Search results for: patient safety culture

Authors: Vera Lúcia Raposo

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Medical devices are products used for medical purposes and aimed to operate in the human body, sometimes even inside the human body. Therefore, they can become particularly risky products, and some of the injuries caused by medical devices can have serious effects on the person’s health or body, even leading to death. Because they fit in the category of 'products' as described in Article 2 of Council Directive 85/374/EEC of 25 July 1985, concerning liability for defective products, the liability of the manufacturer of medical devices follows the rules of strict liability as long as one of the defects covered by the directive is at stake. The directive is not concerned with the product’s efficiency, but instead with the product’s safety, although in what regards medical devices (the same being valid for drugs) the two concepts frequently go together, and a lack of efficiency can result in a lack of safety. In the particular case of medical devices, the most debatable defects are the ones related with erroneous or non-existing information and the so-called development defects. This paper analyses how directive 85/374/EEC applies to medical devices, which defects are covered by its regulation, and which criteria can be used to evaluate the product’s safety. Some issues are still to be clarified, even though the decisions from the European Court of Justice and from national courts are valuable tools to understand the scope of directive 85/374/EEC in what regards medical devices.

Keywords: medical devices, producer’s liability, product safety, strict liability

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Authors: Saba Amreen Syeda, Summaiah Asim, Syeda, Hafsa, Essam Quraishi

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Mantle Cell Lymphoma (MCL) is a relatively uncommon type of lymphoma that comprises approximately 7 percent of non hodgkin's lymphomas (NHL), Classic MCL presents mostly in lymph nodes and occasionally in extranodal sites. About 26 % of MCL is present primarily in the Gastrointestinal tract. While both the upper GI tract and the lower GI tract could be involved, it is rare to present with concurrent upper and lower GI involvement with MCL. We present the case of a 51-year-old Asian Indian male that presented to our clinic with complaints of chronic diarrhea for the last one year, progressively worsening over the past three months. The Patient also reported black stool as well as bright red blood per rectum. Patient reported severe fatigue on minimal exertion. On a physical exam, the patient was noted to have matted lymphadenopathy in the neck. Patient was noted to be anemic with a hemoglobin to be 8 g/dl. Esophagogastroduodenoscopy and colonoscopy was performed. EGD showed a large 4 cm ulcer in the gastric antrum with thick heaped up edges. There was bleeding on contact. Colonoscopy showed a large 35 mm multilobulated polyp in the ascending colon, which was biopsied. The patient was also noted to have nodular proctitis in the mid rectum. This was localized and extended to about 5 cm. This area was biopsied as well. Biopsies from the stomach, colon, as well as the rectum, returned with findings of mantle cell lymphoma on pathology. Lymphoid cells in the biopsy were stained strongly positive for CD 20, cyclin D1, and CD 5. There was the absence of stain for CD 3 and CD 10. The IHC stain for CD 23 was negative. Biopsies from neck LAD were obtained and were also positive for MCL. The patient was referred to oncology for staging and treatment.

Keywords: mantle cell lymphoma, GI bleed, diarrhea, gastric ulcer, colon polyp

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Authors: Mohammad J. Mortazavi, Arvin Najafi, Pejman Mansouri

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Hemophilia A is simply described as deficiency of factor VIII(FVIII) and patients with this disorder have bleeding complications in different organs. By using the recombinant factor VIII in these patients, elective orthopedic surgeries have been done approximately in 40 last years. About 10-30 % of these patients have bleeding complications in their surgeries even by using recombinant factor VIII because of their inhibitor against FVIII molecule. Preoperative haemostatic management in these patients is challenging. We treated a 28-year-old male patient with hemophilia A with FVIII inhibitor which had been detected when he was14 years old (with the titer 54 Bethesda unit(BU)) scheduled for total knee arthroplasty (TKA). We use 90 µg/kg rFVIIa just before the surgery and every 2 hours during surgery. The patient did not have any significant hemorrhage during the surgery and after that. For the 2 days after surgery, the rFVIIa repeated every 2 hours as the same as preoperative dosage(90 µg/kg) and for another 2 days of postoperative admission it continued every 4 hours. After 4th day, the rFVIIa continued every 6 hours with the same dosage until the sixth day from the surgery, and finally the patient were discharged about two weeks after surgery. Seven days after the discharge, he came back for the follow up visit. On the follow up examination, the site of the surgery had neither infection hemarthroses signs.

Keywords: hemophilia, factor VIII inhibitor, total knee replacement, rFVIIa

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Authors: Diane Ghanem, Oscar Covarrubias, Ridge Maxson, Samir Sabharwal, Babar Shafiq

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Introduction: Web-based resources serve as a fundamental educational platform for orthopaedic trauma patients; however, they are notoriously written at a high grade reading level and are often too complicated for patients to benefit from them. The aim of this study is to perform an updated assessment of the readability of the AAOS trauma-related educational articles and compare their readability with that of injury-specific patient education materials developed by the OTA. Methods: All forty-six trauma-related articles on the AAOS patient education website were analyzed for readability. Two independent reviewers used the (1) Flesch-Kincaid Grade Level (FKGL) and the (2) Flesch Reading Ease (FRE) algorithms to calculate the readability level. Mean readability scores were compared across body part categories. One-sample t-test was done to compare mean FKGL with the recommended 6th-grade readability level and the average American adult reading level. Two-sample t-test was used to compare the readability scores of the AAOS trauma-related articles to those of the OTA. Results: The average FKGL and FRE for the AAOS articles were 8.9±0.74 and 57.2±5.8, respectively. All articles were written above the 6th-grade reading level. The average readability of the AAOS articles was significantly greater than the recommended 6th-grade and average American adult reading level. The average FKGL (8.9±0.74 vs 8.1±1.14) and FRE (57.2±5.8 vs 65.6±6.6) for all AAOS articles was significantly greater compared to that of OTA articles. Excellent agreement was observed between raters for the FKGL 0.956 (95%CI 0.922 - 0.975) and FRE 0.993 (95%CI 0.987 – 0.996). Discussion: Our findings suggest that, after almost a decade, the readability of the AAOS trauma-related articles remains unchanged. The AAOS and OTA trauma patient education materials have high readability levels and may be too difficult for patient comprehension. A need remains to improve the readability of these commonly used trauma education materials.

Keywords: american ocademy of orthopaedic surgeons, FKGL, FRE, orthopaedic trauma association, patient education, readability

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Authors: Wendy Ampadu, Ray Diezmos, Hassan Malik, Jeremy Hyslob

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There are several technologies out there for use as high-level switches as part of a system for shutting down flow to a vessel. Given that the asphalt truck loading poses issues such as poor visibility, coating, condensation, and fumes, a solution that is robust enough to last in these conditions is often needed in industries. Furthermore, the design of the loading arm, rack, and process equipment should allow for the safety of workers. The objective of this report includes the redesign of structures for use at loading facilities and selecting an overflow technology protection from hot bitumen. The report is based on loading facilities at a Canadian bitumen production company. The engineering design approach was used to create multiple redesign concepts for the loading dock system. Research on overfill systems was also completed by surveying the existing market for technologies and securing quotes from over 20 Canadian and United States instrumentation companies. A final loading dock redesign and level transmitter for overfill protection solution were chosen.

Keywords: bitumen, reliability engineering, safety system, process safety management, asphalt, loading docks, tanker trucks

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Authors: Suphitcha Charoen-Amornkitt, Chokeanand Bussracumpakorn

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The tendency of the Karen backstrap weaving succession has gradually decreased due to the difficulty of weaving techniques and the relocation of the young generation. The Yang Nam Klat Nuea community, Nong Ya Plong District, Phetchaburi, is a Pwo Karen community that is seriously confronted with a lack of cultural heritage. Thus, a group of weavers was formed to revive the knowledge of weaving. However, they have been gradually confronted with culture assimilation to mainstream culture from the desire for marketing acceptance and imperative and forced the extinction of culture due to the disappearance of weaving details and techniques. Although there are practical solutions, i.e., product development, community improvement, knowledge improvement, and knowledge transfer, to inherit the Karen weaving culture, people in the community cannot fulfill their deep intention about the weaving inheritance as most solutions have focused on developing the commercial products and making the income instead of inheriting their knowledge. This research employed qualitative user research with an in-depth user interview to study communal knowledge transfer succession based on the internal involved parties, i.e., four expert weavers, three young weavers, and three 4th generation villagers. The purpose is to explore the correlation and mindset of villagers towards the culture with specific issues, including the psychology of culture, core knowledge and learning methods, cultural inheritance, and cultural engagement. As a result, the existing models of knowledge management mostly focused on tangible strategies, which can notice progress in short terms, such as direct teaching and consistent practicing. At the same time, the motivation and passion of inheritors were abolished while the research found that the young generation who profoundly connected with the textile culture will have a more significant intention to continue the culture. Therefore, this research suggests both internal and external solutions to treat the community. Regarding the internal solutions, family, weaving group, and school have an important role to participate with young villagers by encouraging activities to support the cultivating of Karen’s history, understanding their identities, and adapting the culture as a part of daily life. At the same time, collecting all of the knowledge in the archives, e.g., recorded video, instruction, and books, can crucially prevent the culture from extinction. Regarding the external solutions, this study suggests that working with social media will enhance the intimacy of textile culture, while the community should relieve the roles in marketing competition and start to drive cultural experiences to create a new market position. In conclusion, this research intends to explore the causes and motivation to support the transfer of the culture to the 4th generation villagers and to raise awareness of the diversity of culture in society. With these suggestions and the desire to improve pride and confidence in culture, the community agrees that strengthening the relationships between the young villagers and the weaving culture can bring attention and interest back to the weaving culture.

Keywords: Pwo Karen textile culture, backstrap weaving succession, cultural inheritance, knowledge transfer, knowledge management

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Authors: Naseer Ahmad Bhat

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Jammu and Kashmir Public Safety Act, 1978 provides for administrative detention in Jammu and Kashmir, a disputed region between India & Pakistan, since 1947. This paper shall critically analyse the working of PSA (Public Safety Act) in this J&K since 1978, since its inception. Detentions under this Act traverse between the security of the State and Liberty of citizens but over decades, has this Act served its purpose in Kashmir or not shall be analysed in this paper. J&K PSA is used to detain political workers, Over-Ground Workers and Stone Pelters who pose a direct threat to the ‘security of the State.’ Detentions under J&K PSA are a good measure in the hands of Security agencies to bring calm during periods of turmoil, but it has socio-economic consequences for detainees as well as families. This paper shall highlight the Socio-Economic impact of detentions under J&K PSA on individuals and families.

Keywords: detentions, Kashmir, public safety act, liberty, security

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Authors: Daniel C. S. Lim

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There are numerous nutritional supplements, such as multivitamins and nutrition drinks, in the market today. Many of these supplements are expensive and tend to be driven commercially by business decisions and big marketing budgets. Many of the costs are ultimately borne by the end user in the quest for keeping to a healthy lifestyle. This paper proposes a system with a list of ten determinants to gauge how to decide the value of various supplements. It suggests variables such as composition, safety, efficacy and bioavailability, as well as several other considerations. These guidelines can help to tackle many of the issues that people of all ages face in the way that they receive essential nutrients. The system also aims to promote and improve the safety and choice of foods and supplements. In so doing, the system aims to promote the individual’s or population’s control over their own health and reduce the growing health care burden on the society.

Keywords: choice of foods and supplements, essential nutrients, nutritional supplements, system safety

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Authors: Anna Vildová, H. Hendrychová, J. Kubeš, L. Tůmová

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The abiotic elicitation is one of the methods for increasing the secondary metabolites production in plant tissue cultures and it seems to be more effective than traditional strategies. This study verified the use of silver nitrate as elicitor to enhance flavonolignans and flavonoid taxifolin production in suspension culture of Sylibum marianum (L.) Gaertn. Silver nitrate in various concentrations (5.887.10-3 mol/L, 5.887.10-4 mol/L, 5.887.10-5 mol/L) was used as elicitor. The content of secondary metabolites in cell suspension cultures was determined by high performance liquid chromatography. The samples were taken after 6, 12, 24, 48, 72 and 168 hours of treatment. The highest content of taxifolin production (2.2 mg.g-1) in cell suspension culture of Silybum marianum (L.) Gaertn. was detected after silver nitrate (5.887.10-4 mol/L) treatment and 72 h application. Flavonolignans such as silybinA, silybin B, silydianin, silychristin, isosilybin A, isosilybin B were not produced by cell suspension culture of S. marianum after elicitor treatment. Our results show that the secondarymetabolites could be released from S. marianum cells into the nutrient medium by changed permeability of cell wall.

Keywords: Silybum marianum (L.) Gaertn., elicitation, silver nitrate, taxifolin

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Authors: Peter Kutis, Vladimir Littva

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Nowadays, it is necessary to ensure that this reduction in costs is not at the expense of the quality of health care and future medical success. In general, physiotherapy for total hip joint arthroplasty is considered to be a routine matter that deals mainly with mobility training, increased muscular strength, and basic day-to-day activities such as bed-to-chair transition, standing, and walking. Within the KEGA project no. 003KU-4-2021, we decided to investigate preoperative physiotherapy care in Slovakia and Austria in total hip arthroplasty patients to shortened overall recovery. Research Sample and Methods: The sample comprised 498 respondents –patients who were indicated to total hip arthroplasty on the territory of Slovakia and Austria. There were 130 women in Slovakia and 135 women in Austria. The numbers of men were 120 in Slovakia and 113 men in Austria. The age of respondents was between 40 and 85 years of age. As a method of our research, we chose a non-standardized questionnaire, which consisted of three parts. The first part for the initial examination of the patient contained the identification of the patient according to the assigned number and subsequently 19 questions conditioned by the physical examination and evaluation of the patients. The second part of our questionnaire was completed after the patient's hospitalization and contained 10 questions that were conditioned by the patient's examination. The last third part for the overall assessment of the patient's state of health consisted of 12 questions conditioned by the patient's examination. This part was performed at the last meeting with the patient at the end of the treatment. All data were statistically processed by SPSS 25. Results: All data were evaluated at a significance level of p = 0.05. From the comparison of patients who underwent preoperative preparation, we can clearly state that the total duration of treatment is significantly shorter. A t-test of two mean values with uneven variance was used to verify the validity of the assumption. The total duration of treatment in patients with preoperative preparation was on average 92,635 days and without preoperative preparation was on average 135,884 days (t-Stat = 44,52784, t Critical one-tail = 1,648187415, t Critical two-tail = 1,965157). Conclusion: The results obtained during the research show the importance of adequate preoperative physiotherapeutic preparation of the patient. The results of total hip joint arthroplasty studies showed a significant reduction in a hospital stay as well as shortened total treatment time.

Keywords: THA, physiotherapy, recovery, preoperative physiotherapy care

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Authors: Mai Nguyen-Phuong-Mai

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This paper incorporates insight from various models, studies and disciplines to construct a framework called the Inverted Pyramid Model. It is argued that such a framework has several advantages: (1) it reduces the shortcomings of the problem-focused approach that dominates the mainstream theories of cross-cultural management. With contributing insight from neuroscience, it suggests that training in business cross-cultural awareness should start with potential synergy emerged from differences instead of the traditional approach that focuses on the liability of foreigners and negative consequences of cultural distance. (2) The framework supports a dynamic and holistic way of analyzing cultural diversity by analyzing four major cultural units (global, national, organizational and group culture). (3) The framework emphasizes the role of individuals –an aspect of culture that is often ignored or regarded as a non-issue in the traditional approach. It is based on the notion that people don’t do business with a country, but work (in)directly with a unique person. And it is at this individual level that culture is made, personally, dynamically, and contextually. Insight from neuroscience provides significant evidence that a person can develop a multicultural mind, confirm and contradict, follow and reshape a culture, even when (s)he was previously an outsider to this culture. With this insight, the paper proposes a revision of the old adage (Think global – Act local) and change it into Think global – Plan local – Act individual.

Keywords: static–dynamic paradigm, cultural diversity, multicultural mind, neuroscience

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Authors: Priscilla Adoley Moffat

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Over the years, entrepreneurship has been promoted as an important tool for bridging the socioeconomic gap between the male gender and the female gender. In the face of the efforts to advance gender equity, however, there exist sociocultural factors whose influence on these efforts cannot be ignored or underrated. This study explored the influence of gender role socialization on entrepreneurial decisions in the male-dominated African society, with special focus on Ghana. The study essentially sought to find out whether gender role socialization in the Ghanaian culture affects the individual’s entrepreneurial choices and/or ventures. And if it does, how? The study analyzed the common gender roles found in the Ghanaian culture and the perceptions about these gender roles. 2507 male and female Ghanaian entrepreneurs were randomly sampled and interviewed. One particularly interesting finding of the study is that, while some entrepreneurs have interests in other enterprises, they fear becoming challengers of societal norms, as those ventures have been assigned to the other gender by the culture. Additionally, most of these entrepreneurs fear low or no patronage from members of the society. The study, thus, revealed a significant relationship between culture, especially gender role socialization, and patronage of businesses, as well as the success and profitability of an enterprise. It was, thus, concluded that most entrepreneurs’ entrepreneurial decisions or choices are influenced by the entrepreneur’s gender role socialization. By extension, gender role socialization was found to influence and limit entrepreneurial ventures.

Keywords: gender, role, socialization, entrepreneur, culture, ghana

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Authors: Nelson Barrientos, Matthew J. Davies, Marco C. Marques, Darren N. Nesbeth, Gary J. Lye, Nicolas Szita

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Microbioreactor technology is making important advances towards its application in cell culture and bioprocess development. In particular, the technology promises flexible and controllable devices capable to perform parallelised experimentation at low cost. Currently, state of the art methods (e.g. optical sensors) allow the accurate monitoring of the microbioreactor operation. In addition, the laminar flow regime encountered in these devices allows more predictive fluid dynamics modelling, improving the control over the soluble, physical and mechanical environment of the cells. This work describes the development and characterisation of a novel microbioreactor cassette system (microbioreactor volume is 150 μL. The volumetric oxygen transfer coefficient (KLa) and mixing time have been characterised to be between 25 to 113 h-1 and 0.5 and 0.1 s, respectively. In addition, the Residence time distribution (RTD) analysis confirms that the reactor operates at well mixed conditions. Finally, Staphylococcus carnosus TM300 growth is demonstrated via batch culture experiments. Future work consists in expanding the optics of the microbioreactor design to include the monitoring of variables such as fluorescent protein expression, among others.

Keywords: microbioreactor, cell-culture, fermentation, microfluidics

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Authors: Vanlounni Sibounheuang, Wanarat Anusornsangiam, Pattarin Kittiboonyakun, Chanthanom Manithip

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In worldwide, one of the most common use of oral anticoagulant is warfarin. Its margin between therapeutic inhibition of clot formation and bleeding complications is narrow. Mahosot Hospital, warfarin clinic had not been established yet. The descriptive study was conducted by investigating drug-related problems of outpatients using warfarin, the value of the international normalized ratio (INR) higher than normal ranges (25.40 % of the total 272 outpatients) were mostly identified at Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. This result led to the present study conducting qualitative interviews in order to help establish a warfarin clinic at Mahosot Hospital for the better outcomes of patients using warfarin. The purpose of this study was to explore perspectives of healthcare professional providing services for outpatients using warfarin. The face to face, in-depth interviews were undertaken among nine healthcare professionals (doctor=3, nurse=3, pharmacist=3) working at out-patient clinic, Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. The interview guides were developed, and they were validated by the experts in the fields of qualitative research. Each interview lasted approximately 20 minutes. Three major themes emerged; healthcare professional’s experiences of current practice problems with warfarin therapy, healthcare professionals’ views of medical problems related to patients using warfarin, and healthcare professionals’ perspectives on ways of service improvement. All healthcare professionals had the same views that it’s difficult to achieve INR goal for individual patients because of some important patient barriers especially lack of knowledge about to use warfarin properly and safety, patients not regularly follow-up due to problems with transportations and financial support. Doctors and nurses agreed to have a pharmacist running a routine warfarin clinic and provided counselling to individual patients on the following points: how to take drug properly and safety, drug-drug and food-drug interactions, common side effects and how to manage them, lifestyle modifications. From the interviews, some important components of the establishment of a warfarin clinic included financial support, increased human resources, improved the system of keeping patients’ medical records, short course training for pharmacists. This study indicated the acceptance of healthcare professionals on the important roles of pharmacists and the feasibility of setting up warfarin clinic by working together with the multidisciplinary health care team in order to help improve health outcomes of patients using warfarin at Mahosot Hospital, Lao PDR.

Keywords: perspectives, healthcare professional, warfarin therapy, Mahosot Hospital

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Authors: Mohammad Torabiyan, Kazem Mosawi Nejad

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Today architecture has become as a powerful media for introducing cultures to the world, which in turn brings about a change in the global insight, power gaining, investment and development. Islamic architecture is based on the language of Koran and shows the depth and richness of Islam through spiritual soul. This is in a way that belief in monotheism and faith in Islamic teachings are manifested as Islam's aesthetic thought in Islamic architecture. Unfortunately, Islamic architecture has been damaged a lot due to lack of necessary information and also successive wars which have overtaken the Muslims as well as the dominance of colonizing counties. Islamic architecture is rooted in the history, culture and civilization of Muslims but its deficiencies and shortcomings should be removed through systematizing the Islamic architecture researchers. Islamic countries should act in a way that the art of Islamic architecture shows its true place in different architecture eras and makes everybody aware that Islamic architecture has a historical root and is connected eternally to the genuineness, religious art and culture of Muslims and civilization.

Keywords: art, culture, civilization, Islamic architecture, Muslims

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Authors: Leda Maria Costa Pereira, Maria Denise Lopes, Nucharin Songsasen

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Mammalian ovaries contain thousands of follicles that eventually degenerate or die after culture in vitro. Caspase-3 is a key enzyme that regulating cell death. Our objective was to examine the influence of anti-apoptotic drug Z-VAD-FMK (pan-caspase inhibitor) on in vitro viability of dog follicles within the ovarian cortex. Ovaries were obtained from prepubertal (age, 2.5–6 months) and adult (age, 8 months to 2 years) bitches and ovarian cortical fragments were recovered. The cortices were then incubated on 1.5% (w/v) agarose gel blocks within a 24-wells culture plate (three cortical pieces/well) containing Minimum Essential Medium Eagle - Alpha Modification (Alpha MEM) supplemented with 4.2 µg/ml insulin, 3.8 µg/ml transferrin, 5 ng/ml selenium, 2 mM L-glutamine, 100 µg/mL of penicillin G sodium, 100 µg/mL of streptomycin sulfate, 0.05 mM ascorbic acid, 10 ng/mL of FSH and 0.1% (w/v) polyvinyl alcohol in humidified atmosphere of 5% CO2 and 5% O2. The cortices were divided in six treatment groups: 1) 10 ng/mL EGF (EGF V0); 2) 10 ng/mL of EGF plus 1 mM Z-VAD-FMK (EGF V1); 3) 10 ng/mL of EGF and 10 mM Z-VAD-FMK (EGF V10); 4) 1 mM Z-VAD-FMK; 5) 10 mM Z-VAD-FMK and (6) no EGF and Z-VAD-FMK supplementation. Ovarian follicles within the tissues were processed for histology and assessed for follicle density, viability (based on morphology) and diameter immediately after collection (Control) or after 3 or 7 days of in vitro incubation. Comparison among fresh and culture treatment group was performed using ANOVA test. There were no differences (P > 0.05) in follicle density and viability among different culture treatments. However, there were differences in this parameter between culture days. Specifically, culturing tissue for 7 days resulted in significant reduction in follicle viability and density, regardless of treatments. We found a difference in size between culture days when these follicles were cultured using 10 mM Z-VAD-FMK or 10 ng/mL EGF (EGF V0). In sum, the finding demonstrated that Z-VAD-FMK at the dosage used in the present study does not provide the protective effect to ovarian tissue during in vitro culture. Future studies should explore different Z-VAD-FMK dosages or other anti-apoptotic agent, such as surviving in protecting ovarian follicles against cell death.

Keywords: anti apoptotic drug, bitches, follicles, Z-VAD-FMK

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Authors: Liang Fang

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The development of the large suburban residential area is a product of the leap development during the rapid urbanization process in China. On the process of the large-scale development of large settlements in a short time, various problems arose in the suburban residential area, such as spatial layout being disorder, basic facilities construction lagging behind and being unreasonable, residential neighborhood space and street culture missing. Aimed at the contradictions mentioned above, exploring a way is imminent to construct appropriate residential area. We select a typical Liangzhu Culture Village in Hangzhou and put forward functional composite residential area of fine development strategy, along which business promotes and assists community autonomy and then a good community culture is constructed. All in all, the development and construction mode, contributing to an all-people and full-time participation, is beneficial to create a harmonious community of sustainable development, which gives good implication to a single enterprise development city real estate projects.

Keywords: community autonomy, development and construction mode, functional composite, suburban large residential area

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Authors: Mosab kh. A. A. Bashir, E. Mohamed-Ahmed

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The aim of the study is to compare the results of the external exposure and the range of the dose spread by the patients, hospitalized in two different groups of 3-5 d receiving radioiodine therapy because of thyroid cancer, and one of group were giving the local diuretic plant (barley) as local juice. The control group was 28 patients they were isolated as international precautions after taken I-131 capsule 100 mCi, and their external exposure was recorded day by day after first 24 hrs. and the distance for external measurement was 1 m at the abdominal level. The mean of external exposure values of patients at fourth day were 30.24±12.92 µSv h−1. The second group after taking I-131 capsule 100 mCi we were given barley juice (250 mL) after every meal three times on day and their external exposure was recorded day by day after first 24 hrs. The mean of external exposure values of patients of this group at third day was 26.92±9.89 (14-55) µSv h−1. It was observed that the external exposure from the second group clearly decreased to low levels which contributed to the decrease in patient dose and also to the decrease in the exposure from the patient to his/her family.

Keywords: local diuretic juice, therapy, radiation medicine, diuretic plant

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Authors: Ghazwan Al-Haji, Adeyemi Adedokun

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Traffic safety at intersections is highly represented, given the fact that accidents occur randomly in time and space. It is necessary to judge whether the intersection is dangerous or not based on short-term observations, and not waiting for many years of assessing historical accident data. There are active and pro-active road infrastructure safety methods for assessing safety at intersections. This study aims to investigate the use of quantitative and qualitative pre-observational methods as the best practice for accident prediction, future black spot identification, and treatment. Historical accident data from STRADA (the Swedish Traffic Accident Data Acquisition) was used within Norrkoping city in Sweden. The ADT (Average Daily Traffic), capacity and speed were used to predict accident rates. Locations with the highest accident records and predicted accident counts were identified and hence audited qualitatively by using Street Audit. The results from these quantitative and qualitative methods were analyzed, validated and compared. The paper provides recommendations on the used methods as well as on how to reduce the accident occurrence at the chosen intersections.

Keywords: intersections, traffic conflict, traffic safety, street audit, accidents predictions

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Authors: Katarzyna Drela, Miroslaw Wielgos, Mikolaj Wrobel, Barbara Lukomska

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Mesenchymal stem cells (MSCs) have a great potential in regenerative medicine. Since the initial number of isolated MSCs is limited, in vitro propagation is often required to reach sufficient numbers of cells for therapeutic applications. During long-term culture MSCs may undergo genetic or epigenetic alterations that subsequently increase the probability of spontaneous malignant transformation. Thus, factors that influence genomic stability of MSCs following long-term expansions need to be clarified before cultured MSCs are employed for clinical application. The aim of our study was to investigate the potential for spontaneous transformation of human neonatal cord blood (HUCB-MSCs) and adult bone marrow (BM-MSCs) derived MSCs. Materials and Methods: HUCB-MSCs and BM-MSCs were isolated by standard Ficoll gradient centrifugations method. Isolated cells were initially plated in high density 106 cells per cm2. After 48 h medium were changed and non-adherent cells were removed. The malignant transformation of MSCs in vitro was evaluated by morphological changes, proliferation rate, ability to enter cell senescence, the telomerase expression and chromosomal abnormality. Proliferation of MSCs was analyzed with WST-1 reduction method and population doubling time (PDT) was calculated at different culture stages. Then the expression pattern of genes characteristic for mesenchymal or epithelial cells, as well as transcriptions factors were examined by RT-PCR. Concomitantly, immunocytochemical analysis of gene-related proteins was employed. Results: Our studies showed that MSCs from all bone marrow isolations ultimately entered senescence and did not undergo spontaneous malignant transformation. However, HUCB-MSCs from one of the 15 donors displayed an increased proliferation rate, failed to enter senescence, and exhibited an altered cell morphology. In this sample we observed two different cell phenotypes: one mesenchymal-like exhibited spindle shaped morphology and express specific mesenchymal surface markers (CD73, CD90, CD105, CD166) with low proliferation rate, and the second one with round, densely package epithelial-like cells with significantly increased proliferation rate. The PDT of epithelial-like populations was around 1day and 100% of cells were positive for proliferation marker Ki-67. Moreover, HUCB-MSCs showed a positive expression of human telomerase reverse transcriptase (hTERT), cMYC and exhibit increased number of CFU during the long-term culture in vitro. Furthermore, karyotype analysis revealed chromosomal abnormalities including duplications. Conclusions: Our studies demonstrate that HUCB-MSCs are susceptible to spontaneous malignant transformation during long-term culture. Spontaneous malignant transformation process following in vitro culture has enormous effect on the biosafety issues of future cell-based therapies and regenerative medicine regimens.

Keywords: mesenchymal stem cells, spontaneous, transformation, long-term culture

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Authors: Hansraj Riteesh Bookun, Emily Maree Stevens, Jarryd Leigh Solomon, Anthony Chan

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Objective: This was a retrospective cross-sectional study evaluating the safety and efficacy of femoral endarterectomy using the eversion technique with transection as opposed to the conventional endarterectomy technique with either vein or synthetic patch arterioplasty. Methods: Between 2010 to mid 2017, 19 patients with mean age of 75.4 years, underwent eversion femoral endarterectomy with transection by a single surgeon. There were 13 males (68.4%), and the comorbid burden was as follows: ischaemic heart disease (53.3%), diabetes (43.8%), stage 4 kidney impairment (13.3%) and current or ex-smoking (73.3%). The indications were claudication (45.5%), rest pain (18.2%) and tissue loss (36.3%). Results: The technical success rate was 100%. One patient required a blood transfusion following bleeding from intraoperative losses. Two patients required blood transfusions from low post operative haemogloblin concentrations – one of them in the context of myelodysplastic syndrome. There were no unexpected returns to theatre. The mean length of stay was 11.5 days with two patients having inpatient stays of 36 and 50 days respectively due to the need for rehabilitation. There was one death unrelated to the operation. Conclusion: The eversion technique with transection is safe and effective with low complication rates and a normally expected length of stay. It poses the advantage of not requiring a synthetic patch. This technique features minimal extraneous dissection as there is no need to harvest vein for a patch. Additionally, future endovascular interventions can be performed by puncturing the native vessel. There is no change to the femoral bifurcation anatomy after this technique. We posit that this is a useful adjunct to the surgeon’s panoply of vascular surgical techniques.

Keywords: endarterectomy, eversion, femoral, vascular

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Authors: Rewadee Ungpho

Abstract:

The research on the musical culture of Sea Gypsies in Bulon archipelago, Satun Province, is considered as an anthropology research. Research objectives were to study the history and information culture and also to find the basis information for the restoration and preservation of the music culture of Sea Gypsies who live in Bulon archipelago. Findings of the research are as follows: 1) Musical characteristics of Sea Gypsies in Bulon archipelago is still traditional. It does not mix with any external musical influence such as musical instruments, language, and other musical characteristics. There are various kind of songs which can play a complete melody and rhythm, including a total of 8 songs as follows; Lagu-Ayam-Dide, Lagu-Sitipayong, Lagu-Bulong-pute, Lagu-Chemamat, Laguduwo, Lagu-Ma-I-nang, Lagu-Mana-Ikan. 2) The roles of culture/music in Bulon archipelago correlate with Urak Lawoi society. They use music in the ceremony of votive offering, in the floating ceremony held in Lipe Island and in various festivals. Therefore, music is a spiritual sacrifice and a spiritual instrument that conveys an Urak Lawoi, which makes the Urak Lawoi still unique and has a sense of ethnic identity. 3) The inheritance of Urak Lawoi music is still being made in a traditional way, as an oral tradition with no record. The teaching and learning must be one on one, and it required length of time to practice and accumulate the knowledge. Due to above mentioned reasons, a few people attend in the inheritance. Those who are interested may not be able to practice constantly. As a result, there is only a few, or even none, descendants left.

Keywords: sea gypsy, music, Bulon archipelago, ethnomusicology

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Authors: Sohaib Raza, Parvez Mantry

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Frailty is a multi-system impairment associated with stressors such as age, disease, and invasive surgical procedures. This multi-system impairment can lead to increased post-transplant mortality and functional decline. Additionally, the prevalence and/or severity of frailty increases when patient pre-habilitation is unsatisfactory or lacking. We conducted a retrospective study to examine whether the COVID-19 Pandemic, and subsequent lack of patient access to pre-habilitation and physical therapy resources, led to an increase in the prevalence and severity of frailty, sarcopenia, and other comorbidities including diabetes, hypertension, and COPD. Secondarily, we examined the correlation between patient survival rate and liver frailty index as well as muscle wasting/sarcopenia. Data were analyzed in order to correlate variables associated with these parameters. Three hundred sixty-nine liver transplant candidates at Methodist Dallas Medical Center were administered pre-transplant frailty assessments, which consisted of chair stands, grip strength, and position balance time. A frailty score less than 3.2 indicated a robust condition, a score from 3.3 to 4.4 indicated a pre-frail condition, and a score greater than 4.5 indicated a frail condition. Greater than 50 percent of patients were found to have muscle wasting in the COVID-19 period (March 13, 2020 to February 28, 2022), an increase of 16.5 percent from the pre-COVID period (April 1st, 2018 to March 12, 2020). Additionally, sarcopenia was associated with a two-fold increase in patient mortality rate. Furthermore, high liver frailty index scores were associated with increased patient mortality. However, there was no significant difference in liver frailty index or number of comorbidities between patients in the two cohorts. Conclusion: The COVID-19 Pandemic exacerbated sarcopenia-related muscle wasting in liver transplant candidates, and patient survival rate was directly correlated with liver frailty index score and the presence of sarcopenia.

Keywords: frailty, sarcopenia, covid-19, patient mortality, pre-habilitation, liver transplant candidates

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Authors: Tsai-Hsiu Lin

Abstract:

Three dimensions of teacher culture hinder educational improvement: individualism, conservatism and presentism. To promote the professional development of teachers, these three aspects in teacher culture should be eliminated. Classroom observation may be a useful method of eliminating individualism. The Ministry of Education in Taiwan has attempted to reduce the isolation of teachers to promote their professional growth. Because classroom observation discourse varies, teachers are generally unwilling to allow their teaching to be observed. However, classroom observations take place in the country in the form of school evaluations. The main purpose of this study was to explore the differences in teachers’ conservatism, individualism and presentism after classroom observations had been conducted at an elementary school in Taiwan. The research method was a qualitative case study involving interviews with the school principal, the director of academic affairs, and two classroom teachers. The following conclusions were drawn: (1) Educators in different positions viewed classroom observations differently; (2) The classroom teachers did not highly value classroom observation; (3) There was little change in the teachers’ conservatism, individualism and presentism after classroom observation.

Keywords: classroom observation, Lortie’s Trinity, teacher culture, teacher professional development

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Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: cancer patients, e-learning, nursing, web based education

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Authors: Mahfoodh Saleh Al Sabbagh, Amitabh Mishra, Anwar Al Sheyadi

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A tremendous transformation is taking place in the state of education in Sultanate of Oman. The vision 2040 for Higher Education focuses on both academic and technical sides of education aims at improving the quality of education as per higher international standards with emphasis on learning and innovation, creativity and scientific research. The objective is to achieve a proficient education system that keeps abreast of the recent development, the essentials of sustainable development and enhancing the national identity. Higher Education Institutes have contributed immensely to the growth of education in Oman, in this context; Business Organization represents the most complex social structure known today due to its dynamic nature. Employees are considered as one of the dynamic resources of the organization and through their commitment and involvement organization becomes competitive. Organization Culture can be promoted to facilitate the achievement of job satisfaction and employees commitment. The purpose of the research is to explore the impact of Higher Educational Institutions Culture on employee satisfaction, and commitment. Based on primary data, the study was conducted in Higher Education Institutions in the Sultanate of Oman. Data was collected through questionnaire consisting of 60 questions related to culture, satisfaction, and commitment. The sample consisted of 330 employees of leading Higher Education Institutes in the Sultanate of Oman. Structural Equation Modeling was carried out on the data through SPSS and AMOS. Results indicate that culture of organization is significantly related with employees’ satisfaction and commitment both in direct and indirect ways. Significant theoretical and practical implications are driven from the outcomes of the study.

Keywords: organization culture, employee satisfaction and commitment, higher education, Sultanate of Oman

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Authors: Nkosingiphile M. Mbhele, Jean Steyn

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A focus group discussion was implemented, which comprised of senior South African Police Service managers and police academics in South Africa. The measurement of solidarity, isolation, and cynicism among functional South African Police Service officials and a thirty-item questionnaire came about by reviewing the literature. This research uses a survey format to assess the police culture theme of solidarity, isolation, and cynicism among South African Police Service officers in 9 South African provinces. Although a survey format is used in research, it engages in a quasi-experimental pre-test/post-test repeated measures research (longitudinal) design. Although there are differences among South African Police Service police (SAPS) officers, overall, there are signs of solidarity, isolation, and cynicism among SAPS members. Attitudes of solidarity, isolation, and cynicism are present among most police officials and have been presented from the start of training and held, maintained, or strengthened for the next years of their SAPS careers. This issue is problematic to society with regard to community-orientated policing since they have to interact with the members of the community. To author’s best knowledge, longitudinal studies of police culture are rare to find; not much has been researched on this topic. However, this paper offers to bridge that gap by providing answers to longitudinal police attitudes towards the public within the police culture themes of isolation and cynicism attitudes.

Keywords: South African police service, police culture, solidarity, isolation, cynicism, public

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Authors: Gulten Yilmaz, A. Beril Tugrul, Mustafa Demir, Dogan Yasar, Bayram Demir, Bulent Buyuk

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A Positron Emission Tomography (PET) is a radioisotope imaging technique that illustrates the organs and the metabolisms of the human body. This technique is based on the simultaneous detection of 511 keV annihilation photons, annihilated as a result of electrons annihilating positrons that radiate from positron-emitting radioisotopes that enter biological active molecules in the body. This study was conducted on ten patients in an effort to conduct patient-related experimental studies. Dosage monitoring for the bladder, which was the organ that received the highest dose during PET applications, was conducted for 24 hours. Assessment based on measuring urination activities after injecting patients was also a part of this study. The MIRD method was used to conduct dosage calculations for results obtained from experimental studies. Results obtained experimentally and theoretically were assessed comparatively.

Keywords: PET/CT, TLD, MIRD, dose measurement, patient doses

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Authors: Jin Hun Choi, So Hyun Ahn, Seong Keun Wang, Ik-Seung Chee, Jung Lan Kim, Sun Woo Lee

Abstract:

Objectives: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. Methods: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patient and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, World Health Organization Quality of Life Assessment and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. Results: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. Conclusions: Through the study, it was confirmed that when hospitalized schizophrenic patients received continuous day hospital care after being discharged, they received further out-patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients’ treatment adherence issues and improvement of treatment outcomes.

Keywords: schizophrenia, day hospital care, adherence, outcomes

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Authors: Manal Sultan Alhussein, Xiang Michelle Liu

Abstract:

Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.

Keywords: telehealth, patient satisfaction, pandemic, healthcare, survey

Procedia PDF Downloads 102