contribution in the reservoir, which is considered very limited, considering the total reservoir thickness. Also, Alcohol treatment was the first choice to go with for the AA9 well. The well productivity has been relatively restored but not to its initial productivity. Furthermore, Alcohol treatment in the lab was effective and restored permeability in some plugs by 98%, but operationally, the challenge would be the ability to distribute enough alcohol in a wellbore to attain the sweep Efficiency obtained within a laboratory core plug. However, the Second solution, which is based on fracking wells, has shown excellent results, especially for those wells that suffered a high drop in oil production. It is suggested to frac and pack the wells that are already damaged in the Waha field to mitigate the damage and restore productivity back as much as possible. In addition, Critical fluid velocity and its effect on fine sand migration in the reservoir have to be well studied on core samples, and therefore, suitable pressure drawdown will be applied in the reservoir to limit fine sand migration.

Keywords: alcohol treatment, post-depositional environments, permeability, tight sandstone

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Authors: N. Tochukwu, M. Mukhopadhyay, A. Mohamed

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It is no new that Nigeria faces a continual power shortage problem due to its vast population power demand and heavy reliance on nonrenewable forms of energy such as thermal power or fossil fuel. Many researchers have recommended using geothermal energy as an alternative; however, Past studies focus on the geophysical & geochemical investigation of this energy in the sedimentary and basement complex; only a few studies incorporated the remote sensing methods. Therefore, in this study, the preliminary examination of geothermal resources in the Middle Benue was carried out using satellite imagery in ArcMap. Landsat 8 scene (TIR, NIR, Red spectral bands) was used to estimate the Land Surface Temperature (LST). The Maximum Likelihood Classification (MLC) technique was used to classify sites with very low, low, moderate, and high LST. The intermediate and high classification happens to be possible geothermal zones, and they occupy 49% of the study area (38077km2). Riverline were superimposed on the LST layer, and the identification tool was used to locate high temperate sites. Streams that overlap on the selected sites were regarded as geothermal springs as. Surprisingly, the LST results show lower temperatures (<36°C) at the famous thermal springs (Awe & Wukari) than some unknown rivers/streams found in Kwande (38°C), Ussa, (38°C), Gwer East (37°C), Yola Cross & Ogoja (36°C). Studies have revealed that temperature increases with depth. However, this result shows excellent geothermal resources potential as it is expected to exceed the minimum geothermal gradient of 25.47 with an increase in depth. Therefore, further investigation is required to estimate the depth of the causative body, geothermal gradients, and the sustainability of the reservoirs by geophysical and field exploration. This method has proven to be cost-effective in locating geothermal resources in the study area. Consequently, the same procedure is recommended to be applied in other regions of the Precambrian basement complex and the sedimentary basins in Nigeria to save a preliminary field survey cost.

Keywords: ArcMap, geothermal resources, Landsat 8, LST, thermal springs, MLC

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Authors: Abd El Rahman Mohamed

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Canopic jars made by the ancient Egyptians from different materials were used to preserve the viscera during the mummification process. The canopic jar studied here dates back to the Late Period (712-332 BC). It is found in the Grand Egyptian Museum (GEM), Giza, Egypt. This jar was carved from limestone and covered with a monkey head lid with painted eyes and ears with red pigment and surrounded with black pigment. The jar contains bandages of textile containing mummy viscera with resin and black resin blocks. The canopic jars were made using the sculpting tools that were used by the ancient Egyptians, such as metal chisels (made of copper) and hammers and emptying the mass of the jar from the inside using a tool invented by the ancient Egyptians, which called the emptying drill. This study also aims to use analytical techniques to identify the components of the jar, its contents, pigments, and previous restoration materials and to understand its deterioration aspects. Visual assessment, isolation and identification of fungi, optical microscopy (OM), scanning electron microscopy (SEM), X-ray fluorescence spectroscopy (XRF), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR) were used in our study. The jar showed different signs of deterioration, such as dust, dirt, stains, scratches, classifications, missing parts, and breaks; previous conservation materials include using iron wire, completion mortar and an adhesive for assembly. The results revealed that the jar was carved from Dolomite Limestone, red Hematite pigment, Mastic resin, and Linen textile bandages. The previous adhesive was Animal Glue and used Gypsum for the previous completion. The most dominant Microbial infection on the jar was found in the fungi of (Penicillium waksmanii), (Nigrospora sphaerica), (Actinomycetes sp) and (Spore-Forming Gram-Positive Bacilli). Conservation procedures have been applied with high accuracy to conserve the jar, including mechanical and chemical cleaning, re-assembling, completion and consolidation.

Keywords: Canopic jar, Consolidation, Mummification, Resin, Viscera.

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Authors: Daniel Aberdam

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Haploinsufficiency of PAX6 in humans is the main cause of congenital aniridia, a rare eye disease characterized by reduced visual acuity. Patients have also progressive disorders including cataract, glaucoma and corneal abnormalities making their condition very challenging to manage. Aniridia-related keratopathy (ARK), caused by a combination of factors including limbal stem-cell deficiency, impaired healing response, abnormal differentiation, and infiltration of conjunctival cells onto the corneal surface, affects up to 95% of patients. It usually begins in the first decade of life resulting in recurrent corneal erosions, sub-epithelial fibrosis with corneal decompensation and opacification. Unfortunately, current treatment options for aniridia patients are currently limited. Although animal models partially recapitulate this disease, there is no in vitro cellular model of AKT needed for drug/therapeutic tools screening and validation. We used genome editing (CRISPR/Cas9 technology) to introduce a nonsense mutation found in patients into one allele of the PAX6 gene into limbal stem cells. Resulting mutated clones, expressing half of the amount of PAX6 protein and thus representative of haploinsufficiency were further characterized. Sequencing analysis showed that no off-target mutations were induced. The mutated cells displayed reduced cell proliferation and cell migration but enhanced cell adhesion. Known PAX6 targets expression was also reduced. Remarkably, addition of soluble recombinant PAX6 protein into the culture medium was sufficient to activate endogenous PAX6 gene and, as a consequence, rescue the phenotype. It strongly suggests that our in vitro model recapitulates well the epithelial defect and becomes a powerful tool to identify drugs that could rescue the corneal defect in patients. Furthermore, we demonstrate that the homeotic transcription factor Pax6 is able to be uptake naturally by recipient cells to function into the nucleus.

Keywords: Pax6, crispr/cas9, limbal stem cells, aniridia, gene therapy

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Authors: Seyran Naghdi

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Background: Orphan drug development is limited by very high costs attributed to the research and development and small size market. How health policymakers address this challenge to consider both supply and demand sides need to be explored for directing the policies and plans in the right way. The price is an important signal for pharmaceutical companies’ profitability and the patients’ accessibility as well. Objective: This study aims to find out the orphan drugs' price-setting patterns and approaches in health systems through a systematic review of the available evidence. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach was used. MedLine, Embase, and Web of Sciences were searched via appropriate search strategies. Through Medical Subject Headings (MeSH), the appropriate terms for pricing were 'cost and cost analysis', and it was 'orphan drug production', and 'orphan drug', for orphan drugs. The critical appraisal was performed by the Joanna-Briggs tool. A Cochrane data extraction form was used to obtain the data about the studies' characteristics, results, and conclusions. Results: Totally, 1,197 records were found. It included 640 hits from Embase, 327 from Web of Sciences, and 230 MedLine. After removing the duplicates, 1,056 studies remained. Of them, 924 studies were removed in the primary screening phase. Of them, 26 studies were included for data extraction. The majority of the studies (>75%) are from developed countries, among them, approximately 80% of the studies are from European countries. Approximately 85% of evidence has been produced in the recent decade. Conclusions: There is a huge variation of price-setting among countries, and this is related to the specific pharmacological market structure and the thresholds that governments want to intervene in the process of pricing. On the other hand, there is some evidence on the availability of spaces to reduce the very high costs of orphan drugs development through an early agreement between pharmacological firms and governments. Further studies need to focus on how the governments could incentivize the companies to agree on providing the drugs at lower prices.

Keywords: orphan drugs, orphan drug production, pricing, costs, cost analysis

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Authors: Aditi Madan, Jayant Kumar Routray

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Purpose: Over the years flood related risks have compounded due to increasing vulnerability caused by rapid urbanisation and growing population. This increase is an indication of the need for enhancing the preparedness of institutions to respond to floods. The study describes disaster management structure and its linkages with institutions involved in managing disasters. It addresses issues and challenges associated with readiness of disaster management institutions to respond to floods. It suggests policy options for enhancing the current state of readiness of institutions to respond by considering factors like institutional, manpower, financial, technical, leadership & networking, training and awareness programs, monitoring and evaluation. Methodology: The study is based on qualitative data with statements and outputs from primary and secondary sources to understand the institutional framework for disaster management in India. Primary data included field visits, interviews with officials from institutions managing disasters and the affected community to identify the challenges faced in engaging national, state, district and local level institutions in managing disasters. For focus group discussions, meetings were held with district project officers and coordinators, local officials, community based organisation, civil defence volunteers and community heads. These discussions were held to identify the challenges associated with preparedness to respond of institutions to floods. Findings: Results show that disasters are handled by district authority and the role of local institutions is limited to a reactive role during disaster. Data also indicates that although the existing institutional setup is well coordinated at the district level but needs improvement at the local level. Wide variations exist in awareness and perception among the officials engaged in managing disasters. Additionally, their roles and responsibilities need to be clearly defined with adequate budget and dedicated permanent staff for managing disasters. Institutions need to utilise the existing manpower through proper delegation of work. Originality: The study suggests that disaster risk reduction needs to focus more towards inclusivity of the local urban bodies. Wide variations exist in awareness and perception among the officials engaged in managing disasters. In order to ensure community participation, it is important to address their social and economic problems since such issues can overshadow attempts made for reducing risks. Thus, this paper suggests development of direct linkages among institutions and community for enhancing preparedness to respond to floods.

Keywords: preparedness, response, disaster, flood, community, institution

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Authors: Vivek Anand, Rainer Naegele

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Industry 4.0 is a global mega-trend revolutionizing the world of advanced manufacturing, but also bringing up challenges for SMEs. In response, many regional, as well as digital Industry 4.0 Platforms, have been set up to boost the competencies of established enterprises as well as SMEs. The concept of 'Clusters' is a policy tool that aims to be a starting point to establish sustainable and self-supporting structures in industries of a region by identifying competencies and supporting cluster actors with services that match their growth needs. This paper is motivated by the idea that Clusters have the potential to enable firms, particularly SMEs, to accelerate the innovation process and transition to digital technologies. In this research, the efficacy of Industry 4.0 platforms as Cluster ecosystems is evaluated, especially for SMEs. Focusing on the Baden Wurttemberg region in Germany, an action research method is employed to study how SMEs leverage other actors on Industry 4.0 Platforms to further their Industry 4.0 journeys. The aim is to evaluate how such Industry 4.0 platforms stimulate innovation, cooperation and competitiveness. Additionally, the barriers to these platforms fulfilling their promise to serve as capacity building cluster ecosystems for SMEs in a region will also be identified. The findings will be helpful for academicians and policymakers alike, who can leverage a ‘cluster policy’ to enable Industry 4.0 ecosystems in their regions. Furthermore, relevant management and policy implications stem from the analysis. This will also be of interest to the various players in a cluster ecosystem - like SMEs and service providers - who benefit from the cooperation and competition. The paper will improve the understanding of how a dialogue orientation, a bottom-up approach and active integration of all involved cluster actors enhance the potential of Industry 4.0 Platforms. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position Industry 4.0 Platforms at the forefront of the industrial renaissance. Motivated by this argument and based on the results of the qualitative research, a roadmap will be proposed to position Industry 4.0 Platforms as effective clusters ecosystems to support Industry 4.0 adoption in a region.

Keywords: cluster policy, digital transformation, industry 4.0, innovation clusters, innovation policy, SMEs and startups

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Authors: Martyna Chotomska, Aleksandra Studzinska, Marta Lisowska, Justyna Szubert, Aleksandra Tabis, Jacek Bania, Arkadiusz Miazek

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Objectives: Assessing antigen-specific T cell responses is of utmost importance for the pre-clinical testing of prototype vaccines against intracellular pathogens and tumor antigens. Mainly two types of in vitro assays are used for this purpose 1) enzyme-linked immunospot (ELISpot) and 2) intracellular cytokine staining (ICS). Both are time-consuming, relatively expensive, and require manual dexterity. Here, we assess if a straightforward detection of luciferase activity in blood samples of transgenic reporter mice expressing a secreted Lucia luciferase under the transcriptional control of IFN-γ promoter parallels the sensitivity of IFNγ ELISpot assay. Methods: IFN-γ-LUCIA mouse strain carrying multiple copies of Lucia luciferase transgene under the transcriptional control of IFNγ minimal promoter were generated by pronuclear injection of linear DNA. The specificity of transgene expression and mobilization was assessed in vitro using transgenic splenocytes exposed to various mitogens. The IFN-γ-LUCIA mice were immunized with 50mg of ovalbumin (OVA) emulsified in incomplete Freund’s adjuvant three times every two weeks by subcutaneous injections. Blood samples were collected before and five days after each immunization. Luciferase activity was assessed in blood serum. Peripheral blood mononuclear cells were separated and assessed for frequencies of OVA-specific IFNγ-secreting T cells. Results: We show that in vitro cultured splenocytes of IFN-γ-LUCIA mice respond by 2 and 3 fold increase in secreted luciferase activity to T cell mitogens concanavalin A and phorbol myristate acetate, respectively but fail to respond to B cell-stimulating E.coli lipopolysaccharide. Immunization of IFN-γ-LUCIA mice with OVA leads to over 4 fold increase in luciferase activity in blood serum five days post-immunization with a barely detectable increase in OVA-specific, IFNγ-secreting T cells by ELISpot. Second and third immunizations, further increase the luciferase activity and coincidently also increase the frequencies of OVA-specific T cells by ELISpot. Conclusions: We conclude that minimally invasive monitoring of luciferase secretions in blood serum of IFN-γ-LUCIA mice constitutes a sensitive method for evaluating primary and memory Th1 responses to protein antigens. As such, this method may complement existing methods for rapid immunogenicity assessment of prototype vaccines.

Keywords: ELISpot, immunogenicity, interferon-gamma, reporter mice, vaccines

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Authors: Fatemeh Zeinali Sehrigh

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Background: Breast cancer is the most common and deadly cancer among women. The incidence of breast cancer depends on various genetic, epigenetic and environmental factors. DNA methylation and miRNAs are the most important epigenetic factors involved in breast cancer. miRNAs play an important role in the post-transcriptional regulation of genes, including genes involved in DNA methylation (DNMTs), and are also important regulators of oncogenic pathways. The study of microRNAs and DNMTs in Breast cancer allows the development of targeted treatments and early detection of this cancer. Methods and Materials: Experimental Statistical significance of differences in miRNAs and DNMTs relative expression results were analyzed by pair-wise fixed reallocation randomization test as a statistical model included in the REST (relative expression software tool). In silico analysis confirmed that microarray datasets miRNAs and DNMTs were downloaded from the GEO database. The analysis was defined using the Affy packages in R software to screen remarkably dysregulated miRNAs and DNMTs. the target genes in terms of molecular pathways in the web, Gestalt and GO (Gene Ontology) that specify the biological processes of molecular functions and cellular components to be investigated. In laboratory studies, sampling was done from 100 women with breast cancer and 100 healthy women with written consent. Tissue RNA was extracted using a Trizol solution. Then, using the cDNA synthesis kit, DNA was synthesized from the extracted RNAs, and the expression level of miR-509-3-5p and miR-596 was investigated using the Realtime PCR method. Results: In the present study, we found significant (p-value<0.05) changes in the expression level of miRNAs and DNMTs in patients with breast cancer. In bioinformatics studies, the GEO microarray data set, similar to qPCR results, showed a decreased expression of miRNAs and an increased expression of DNMTs in breast cancer. Conclusion: The results of the present study, which showed a decrease in the expression of miRNAs and DNMTs in breast cancer, suggest that these genes can be used as important diagnostic and therapeutic biomarkers in breast cancer.

Keywords: expression omnibus (GEO), microarray dataset, breast cancer, miRNA

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Authors: Anwesha Pathak

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With the increasing number of satellites and space debris, space traffic management (STM) becomes crucial. AI can aid in STM by predicting and preventing potential collisions, optimizing satellite trajectories, and managing orbital slots. Governance frameworks need to address the integration of AI algorithms in STM to ensure safe and sustainable satellite activities. AI and governance play significant roles in the context of satellite activities in space. Artificial intelligence (AI) technologies, such as machine learning and computer vision, can be utilized to process vast amounts of data received from satellites. AI algorithms can analyse satellite imagery, detect patterns, and extract valuable information for applications like weather forecasting, urban planning, agriculture, disaster management, and environmental monitoring. AI can assist in automating and optimizing satellite operations. Autonomous decision-making systems can be developed using AI to handle routine tasks like orbit control, collision avoidance, and antenna pointing. These systems can improve efficiency, reduce human error, and enable real-time responsiveness in satellite operations. AI technologies can be leveraged to enhance the security of satellite systems. AI algorithms can analyze satellite telemetry data to detect anomalies, identify potential cyber threats, and mitigate vulnerabilities. Governance frameworks should encompass regulations and standards for securing satellite systems against cyberattacks and ensuring data privacy. AI can optimize resource allocation and utilization in satellite constellations. By analyzing user demands, traffic patterns, and satellite performance data, AI algorithms can dynamically adjust the deployment and routing of satellites to maximize coverage and minimize latency. Governance frameworks need to address fair and efficient resource allocation among satellite operators to avoid monopolistic practices. Satellite activities involve multiple countries and organizations. Governance frameworks should encourage international cooperation, information sharing, and standardization to address common challenges, ensure interoperability, and prevent conflicts. AI can facilitate cross-border collaborations by providing data analytics and decision support tools for shared satellite missions and data sharing initiatives. AI and governance are critical aspects of satellite activities in space. They enable efficient and secure operations, ensure responsible and ethical use of AI technologies, and promote international cooperation for the benefit of all stakeholders involved in the satellite industry.

Keywords: satellite, space debris, traffic, threats, cyber security.

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Authors: Sarocha Vivatvakin, Thanaporn Ratchataswan, Thiratest Leesutipornchai, Komkrit Ruangritchankul, Somboon Keelawat, Virachai Kerekhanjanarong, Patnarin Mahattanasakul, Saknan Bongsebandhu-Phubhakdi

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In this globalization era, much attention has been drawn to various molecular biomarkers, which may have the potential to predict the progression of cancer. Epidermal growth factor receptor (EGFR) is the classic member of the ErbB family of membrane-associated intrinsic tyrosine kinase receptors. EGFR expression was found in several organs throughout the body as its roles involve in the regulation of cell proliferation, survival, and differentiation in normal physiologic conditions. However, anomalous expression, whether over- or under-expression is believed to be the underlying mechanism of pathologic conditions, including carcinogenesis. Even though numerous discussions regarding the EGFR as a prognostic tool in head and neck cancer have been established, the consensus has not yet been met. The aims of the present study are to assess the correlation between the level of EGFR expression and demographic data as well as clinicopathological features and to evaluate the ability of EGFR as a reliable prognostic marker. Furthermore, another aim of this study is to investigate the probable pathophysiology that explains the finding results. This retrospective study included 30 squamous cell laryngeal carcinoma patients treated at King Chulalongkorn Memorial Hospital from January 1, 2000, to December 31, 2004. EGFR expression level was observed to be significantly downregulated with the progression of the laryngeal cancer stage. (one way ANOVA, p = 0.001) A statistically significant lower EGFR expression in the late stage of the disease compared to the early stage was recorded. (unpaired t-test, p = 0.041) EGFR overexpression also showed the tendency to increase recurrence of cancer (unpaired t-test, p = 0.128). A significant downregulation of EGFR expression was documented in advanced stage laryngeal cancer. The results indicated that EGFR level correlates to prognosis in term of stage progression. Thus, EGFR expression might be used as a prevailing biomarker for laryngeal squamous cell carcinoma prognostic prediction.

Keywords: downregulation, epidermal growth factor receptor, immunohistochemistry, laryngeal squamous cell carcinoma

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Authors: Bassma A. Abdel Haleem, Ehab K. Emam, George E. Yacoub, Ashraf M. Salem

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Background: Obesity is an increasingly common problem in childhood. Childhood obesity is considered the main risk factor for the development of metabolic syndrome (MetS) (diabetes type 2, dyslipidemia, and hypertension). Recent studies estimated that among children with obesity 30-60% will develop MetS. Visceral fat thickness is a valuable predictor of the development of MetS. Computed tomography and dual-energy X-ray absorptiometry are the main techniques to assess visceral fat. However, they carry the risk of radiation exposure and are expensive procedures. Consequently, they are seldom used in the assessment of visceral fat in children. Some studies explored the potential of ultrasound as a substitute to assess visceral fat in the elderly and found promising results. Given the vulnerability of children to radiation exposure, we sought to evaluate ultrasound as a safer and more cost-efficient alternative for measuring visceral fat in obese children. Additionally, we assessed the correlation between visceral fat and obesity indicators such as insulin resistance. Methods: A cross-sectional study was conducted on 46 children with obesity (aged 6–16 years). Their visceral fat was evaluated by ultrasound. Subcutaneous fat thickness (SFT), i.e., the measurement from the skin-fat interface to the linea alba, and visceral fat thickness (VFT), i.e., the thickness from the linea alba to the aorta, were measured and correlated with anthropometric measures, fasting lipid profile, homeostatic model assessment for insulin resistance (HOMA-IR) and liver enzymes (ALT). Results: VFT assessed via ultrasound was found to strongly correlate with the BMI, HOMA-IR with AUC for VFT as a predictor of insulin resistance of 0.858 and cut off point of >2.98. VFT also correlates positively with serum triglycerides and serum ALT. VFT correlates negatively with HDL. Conclusions: Ultrasound, a safe and cost-efficient technique, could be a useful tool for measuring the abdominal fat thickness in children with obesity. Ultrasound-measured VFT could be an appropriate prognostic factor for insulin resistance, hypertriglyceridemia, and elevated liver enzymes in obese children.

Keywords: metabolic syndrome, pediatric obesity, sonography, visceral fat

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Authors: Helena Bolini, Erick Esmerino, Adriano Cruz, Juliana Paixao

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The currently concern for health has increased demand for low-calorie ingredients and functional foods as probiotics. Understand the reasons that infer on food choice, besides a challenging task, it is important step for development and/or reformulation of existing food products. The use of appropriate multivariate statistical techniques, such as External Preference Map (PrefMap), associated with regression by Partial Least Squares (PLS) can help in determining those factors. Thus, this study aimed to determine, through PLS regression analysis, the sensory attributes considered drivers of liking in probiotic petit suisse cheeses, strawberry flavor, sweetened with different sweeteners. Five samples in same equivalent sweetness: PROB1 (Sucralose 0.0243%), PROB2 (Stevia 0.1520%), PROB3 (Aspartame 0.0877%), PROB4 (Neotame 0.0025%) and PROB5 (Sucrose 15.2%) determined by just-about-right and magnitude estimation methods, and three commercial samples COM1, COM2 and COM3, were studied. Analysis was done over data coming from QDA, performed by 12 expert (highly trained assessors) on 20 descriptor terms, correlated with data from assessment of overall liking in acceptance test, carried out by 125 consumers, on all samples. Sequentially, results were submitted to PLS regression using XLSTAT software from Byossistemes. As shown in results, it was possible determine, that three sensory descriptor terms might be considered drivers of liking of probiotic petit suisse cheese samples added with sweeteners (p<0.05). The milk flavor was noticed as a sensory characteristic with positive impact on acceptance, while descriptors bitter taste and sweet aftertaste were perceived as descriptor terms with negative impact on acceptance of petit suisse probiotic cheeses. It was possible conclude that PLS regression analysis is a practical and useful tool in determining drivers of liking of probiotic petit suisse cheeses sweetened with artificial and natural sweeteners, allowing food industry to understand and improve their formulations maximizing the acceptability of their products.

Keywords: acceptance, consumer, quantitative descriptive analysis, sweetener

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Authors: Cristian Păuna

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In the first decades of the 21st century, in the electronic trading environment, algorithmic capital investments became the primary tool to make a profit by speculations in financial markets. A significant number of traders, private or institutional investors are participating in the capital markets every day using automated algorithms. The autonomous trading software is today a considerable part in the business intelligence system of any modern financial activity. The trading decisions and orders are made automatically by computers using different mathematical models. This paper will present one of these models called Price Prediction Line. A mathematical algorithm will be revealed to build a reliable trend line, which is the base for limit conditions and automated investment signals, the core for a computerized investment system. The paper will guide how to apply these tools to generate entry and exit investment signals, limit conditions to build a mathematical filter for the investment opportunities, and the methodology to integrate all of these in automated investment software. The paper will also present trading results obtained for the leading German financial market index with the presented methods to analyze and to compare different automated investment algorithms. It was found that a specific mathematical algorithm can be optimized and integrated into an automated trading system with good and sustained results for the leading German Market. Investment results will be compared in order to qualify the presented model. In conclusion, a 1:6.12 risk was obtained to reward ratio applying the trigonometric method to the DAX Deutscher Aktienindex on 24 months investment. These results are superior to those obtained with other similar models as this paper reveal. The general idea sustained by this paper is that the Price Prediction Line model presented is a reliable capital investment methodology that can be successfully applied to build an automated investment system with excellent results.

Keywords: algorithmic trading, automated trading systems, high-frequency trading, DAX Deutscher Aktienindex

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Authors: Ma. Roxanne Fernandez, Josie Athens, Balsalobre-Fernandez, Masayoshi Kubo, Kim Hébert-Losier

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Objectives: The calf raise test (CRT) is used in rehabilitation and sports medicine to evaluate calf muscle function. For testing, individuals stand on one leg and go up on their toes and back down to volitional fatigue. The newly developed Calf Raise application (CRapp) for iOS uses computer-vision algorithms enabling objective measurement of CRT outcomes. We aimed to validate the CRapp by examining its concurrent validity and agreement levels against laboratory-based equipment and establishing its intra- and inter-rater reliability. Methods: CRT outcomes (i.e., repetitions, positive work, total height, peak height, fatigue index, and peak power) were assessed in thirteen healthy individuals (6 males, 7 females) on three occasions and both legs using the CRapp, 3D motion capture, and force plate technologies simultaneously. Data were extracted from two markers: one placed immediately below the lateral malleolus and another on the heel. Concurrent validity and agreement measures were determined using intraclass correlation coefficients (ICC₃,ₖ), typical errors expressed as coefficient of variations (CV), and Bland-Altman methods to assess biases and precision. Reliability was assessed using ICC3,1 and CV values. Results: Validity of CRapp outcomes was good to excellent across measures for both markers (mean ICC ≥0.878), with precision plots showing good agreement and precision. CV ranged from 0% (repetitions) to 33.3% (fatigue index) and were, on average better for the lateral malleolus marker. Additionally, inter- and intra-rater reliability were excellent (mean ICC ≥0.949, CV ≤5.6%). Conclusion: These results confirm the CRapp is valid and reliable within and between users for measuring CRT outcomes in healthy adults. The CRapp provides a tool to objectivise CRT outcomes in research and practice, aligning with recent advances in mobile technologies and their increased use in healthcare.

Keywords: calf raise test, mobile application, validity, reliability

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Authors: Vandana Mishra, Niladri Sekhar Dash, Jayshree Charkraborty

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This present paper focuses on the application of corpus linguistics techniques for critical discourse analysis (CDA) of Hindi newspapers. While Corpus linguistics is the study of language as expressed in corpora (samples) of 'real world' text, CDA is an interdisciplinary approach to the study of discourse that views language as a form of social practice. CDA has mainly been studied from a qualitative perspective. However, we can say that recent studies have begun combining corpus linguistics with CDA in analyzing large volumes of text for the study of existing power relations in society. The corpus under our study is also of a sizable amount (1 million words of Hindi newspaper texts) and its analysis requires an alternative analytical procedure. So, we have combined both the quantitative approach i.e. the use of corpus techniques with CDA’s traditional qualitative analysis. In this context, we have focused on the Keyword Analysis Sorting Concordance Lines of the selected Keywords and calculating collocates of the keywords. We have made use of the Wordsmith Tool for all these analysis. The analysis starts with identifying the keywords in the political news corpus when compared with the main news corpus. The keywords are extracted from the corpus based on their keyness calculated through statistical tests like chi-squared test and log-likelihood test on the frequent words of the corpus. Some of the top occurring keywords are मोदी (Modi), भाजपा (BJP), कांग्रेस (Congress), सरकार (Government) and पार्टी (Political party). This is followed by the concordance analysis of these keywords which generates thousands of lines but we have to select few lines and examine them based on our objective. We have also calculated the collocates of the keywords based on their Mutual Information (MI) score. Both concordance and collocation help to identify lexical patterns in the political texts. Finally, all these quantitative results derived from the corpus techniques will be subjectively interpreted in accordance to the CDA’s theory to examine the ways in which political news discourse produces social and political inequality, power abuse or domination.

Keywords: critical discourse analysis, corpus linguistics, Hindi newspapers, power relations

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Authors: Cassandra A. Skinner, Linda R. Chamberlain

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The nonprofit and public sectors are increasingly turning to Geographic Information Systems for data visualizations which can better inform programmatic and policy decisions. Additionally, the private and nonprofit sectors are turning to systems mapping to better understand the ecosystems within which they operate. This study explores the potential which combining these data visualization methods—a method which is called geographic systems mapping—to create an exhaustive and comprehensive understanding of a social problem’s ecosystem may have in social innovation efforts. Researchers with Grand Valley State University collaborated with Talent 2025 of West Michigan to conduct a mixed-methods research study to paint a comprehensive picture of the workforce development ecosystem in West Michigan. Using semi-structured interviewing, observation, secondary research, and quantitative analysis, data were compiled on workforce development organizations’ locations, programming, metrics for success, partnerships, funding sources, and service language. To best visualize and disseminate the data, a geographic system map was created which identifies programmatic, operational, and geographic gaps in workforce development services of West Michigan. By combining geographic and systems mapping methods, the geographic system map provides insight into the cross-sector relationships, collaboration, and competition which exists among and between workforce development organizations. These insights identify opportunities for and constraints around cross-sectoral social innovation in the West Michigan workforce development ecosystem. This paper will discuss the process utilized to prepare the geographic systems map, explain the results and outcomes, and demonstrate how geographic systems mapping illuminated the needs of the community and opportunities for social innovation. As complicated social problems like unemployment often require cross-sectoral and multi-stakeholder solutions, there is potential for geographic systems mapping to be a tool which informs, enables, and inspires these solutions.

Keywords: cross-sector collaboration, data visualization, geographic systems mapping, social innovation, workforce development

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Shaun G. Abbott, Rebecca C. Reynolds, James B. Etter, John B. F. de Wit

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The benefits of physical activity (PA) on health are well documented. Low socioeconomic status (SES) is associated with poor health, with PA a suggested mediator. Pedometers and accelerometers offer an effective behavior change tool to increase PA levels. While the role of pedometer and accelerometer use in increasing PA is recognized in many populations, little is known in low-SES groups. We are aiming to assess the effectiveness of pedometer- and accelerometer-based interventions for increasing PA step count and improving subsequent health outcomes among low-SES groups of high-income countries. Medline, Embase, PsycINFO, CENTRAL and SportDiscus databases were searched to identify articles published before 10th July, 2015; using search terms developed from previous systematic reviews. Inclusion criteria are: low-SES participants classified by income, geography, education, occupation or ethnicity; study duration minimum 4 weeks; an intervention and control group; wearing of an unsealed pedometer or accelerometer to objectively measure PA as step counts per day for the duration of the study. We retrieved 2,142 articles from our database searches, after removal of duplicates. Two investigators independently reviewed titles and abstracts of these articles (50% each) and a combined 20% sample were reviewed to account for inter-assessor variation. We are currently verifying the full texts of 430 articles. Included studies will be critically appraised for risk of bias using guidelines suggested by the Cochrane Public Health Group. Two investigators will extract data concerning the intervention; study design; comparators; steps per day; participants; context and presence or absence of obesity and/or chronic disease. Heterogeneity amongst studies is anticipated, thus a narrative synthesis of data will be conducted with the simplification of selected results into percentage increases from baseline to allow for between-study comparison. Results will be presented at the conference in December if selected.

Keywords: accelerometer, pedometer, physical activity, socioeconomic, step count

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Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

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Authors: Kim Katherine Castillo, Nelson John Datubatang, Terrence Phillip Dy, Norelie Hampac, Reichen Crismark Martinez, Nina Faith Pantinople, Jose Dante Santos II, Marchel Ann Santos, Sophia Abigail Santiago, Zyrill Xsar San Juan, Aira Mae Tagao, Crystal Kylla Viagedor

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The Work Immersion Program was implemented to help students gain abundant work-related experiences while on-site; additionally, the program aims to help students improve their competencies and interpersonal skills as they are given the option to join the workforce if they ever choose to do so after senior high school. The work immersion experience posed diverse challenges for students, spanning personal, financial, engagement, environmental, and equipment-related domains. These included the need for assistance in time management, transportation expenses, and procurement of materials. Furthermore, students faced difficulties in independent task completion and encountered suboptimal work environments. Addressing these multifaceted obstacles is crucial to optimize the educational outcomes of work immersion programs. In addition to the challenges, several other issues have been identified, including the absence of standardized work immersion programs across schools and industries, the challenges in securing appropriate work immersion placements, the necessity for enhanced monitoring and evaluation of program effectiveness, and the limited availability of field programs aligned with students' chosen courses. Furthermore, there is a lack of comprehensive information regarding the attitudes of Senior High School students toward work immersion programs within their respective schools. This study aims to investigate the attitudes of senior high school students at Nazareth School of National University towards work immersion programs, with a focus on identifying factors that influence their perception and participation, including collegiality and expectations. By exploring the students' attitudes, the research endeavors to enhance the school's work immersion programs and contribute to the overall educational experience of the students. This study addresses challenges related to work immersion programs, focusing on six subtopics: Work Immersion, Work Immersion in the Philippines, Students' Attitudes, Factors Affecting Students' Attitudes, Effectiveness of Work Immersion for Senior High School Students, and Students' Perception and Willingness to Participate. Using a descriptive research design, the study examines the attitudes of senior high school students at Nazareth School of National University in Manila. Data was collected from 100 students, representing different academic strands, through a 35-item researcher-made survey. Descriptive statistics, including measures of central tendency and variability, will be used to analyze the data using JASP, providing valuable insights into the students' attitudes toward work immersion.

Keywords: attitudes, challenges, educational outcomes, work immersion programs

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