Search results for: abdominal delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2284

Search results for: abdominal delivery

1444 Study of Demographic, Hematological Profile and Risk Stratification in Chronic Myeloid Leukemia Patients

Authors: Rajandeep Kaur, Rajeev Gupta

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Background: Chronic myeloid leukemia (CML) is the most common leukaemia in India. The annual incidence of chronic myeloid leukemia in India was originally reported to be 0.8 to 2.2 per 1,00,000 population. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity, has significantly reduced the mortality rate associated with chronic myeloid leukemia (CML) and revolutionized treatment. Material and Methods: 80 diagnosed cases of CML were taken. Investigations were done. Bone marrow and molecular studies were also done and with EUTOS, patients were stratified into low and high-risk groups and then treatment with Imatinib was given to all patients and the molecular response was evaluated at 6 months and 12 months follow up with BCR-ABL by RT-PCR quantitative assay. Results: In the study population, out of 80 patients in the study population, 40 were females and 40 were males, with M: F is 1:1. Out of total 80 patients’ maximum patients (54) were in 31-60 years age group. Our study showed a most common symptom of presentation is abdominal discomfort followed by fever. Out of the total 80 patients, 25 (31.3%) patients had high EUTOS scores and 55 (68.8%) patients had low EUTOS scores. On 6 months follow up 36.3% of patients had Complete Molecular Response, 16.3% of patients had Major Molecular Response and 47.5% of patients had No Molecular Response but on 12 months follow up 71.3% of patients had Complete Molecular Response, 16.25% of patients had Major Molecular Response and 12.5% patients had No Molecular Response. Conclusion: In this study, we found a significant correlation between EUTOS score and Molecular response at 6 months and 12 months follow up after Imatinib therapy.

Keywords: chronic myeloid leukemia, European treatment and outcome study score, hematological response, molecular response, tyrosine kinase inhibitor

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1443 A Framework for Rating Synchronous Video E-Learning Applications

Authors: Alex Vakaloudis, Juan Manuel Escano-Gonzalez

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Setting up a system to broadcast live lectures on the web is a procedure which on the surface does not require any serious technical skills mainly due to the facilities provided by popular learning management systems and their plugins. Nevertheless, producing a system of outstanding quality is a multidisciplinary and by no means a straightforward task. This complicatedness may be responsible for the delivery of an overall poor experience to the learners, and it calls for a formal rating framework that takes into account the diverse aspects of an architecture for synchronous video e-learning systems. We discuss the specifications of such a framework which at its final stage employs fuzzy logic technique to transform from qualitative to quantitative results.

Keywords: synchronous video, fuzzy logic, rating framework, e-learning

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1442 Public-Private Partnership Projects in Canada: A Case Study Approach

Authors: Samuel Carpintero

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Public-private partnerships (PPP) arrangements have emerged all around the world as a response to infrastructure deficits and the need to refurbish existing infrastructure. The motivations of governments for embarking on PPPs for the delivery of public infrastructure are manifold, and include on-time and on-budget delivery as well as access to private project management expertise. The PPP formula has been used by some State governments in United States and Canada, where the participation of private companies in financing and managing infrastructure projects has increased significantly in the last decade, particularly in the transport sector. On the one hand, this paper examines the various ways used in these two countries in the implementation of PPP arrangements, with a particular focus on risk transfer. The examination of risk transfer in this paper is carried out with reference to the following key PPP risk categories: construction risk, revenue risk, operating risk and availability risk. The main difference between both countries is that in Canada the demand risk remains usually within the public sector whereas in the United States this risk is usually transferred to the private concessionaire. The aim is to explore which lessons can be learnt from both models than might be useful for other countries. On the other hand, the paper also analyzes why the Spanish companies have been so successful in winning PPP contracts in North America during the past decade. Contrary to the Latin American PPP market, the Spanish companies do not have any cultural advantage in the case of the United States and Canada. Arguably, some relevant reasons for the success of the Spanish groups are their extensive experience in PPP projects (that dates back to the late 1960s in some cases), their high technical level (that allows them to be aggressive in their bids), and their good position and track-record in the financial markets. The article’s empirical base consists of data provided by official sources of both countries as well as information collected through face-to-face interviews with public and private representatives of the stakeholders participating in some of the PPP schemes. Interviewees include private project managers of the concessionaires, representatives of banks involved as financiers in the projects, and experts in the PPP industry with close knowledge of the North American market. Unstructured in-depth interviews have been adopted as a means of investigation for this study because of its powers to achieve honest and robust responses and to ensure realism in the collection of an overall impression of stakeholders’ perspectives.

Keywords: PPP, concession, infrastructure, construction

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1441 Clinical, Demographic and Molecular Characterization of Dengue, Chikungunya and Zika Viruses Causing Hemorrhagic Fever in North India

Authors: Suruchi Shukla, Shantanu Prakash, Amita Jain

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Introduction: Arboviral diseases are one of the most common causes of viral hemorrhagic fever (VHF). Of which, Dengue and Chikungunya pose a significant health problem in India. Arbovirus has a tendency to cross the territories and emerge in the new region. Considering the above issues, in the current study active surveillance was conducted among viral hemorrhagic fever (VHF) cases reported from Uttar Pradesh (UP), India. We studied the arboviral etiology of VHF; mainly Dengue, Chikungunya, and ZIKA. Methods: Clinical samples of 465 suspected VHF cases referred to tertiary care referral center of UP, India were enrolled in the study during a period from 15th May 2016 to 9th March 2018. Serum specimens were collected and analyzed for the presence of Dengue, Chikungunya, and ZIKA either by serology and/or by molecular assays. Results: Of all tested, 165 (35.4%) cases were positive for either Dengue or Chikungunya. Dengue (21.2%) was found to be the most prevalent, followed by Chikungunya, (6.6%). None of the cases tested positive for ZIKA virus. Serum samples of 35 (7.5%) cases were positive for both Dengue and Chikungunya. DEN-2 serotype was the most predominant serotype. Phylogenetic and sequence analysis of DEN-2 strains showed 100% clustering with the Cosmopolitan genotype strain. Bleeding from several sites, jaundice, abdominal pain, arthralgia, haemoconcentration, and thrombocytopenia were significantly higher in dengue hemorrhagic cases. However, the rash was significantly more common in Chikungunya patients. Most of the Dengue and Chikungunya positive cases (Age group 6-40 years) were seen in post monsoon season (September to November). Conclusion: Only one-third of total VHF cases are positive for either Dengue/Chikungunya or both. This necessitates the screening of other etiologies capable of causing hemorrhagic manifestations.

Keywords: viral hemorrhagic fever, dengue, chikungunya, zika, India

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1440 Astragaioside IV Inhibits Type2 Allergic Contact Dermatitis in Mice and the Mechanism Through TLRs-NF-kB Pathway

Authors: Xiao Wei, Dandan Sheng, Xiaoyan Jiang, Lili Gui, Huizhu Wang, Xi Yu, Hailiang Liu, Min Hong

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Objective: Mice Type2 allergic contact dermatitis was utilized in this study to explore the effect of AS-IV on Type 2 allergic inflammatory. Methods: The mice were topically sensitized on the shaved abdomens with 1.5% FITC solution on abdominal skin in the day 1 and day 2 and elicited on the right ear with 0.5% FITC solution at day 6. Mice were treated with either AS-IV or normal saline from day 1 to day 5 (induction phase). Auricle swelling was measured 24 h after the elicitation. Ear pathohistological examination was carried out by HE staining. IL-4\IL-13, and IL-9 levels of ear tissue were detected by ELISA. Mice were treated with AS-IV at the initial stage of induction phase, ear tissue was taked at day 3.TSLP level of ear tissue was detected by ELISA and TSLPmRNA\NF-kBmRNA\TLRs(TLR2\TLR3\TLR8\TLR9)mRNA were detected by PCR. Results: AS-IV induction phase evidently inhibited the auricle inflam-mation of the models; pathohistological results indicated that AS-IV induction phase alleviated local edema and angiectasis of mice models and reduced lymphocytic infiltration. AS-IV induction phase markedly decreased IL-4\IL-13, and IL-9 levels in ear tissue. Moreover, at the initial stage of induction pha-se, AS-IV significantly reduced TSLP\TSLPmRNA\NF-kBmRNA\TLR2mRNA\TLR8 mRNA levels in ear tissue. Conclusion: Administration with AS-IV in induction phase could inhibit Type 2 allergic contact dermatitis in mice significantly, and the mechanism may be related with regulating TSLP through TLRs-NF-kB pathway.

Keywords: Astragaioside IV, allergic contact dermatitis, TSLP, interleukin-4, interleukin-13, interleukin-9

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1439 Transdermal Delivery of Sodium Diclofenac from Palm Kernel Oil Esteres Nanoemulsions

Authors: Malahat Rezaee, Mahiran Basri, Abu Bakar Salleh, Raja Noor Zaliha Raja Abdul Rahman

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Sodium diclofenac is one of the most commonly used drugs of nonsteroidal anti-inflammatory drugs (NSAIDs). It is especially effective in the controlling the severe conditions of inflammation and pain, musculoskeletal disorders, arthritis, and dysmenorrhea. Formulation as nanoemulsions is one of the nanoscience approaches that has been progressively considered in pharmaceutical science for transdermal delivery of the drug. Nanoemulsions are a type of emulsion with particle sizes ranging from 20 nm to 200 nm. An emulsion is formed by the dispersion of one liquid, usually the oil phase in another immiscible liquid, water phase that is stabilized using the surfactant. Palm kernel oil esters (PKOEs), in comparison to other oils, contain higher amounts of shorter chain esters, which suitable to be applied in micro and nanoemulsion systems as a carrier for actives, with excellent wetting behavior without the oily feeling. This research aimed to study the effect of terpene type and concentration on sodium diclofenac permeation from palm kernel oil esters nanoemulsions and physicochemical properties of the nanoemulsions systems. The effect of various terpenes of geraniol, menthone, menthol, cineol and nerolidol at different concentrations of 0.5, 1.0, 2.0, and 4.0% on permeation of sodium diclofenac were evaluated using Franz diffusion cells and rat skin as permeation membrane. The results of this part demonstrated that all terpenes showed promoting effect on sodium diclofenac penetration. However, menthol and menthone at all concentrations showed significant effects (<0.05) on drug permeation. The most outstanding terpene was menthol with the most significant effect for skin permeability of sodium diclofenac. The effect of terpenes on physicochemical properties of nanoemulsion systems was investigated on the parameters of particle size, zeta potential, pH, viscosity and electrical conductivity. The result showed that all terpenes had the significant effect on particle size and non-significant effects on the zeta potential of the nanoemulsion systems. The effect of terpenes was significant on pH, excluding the menthone at concentrations of 0.5 and 1.0%, and cineol and nerolidol at the concentration of 2.0%. Terpenes also had significant effect on viscosity of nanoemulsions exception of menthone and cineol at the concentration of 0.5%. The result of conductivity measurements showed that all terpenes at all concentration except cineol at the concentration of 0.5% represented significant effect on electrical conductivity.

Keywords: nanoemulsions, palm kernel oil esters, sodium diclofenac, terpenes, skin permeation

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1438 Shared Heart with a Common Atrial Complex and Persistent Right Dorsal Aorta in Conjoined Twins

Authors: L. C. Prasanna, Antony Sylvan D’Souza, Kumar M. R. Bhat

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Although life as a conjoined twin would seem intolerable, there has recently been an increased interest in this subject because of the increasing number of cases where attempts have been made to separate them surgically. We have reviewed articles on cardiovascular anomalies in conjoined twins and presenting rarest anomaly in dicephalus parapagus fetus having two heads attached to one body from the neck or upper chest downwards, with a pair of limbs and a set of reproductive organs. Both the twins shared a common thoracic cavity with a single sternum. When the thoracic cavity was opened, a common anterior mediastinum was found. On opening the pericardium, two separate, closely apposed hearts were exposed. The two cardia are placed side by side. The left heart was slightly larger than the right and were joined at the atrial levels. Four atrial appendages were present, two for each twin. The atrial complex was a common chamber posterior to the ventricles. A single large tributary which could be taken as inferior vena cava drains into the common atrial chamber. In this case, the heart could not be assigned to either twin and therefore, it is referred to as the shared heart within a common pericardial sac. The right and left descending thoracic aorta have joined with each other just above the diaphragm to form a common descending thoracic aorta which has an opening in the diaphragm to be continued as common abdominal aorta which has a normal branching pattern. Upon an interior dissection, it is observed that the two atria have a wide communication which could be a wide patent foramen ovale and this common atrial cavity has a communication with a remnant of a possible common sinus venosus.

Keywords: atrium, congenital anomaly, conjoined twin, sinus venosus

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1437 Problem, Policy and Polity in Agenda Setting: Analyzing Safe Motherhood Program in India

Authors: Vanita Singh

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In developing countries, there are conflicting political agendas; policy makers have to prioritize issues from a list of issues competing for the limited resources. Thus, it is imperative to understand how some issues gain attention, and others lose in the policy circles. Multiple-Streams Theory of Kingdon (1984) is among the influential theories that help to understand the public policy process and is utilitarian for health policy makers to understand how certain health issues emerge on the policy agendas. The issue of maternal mortality was long standing in India and was linked with high birth rate thus the focus of maternal health policy was on family planning since India’s independence. However, a paradigm shift was noted in the maternal health policy in the year 1992 with the launch of Safe Motherhood Programme and then in the year 2005, when the agenda of maternal health policy became universalizing institutional deliveries and phasing-out of Traditional Birth Attendants (TBAs) from the health system. There were many solutions proposed by policy communities other than universalizing of institutional deliveries, including training of TBAs and improving socio-economic conditions of pregnant women. However, Government of India favored medical community, which was advocating for the policy of universalizing institutional delivery, and neglected the solutions proposed by other policy communities. It took almost 15 years for the advocates of institutional delivery to transform their proposed solution into a program - the Janani Suraksha Yojana (JSY), a safe-motherhood program promoting institutional delivery through cash incentives to pregnant women. Thus, the case of safe motherhood policy in India is worth studying to understand how certain issues/problems gain political attention and how advocacy work in policy circles. This paper attempts to understand the factors that favored the agenda of safe-motherhood in the policy circle in India, using John Kingdon’s Multiple-Stream model of agenda-setting. Through document analysis and literature review, the paper traces the evolution of safe motherhood program and maternal health policy. The study has used open source documents available on the website of Ministry of Health and Family Welfare, media reports (Times of India Archive) and related research papers. The documents analyzed include National health policy-1983, National Health Policy-2002, written reports of Ministry of Health and Family Welfare Department, National Rural Health Mission (NRHM) document, documents related to Janani Suraksha Yojana and research articles related to maternal health programme in India. The study finds that focusing events and credible indicators coupled with media attention has the potential to recognize a problem. The political elites favor clearly defined and well-accepted solutions. The trans-national organizations affect the agenda-setting process in a country through conditional resource provision. The closely-knit policy communities and political entrepreneurship are required for advocating solutions high on agendas. The study has implications for health policy makers in identifying factors that have the potential to affect the agenda-setting process for a desired policy agenda and identify the challenges in generating political priorities.

Keywords: agenda-setting, focusing events, Kingdon’s model, safe motherhood program India

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1436 A Holistic Workflow Modeling Method for Business Process Redesign

Authors: Heejung Lee

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In a highly competitive environment, it becomes more important to shorten the whole business process while delivering or even enhancing the business value to the customers and suppliers. Although the workflow management systems receive much attention for its capacity to practically support the business process enactment, the effective workflow modeling method remain still challenging and the high degree of process complexity makes it more difficult to gain the short lead time. This paper presents a workflow structuring method in a holistic way that can reduce the process complexity using activity-needs and formal concept analysis, which eventually enhances the key performance such as quality, delivery, and cost in business process.

Keywords: workflow management, re-engineering, formal concept analysis, business process

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1435 Structural Optimization, Design, and Fabrication of Dissolvable Microneedle Arrays

Authors: Choupani Andisheh, Temucin Elif Sevval, Bediz Bekir

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Due to their various advantages compared to many other drug delivery systems such as hypodermic injections and oral medications, microneedle arrays (MNAs) are a promising drug delivery system. To achieve enhanced performance of the MN, it is crucial to develop numerical models, optimization methods, and simulations. Accordingly, in this work, the optimized design of dissolvable MNAs, as well as their manufacturing, is investigated. For this purpose, a mechanical model of a single MN, having the geometry of an obelisk, is developed using commercial finite element software. The model considers the condition in which the MN is under pressure at the tip caused by the reaction force when penetrating the skin. Then, a multi-objective optimization based on non-dominated sorting genetic algorithm II (NSGA-II) is performed to obtain geometrical properties such as needle width, tip (apex) angle, and base fillet radius. The objective of the optimization study is to reach a painless and effortless penetration into the skin along with minimizing its mechanical failures caused by the maximum stress occurring throughout the structure. Based on the obtained optimal design parameters, master (male) molds are then fabricated from PMMA using a mechanical micromachining process. This fabrication method is selected mainly due to the geometry capability, production speed, production cost, and the variety of materials that can be used. Then to remove any chip residues, the master molds are cleaned using ultrasonic cleaning. These fabricated master molds can then be used repeatedly to fabricate Polydimethylsiloxane (PDMS) production (female) molds through a micro-molding approach. Finally, Polyvinylpyrrolidone (PVP) as a dissolvable polymer is cast into the production molds under vacuum to produce the dissolvable MNAs. This fabrication methodology can also be used to fabricate MNAs that include bioactive cargo. To characterize and demonstrate the performance of the fabricated needles, (i) scanning electron microscope images are taken to show the accuracy of the fabricated geometries, and (ii) in-vitro piercing tests are performed on artificial skin. It is shown that optimized MN geometries can be precisely fabricated using the presented fabrication methodology and the fabricated MNAs effectively pierce the skin without failure.

Keywords: microneedle, microneedle array fabrication, micro-manufacturing structural optimization, finite element analysis

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1434 Identifying the Challenges of Subcontractors Management in Building Area Projects and Providing Solutions (Supply Chain Management Approach)

Authors: Hamideh Sadat Zekri, Seyed Mojtaba Hosseinalipour, Mohammadreza Hafezi

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Nowadays, an organization cannot usually overcome all tasks singly due to the increasing complexity and vast expanse of projects, increment in uncertainty of activities, fast advances in technology, advent and influence of various factors in decision-making and implication of projects, and competitive atmosphere of different affairs. Thus, firms proceed to outsource the tasks to subcontractors. Nevertheless, large Iranian contracting companies suffer from extra consumed costs and time owing to conflicts between the activities of suppliers and subcontractors. The paucity of coordination in planning and execution, scarcity of coordination among suppliers, subcontractors, and the main contractor during the implementation of construction activities and also the lack of proper management of the aforesaid situation result in the growth of contradictions, number of claims, and legal issues in a project and consequently impose enormous expenses on those companies. Regarding the prosperity of supply chain management in other industries, its importance is increasingly getting appreciated in the field of construction. The ultimate aim of supply chain management is an effective delivery of the best value for customers, which is achievable by encouraging the members to interact and collaborate. In the present research, there was an effort to obtain a set of relevant challenges in the managing of subcontractors by identifying the main contractors and subcontractors and their role in the execution of projects and the supply chain management in the construction industry. Then, some of those challenges were selected in accordance with the views of industry professionals and academic experts. In the next step, a questionnaire was prepared and completed based on the analytic hierarchy process (AHP) and the challenges were prioritized. When it comes to subcontractors, the findings of the research demonstrate that difficulties in timely payments, alterations in approved drawings and the lack of rectification of job after completion by the subcontractor, paucity of a predetermined and legal process for qualifications of subcontractors, neglecting the supply chain processes in material procurement from producers, and delays in delivery of works by a subcontractor are the most significant problems. Finally, some solutions for encountering, eradicating, or reducing of mentioned problems are presented in accordance with previous studies and a survey from specialists.

Keywords: main contractors, subcontractors, supply chain management, construction supply chain, analytic hierarchy process, solution

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1433 Impact of Rapid Urbanization on Health Sector in India

Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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1432 A Study of 3 Different Reintroduction Regimens in Anti-Tubercular Therapy-Induced Hepatitis in Extra-Pulmonary Tuberculosis

Authors: Alpana Meena

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Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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1431 Nanoliposomes in Photothermal Therapy: Advancements and Applications

Authors: Mehrnaz Mostafavi

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Nanoliposomes, minute lipid-based vesicles at the nano-scale, show promise in the realm of photothermal therapy (PTT). This study presents an extensive overview of nanoliposomes in PTT, exploring their distinct attributes and the significant progress in this therapeutic methodology. The research delves into the fundamental traits of nanoliposomes, emphasizing their adaptability, compatibility with biological systems, and their capacity to encapsulate diverse therapeutic substances. Specifically, it examines the integration of light-absorbing materials, like gold nanoparticles or organic dyes, into nanoliposomal formulations, enabling their efficacy as proficient agents for photothermal treatment Additionally, this paper elucidates the mechanisms involved in nanoliposome-mediated PTT, highlighting their capability to convert light energy into localized heat, facilitating the precise targeting of diseased cells or tissues. This precise regulation of light absorption and heat generation by nanoliposomes presents a non-invasive and precisely focused therapeutic approach, particularly in conditions like cancer. The study explores advancements in nanoliposomal formulations aimed at optimizing PTT outcomes. These advancements include strategies for improved stability, enhanced drug loading, and the targeted delivery of therapeutic agents to specific cells or tissues. Furthermore, the paper discusses multifunctional nanoliposomal systems, integrating imaging components or targeting elements for real-time monitoring and improved accuracy in PTT. Moreover, the review highlights recent preclinical and clinical trials showcasing the effectiveness and safety of nanoliposome-based PTT across various disease models. It also addresses challenges in clinical implementation, such as scalability, regulatory considerations, and long-term safety assessments. In conclusion, this paper underscores the substantial potential of nanoliposomes in advancing PTT as a promising therapeutic approach. Their distinctive characteristics, combined with their precise ability to convert light into heat, offer a tailored and efficient method for treating targeted diseases. The encouraging outcomes from preclinical studies pave the way for further exploration and potential clinical applications of nanoliposome-based PTT.

Keywords: nanoliposomes, photothermal therapy, light absorption, heat conversion, therapeutic agents, targeted delivery, cancer therapy

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1430 The Role of Leukocyte-Derived IL-10 on Postoperative ileus and Intestinal Macrophage Differentiation in Mice

Authors: Kathy Stein, Mariola Lysson, Anja Schmidt, Beatrix Schumak, Sabine Specht, Hicham Bouabe, Jürgen Heesemann, Axel Roers, Joerg C. Kalff, Sven Wehner

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Objective: Postoperative ileus (POI) is a common complication of abdominal surgery. Monocyte infiltration is a hallmark of POI. The polarization of macrophages/monocytes in this process is not well understood. We aimed to investigate if and how M2 macrophage/monocyte differentiation is involved in POI pathogenesis. Design: POI was induced by intestinal manipulation (IM). C57Bl/6, CCR2-/-, IL-10 reporter (ITIB), IL-10-/- and LysMcre/IL-10fl/fl mice underwent IM. At various points in time leukocyte influx, gene and protein expression of cytokines, chemokines and M2 differentiation markers and intestinal motility were analyzed. Results: IM induced the postoperative expression of the M2 markers Arginase-1 and YM-1, predominantly in F4/80+Ly6C+ monocytes. Gene expression analyses indicated an IL-10-dependent, IL-4-independent M2 polarization of these monocytes. IL-10 dependency of M2 differentiation was confirmed in IL-10 deficient mice. Leukocytes, in the order of infiltrating monocytes, neutrophils, and resident macrophages were the main IL-10 producers during POI. IL-10 producing monocytes as well as M2 marker expression were almost absent in CCR2-deficient mice. However, postoperative IL-10 expression was not altered in CCR2-/- mice. The loss of M2 polarized monocytes neither protected CCR2-/- mice from nor affected resolution of POI. In contrast, IL-10 deficiency reduced postoperative neutrophil numbers and ameliorated POI. IL-10Ra expression was strongly induced in neutrophils but not in monocytes. Conclusion: We conclude that IL-10 counteracts POI resolution by activating IL-10Ra-expressing neutrophils in the late phase of disease while IL-10-dependent M2 differentiation is not pivotal to POI manifestation and resolution.

Keywords: interleukin-10, macrophages, neutrophils, postoperative ileus

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1429 Comparison of Due Date Assignment Rules in a Dynamic Job Shop

Authors: Mumtaz Ipek, Burak Erkayman

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Due date is assigned as an input for scheduling problems. At the same time, due date is selected as a decision variable for real time scheduling applications. Correct determination of due dates increases shop floor performance and number of jobs completed on time. This subject has been mentioned widely in the literature. Moreover rules for due date determination have been developed from analytical analysis. When a job arrives to the shop floor, a due date is assigned for delivery. Various due date determination methods are used in the literature. In this study six different due date methods are implemented for a hypothetical dynamic job shop and the performances of the due date methods are compared.

Keywords: scheduling, dynamic job shop, due date assignment, management engineering

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1428 Innovative Preparation Techniques: Boosting Oral Bioavailability of Phenylbutyric Acid Through Choline Salt-Based API-Ionic Liquids and Therapeutic Deep Eutectic Systems

Authors: Lin Po-Hsi, Sheu Ming-Thau

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Urea cycle disorders (UCD) are rare genetic metabolic disorders that compromise the body's urea cycle. Sodium phenylbutyrate (SPB) is a medication commonly administered in tablet or powder form to lower ammonia levels. Nonetheless, its high sodium content poses risks to sodium-sensitive UCD patients. This necessitates the creation of an alternative drug formulation to mitigate sodium load and optimize drug delivery for UCD patients. This study focused on crafting a novel oral drug formulation for UCD, leveraging choline bicarbonate and phenylbutyric acid. The active pharmaceutical ingredient-ionic liquids (API-ILs) and therapeutic deep eutectic systems (THEDES) were formed by combining these with choline chloride. These systems display characteristics like maintaining a liquid state at room temperature and exhibiting enhanced solubility. This in turn amplifies drug dissolution rate, permeability, and ultimately oral bioavailability. Incorporating choline-based phenylbutyric acid as a substitute for traditional SPB can effectively curtail the sodium load in UCD patients. Our in vitro dissolution experiments revealed that the ILs and DESs, synthesized using choline bicarbonate and choline chloride with phenylbutyric acid, surpassed commercial tablets in dissolution speed. Pharmacokinetic evaluations in SD rats indicated a notable uptick in the oral bioavailability of phenylbutyric acid, underscoring the efficacy of choline salt ILs in augmenting its bioavailability. Additional in vitro intestinal permeability tests on SD rats authenticated that the ILs, formulated with choline bicarbonate and phenylbutyric acid, demonstrate superior permeability compared to their sodium and acid counterparts. To conclude, choline salt ILs developed from choline bicarbonate and phenylbutyric acid present a promising avenue for UCD treatment, with the added benefit of reduced sodium load. They also hold merit in formulation engineering. The sustained-release capabilities of DESs position them favorably for drug delivery, while the low toxicity and cost-effectiveness of choline chloride signal potential in formulation engineering. Overall, this drug formulation heralds a prospective therapeutic avenue for UCD patients.

Keywords: phenylbutyric acid, sodium phenylbutyrate, choline salt, ionic liquids, deep eutectic systems, oral bioavailability

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1427 Study of the Prevalence, Associated Factors and Impact of Maternal Perinatal Depression in Women Alexandria 2022

Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

Abstract:

Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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1426 Differential Expression of GABA and Its Signaling Components in Ulcerative Colitis and Irritable Bowel Syndrome Pathogenesis

Authors: Surbhi Aggarwal, Jaishree Paul

Abstract:

Background: Role of GABA has been implicated in autoimmune diseases like multiple sclerosis, type1 diabetes and rheumatoid arthritis where they modulate the immune response but role in gut inflammation has not been defined. Ulcerative colitis (UC) and diarrhoeal predominant irritable bowel syndrome (IBS-D) both involve inflammation of gastrointestinal tract. UC is a chronic, relapsing and idiopathic inflammation of gut. IBS is a common functional gastrointestinal disorder characterised by abdominal pain, discomfort and alternating bowel habits. Mild inflammation is known to occur in IBS-D. Aim: Aim of this study was to investigate the role of GABA in UC as well as in IBS-D. Materials and methods: Blood and biopsy samples from UC, IBS-D and controls were collected. ELISA was used for measuring level of GABA in serum of UC, IBS-D and controls. RT-PCR analysis was done to determine GABAergic signal system in colon biopsy of UC, IBS-D and controls. RT-PCR was done to check the expression of proinflammatory cytokines. CurveExpert 1.4, Graphpad prism-6 software were used for data analysis. Statistical analysis was done by unpaired, two-way student`s t-test. All sets of data were represented as mean± SEM. A probability level of p < 0.05 was considered statistically significant. Results and conclusion: Significantly decreased level of GABA and altered GABAergic signal system was detected in UC and IBS-D as compared to controls. Significantly increased expression of proinflammatory cytokines was also determined in UC and IBS-D as compared to controls. Hence we conclude that insufficient level of GABA in UC and IBS-D leads to overproduction of proinflammatory cytokines which further contributes to inflammation. GABA may be used as a promising therapeutic target for treatment of gut inflammation or other inflammatory diseases.

Keywords: diarrheal predominant irritable bowel syndrome, γ-aminobutyric acid (GABA), inflammation, ulcerative colitis

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1425 Radiation Dose and Associated Exposure Parameters in Selected MDCT Scanners in Multiphase Scan of Abdomen-Pelvic Region: A Clinical Study

Authors: P. Sathyathas, H. M. I. S. W. Herath, T. Amalraj, U. J. M. A. L. Jayasinghe

Abstract:

Over two thirds of medical radiation can now be attributed to Computed Tomography (CT). There is little information on amount of radiation received from multiphase CT scan of abdomen- pelvic region in clinical practice. We sought to estimate the radiation dose and associated exposure parameters in the multiphase abdomen - pelvic scan of Multideteror Computed Tomography (MDCT) studies in clinical practice. This was a retrospective cross sectional studies describing radiation dose associated with main exposure parameters in diagnostic multiphase abdomen - pelvic scans performed on 152 consecutive patients by two different sixteen slice CT scanners. Patient information, exposure parameters of CTDI (volume), DLP, kVp, mAs and pitch were recorded for every phases of abdomen- a pelvic study from dose report of MDCT scanners (MDCTs). Age of patients range from 14 years to 87 years in both MDCT scanners. Overall CTDI (volume) median was 63.8 (±10.4) mGy for a multiphase abdominal-pelvic scan with scanner A while it was 35.4 (±15.6) mGy for scanner B. Patients' effective dose for multiphase abdomen - pelvic CT scan range from 8.2 mSv to 58 mSv. Median effective dose for patients, who underwent multiphase abdomen- pelvis scan with scanner A and B were 38.5 (± 8.2) mSv and 21.3 (± 8.6) mSv respectively. Median value of exposure parameters of mAs, kVp and pitch, were 150 (±29.7), 130 (±15.3) and 1.3 (±0.1) respectively in scanner A. In scanner B; they were 60 (±14.5), 120 and 1. The median effective dose for patients between multiphase abdomen-pelvic scan of both MDCT, a significant different (P<0.05) was observed. Multiphase abdomen – pelvic scan of clinical study shows significant different of effective dose with reference level of phantom studies (8-14mSv) and it depends on the type of vendors.

Keywords: abdomen-pelvic region, computed tomography, exposure parameters, radiation dose

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1424 Growth Performance and Meat Quality of Cobb 500 Broilers Fed Phytase and Tannase Treated Sorghum-Based Diets

Authors: Magaya Rutendo P., Mutibvu Tonderai, Nyahangare emmanuel T., Ncube Sharai

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This study aimed to evaluate the effects of phytase and tannase addition in broiler diets on growth performance and meat quality of broilers fed sorghum-based diets. Twelve experimental diets were formulated at three sorghum levels, which include 0, 50, and 100%, and 4 enzyme levels: No enzyme, 5000FTU phytase, 25TU tannase, and a combination of 5000FTU phytase plus 25TU tannase. Data on voluntary feed intake, average weekly weight gain and feed conversion ratio were recorded and used to assess growth performance. Meat technical and nutritional parameters were used to determine meat quality. Broilers fed total sorghum diets with phytase and tannase enzyme combination had the highest feed intake in the first (24.4 ± 0.04g/bird/day) and second weeks of life (23.0 ± 1.06g/bird/day), respectively. Complete sorghum diets with phytase (83.0 ± 0.88g/bird/day) and tannase (122.0 ± 0.88g/bird/day) showed the highest feed intake in the third and fourth weeks, respectively. Broilers fed 50% sorghum diets with tannase (135.3 ± 0.05g/bird/day) and complete maize diets with phytase (158.1 ± 0.88g/bird/day) had the highest feed intake during weeks five and six, respectively. Broilers fed a 50% sorghum diet without enzymes had the highest weight gain in the final week (606.5 ± 32.39g). Comparable feed conversion was observed in birds fed complete maize and 50% sorghum diets. Dietary treatment significantly influences the live body, carcass, liver, kidneys, abdominal fat pad weight, and intestinal length. However, it did not affect Pectoralis major meat nutritional and technical parameters.

Keywords: feed efficiency, sorghum, carcass, exogenous enzymes

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1423 A Two Phase VNS Algorithm for the Combined Production Routing Problem

Authors: Nejah Ben Mabrouk, Bassem Jarboui, Habib Chabchoub

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Production and distribution planning is the most important part in supply chain management. In this paper, a NP-hard production-distribution problem for one product over a multi-period horizon is investigated. The aim is to minimize the sum of costs of three items: production setups, inventories and distribution, while determining, for each period, the amount produced, the inventory levels and the delivery trips. To solve this difficult problem, we propose a bi-phase approach based on a Variable Neighbourhood Search (VNS). This heuristic is tested on 90 randomly generated instances from the literature, with 20 periods and 50, 100, 200 customers. Computational results show that our approach outperforms existing solution procedures available in the literature

Keywords: logistic, production, distribution, variable neighbourhood search

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1422 Developing API Economy: Associating Value to APIs and Microservices in an Enterprise

Authors: Mujahid Sultan

Abstract:

The IT industry has seen many transformations in the Software Development Life Cycle (SDLC) methodologies and development approaches. SDLCs range from waterfall to agile, and the development approaches from monolith to microservices. Management, orchestration, and monetization of microservices have created an API economy in the modern enterprise. There are two approaches to API design, code first and design first. Design first is gaining popularity in the industry as this allows capturing the API needs from the stakeholders rather than the development teams guesstimating the needs and associating a monetary value with the APIs and microservices. In this publication, we describe an approach to organizing and creating stakeholder needs and requirements for designing microservices and APIs.

Keywords: requirements engineering, enterprise architecture, APIs, microservices, DevOps, continuous delivery, continuous integration, stakeholder viewpoints

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1421 Effectiveness of a Malaysian Workplace Intervention Study on Physical Activity Levels

Authors: M. Z. Bin Mohd Ghazali, N. C. Wilson, A. F. Bin Ahmad Fuad, M. A. H. B. Musa, M. U. Mohamad Sani, F. Zulkifli, M. S. Zainal Abidin

Abstract:

Physical activity levels are low in Malaysia and this study was undertaken to determine if a four week work-based intervention program would be effective in changing physical activity levels. The study was conducted in a Malaysian Government Department and had three stages: baseline data collection, four-week intervention and two-month post intervention data collection. During the intervention and two-month post intervention phases, physical activity levels (determined by a pedometer) and basic health profiles (BMI, abdominal obesity, blood pressure) were measured. Staff (58 males, 47 females) with an average age of 33 years completed baseline data collection. Pedometer steps averaged 7,102 steps/day at baseline, although male step counts were significantly higher than females (7,861 vs. 6114). Health profiles were poor: over 50% were overweight/obese (males 66%, females 40%); hypertension (males 23%, females 6%); excess waist circumference (males 52%, females 17%). While 86 staff participated in the intervention, only 49 regularly reported their steps. There was a significant increase (17%) in average daily steps from 8,965 (week 1) to 10,436 (week 4). Unfortunately, participation in the intervention program was avoided by the less healthy staff. Two months after the intervention there was no significant difference in average steps/day, despite the fact that 89% of staff reporting they planned to make long-term changes to their lifestyle. An unexpected average increase of 2kg in body weight occurred in participants, although this was less than the 5.6kg in non-participants. A number of recommendations are made for future interventions, including the conclusion that pedometers were a useful tool and popular with participants.

Keywords: pedometers, walking, health, intervention

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1420 The Relationship Between Exposure to Traumatic Events in the Delivery Room, Post-Traumatic Stress Symptoms, Personal Resilience, Organizational Commitment, and Professional Quality of Life Among Midwives

Authors: Kinneret Segal

Abstract:

Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life

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1419 Clean Sky 2 – Project PALACE: Aeration’s Experimental Sound Velocity Investigations for High-Speed Gerotor Simulations

Authors: Benoît Mary, Thibaut Gras, Gaëtan Fagot, Yvon Goth, Ilyes Mnassri-Cetim

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A Gerotor pump is composed of an external and internal gear with conjugate cycloidal profiles. From suction to delivery ports, the fluid is transported inside cavities formed by teeth and driven by the shaft. From a geometric and conceptional side it is worth to note that the internal gear has one tooth less than the external one. Simcenter Amesim v.16 includes a new submodel for modelling the hydraulic Gerotor pumps behavior (THCDGP0). This submodel considers leakages between teeth tips using Poiseuille and Couette flows contributions. From the 3D CAD model of the studied pump, the “CAD import” tool takes out the main geometrical characteristics and the submodel THCDGP0 computes the evolution of each cavity volume and their relative position according to the suction or delivery areas. This module, based on international publications, presents robust results up to 6 000 rpm for pressure greater than atmospheric level. For higher rotational speeds or lower pressures, oil aeration and cavitation effects are significant and highly drop the pump’s performance. The liquid used in hydraulic systems always contains some gas, which is dissolved in the liquid at high pressure and tends to be released in a free form (i.e. undissolved as bubbles) when pressure drops. In addition to gas release and dissolution, the liquid itself may vaporize due to cavitation. To model the relative density of the equivalent fluid, modified Henry’s law is applied in Simcenter Amesim v.16 to predict the fraction of undissolved gas or vapor. Three parietal pressure sensors have been set up upstream from the pump to estimate the sound speed in the oil. Analytical models have been compared with the experimental sound speed to estimate the occluded gas content. Simcenter Amesim v.16 model was supplied by these previous analyses marks which have successfully improved the simulations results up to 14 000 rpm. This work provides a sound foundation for designing the next Gerotor pump generation reaching high rotation range more than 25 000 rpm. This improved module results will be compared to tests on this new pump demonstrator.

Keywords: gerotor pump, high speed, numerical simulations, aeronautic, aeration, cavitation

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1418 Irritable Bowel Syndrome Prevalence and Associated Risk Factors Among Medical Students And Intern Doctors in Sudan

Authors: Zainab Alghali Elsaid Muhammed

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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.

Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students

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1417 Effect of Span 60, Labrasol, and Cholesterol on Labisia pumila Loaded Niosomes Quality

Authors: H. Binti Ya’akob, C. Siew Chin, A. Abd Aziz, I. Ware, M. Fauzi Abd Jalil, N. Rashidah Ahmed, R. Sabtu

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Labisia pumila (LP) plant extract has the potential to be applied in cosmeceutical products due to its anti-photoaging properties. The main purpose of this study was to improve transdermal delivery of LP by encapsulating LP in niosomes. Niosomes loaded LPs were prepared by coacervation phase separation method using non-ionic surfactant (Span 60), labrasol, and cholesterol. The optimum formula obtained were Span 60, labrasol and cholesterol at the mole ratio of 6:1:4. At the optimum formulation, the niosome obtained significantly improved the quality of transdermal penetration of LP compared to free LP.

Keywords: Labisia pumila, niosomes, transdermal, quality

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1416 Post Operative Analgesia after Orthotopic Liver Transplantation; A Clinical Randomized Trial

Authors: Soudeh Tabashi, Mohammadreza Moshari, Parisa Sezari

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Introduction: Postoperative analgesia in Orthotopic Liver Transplantation (OLT) surgery is challenging for anesthesiologists. Although OLT is one of the most extensive abdominal operations, it seems that patients don’t suffer from severe post operative pain. On the other hands drug metabolism is unpredictable due to unknown graft function. The aim of this study was to compare intraoperative infusion of remifentanil versus fentanyl in postoperative opioid demand in patients with OLT and evaluating the complications in two groups. Method: In this double-blind clinical trial 34 patients who had OLT were included. They divided randomly in two groups of Remifentanil (R) and Fentanyl (F). Patients in group R and F received infusion of Remifentanil 0.3-1 µg/Kg/min and Fentanyl 0.3-1 µg/Kg/min during maintenance of anesthesia. Post operative pain were measured in 6, 12, 18, 24 hours and second and third days after surgery with Numeric Rate Scale (NRS). Patients had received intravenous acetaminophen as rescue therapy with NRS of 3 or more. In addition to demographic information, post operative opioid consumption were recorded as the primary outcome. Intraoperative blood transfusion, intraoperative inotropic drugs consumption, weaning time and intensive care unit stay were also evaluated. Results: Total dose of acetaminophen consumption in first 3 days after surgery did not have significant difference between two groups (Pvalue=0.716). intraoperative inotrope consumption, blood transfusion and post operative weaning time and ICU stay were also similar in both groups. Conclusion: This study demonstrates that intraoperative infusion of remifentanil in OLT have the same effect on post operative pain management as fentanyl. Despite the complications of operation were not increased by remifentanil.

Keywords: liver transplantation, postoperative pain, remifentanil, fentanyl

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1415 Exploring Problem-Based Learning and University-Industry Collaborations for Fostering Students’ Entrepreneurial Skills: A Qualitative Study in a German Urban Setting

Authors: Eylem Tas

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This empirical study aims to explore the development of students' entrepreneurial skills through problem-based learning within the context of university-industry collaborations (UICs) in curriculum co-design and co-delivery (CDD). The research question guiding this study is: "How do problem-based learning and university-industry collaborations influence the development of students' entrepreneurial skills in the context of curriculum co-design and co-delivery?” To address this question, the study was conducted in a big city in Germany and involved interviews with stakeholders from various industries, including the private sector, government agencies (govt), and non-governmental organizations (NGOs). These stakeholders had established collaborative partnerships with the targeted university for projects encompassing entrepreneurial development aspects in CDD. The study sought to gain insights into the intricacies and subtleties of UIC dynamics and their impact on fostering entrepreneurial skills. Qualitative content analysis, based on Mayring's guidelines, was employed to analyze the interview transcriptions. Through an iterative process of manual coding, 442 codes were generated, resulting in two main sections: "the role of problem-based learning and UIC in fostering entrepreneurship" and "challenges and requirements of problem-based learning within UIC for systematical entrepreneurship development.” The chosen experimental approach of semi-structured interviews was justified by its capacity to provide in-depth perspectives and rich data from stakeholders with firsthand experience in UICs in CDD. By enlisting participants with diverse backgrounds, industries, and company sizes, the study ensured a comprehensive and heterogeneous sample, enhancing the credibility of the findings. The first section of the analysis delved into problem-based learning and entrepreneurial self-confidence to gain a deeper understanding of UIC dynamics from an industry standpoint. It explored factors influencing problem-based learning, alignment of students' learning styles and preferences with the experiential learning approach, specific activities and strategies, and the role of mentorship from industry professionals in fostering entrepreneurial self-confidence. The second section focused on various interactions within UICs, including communication, knowledge exchange, and collaboration. It identified key elements, patterns, and dynamics of interaction, highlighting challenges and limitations. Additionally, the section emphasized success stories and notable outcomes related to UICs' positive impact on students' entrepreneurial journeys. Overall, this research contributes valuable insights into the dynamics of UICs and their role in fostering students' entrepreneurial skills. UICs face challenges in communication and establishing a common language. Transparency, adaptability, and regular communication are vital for successful collaboration. Realistic expectation management and clearly defined frameworks are crucial. Responsible data handling requires data assurance and confidentiality agreements, emphasizing the importance of trust-based relationships when dealing with data sharing and handling issues. The identified key factors and challenges provide a foundation for universities and industrial partners to develop more effective UIC strategies for enhancing students' entrepreneurial capabilities and preparing them for success in today's digital age labor market. The study underscores the significance of collaborative learning and transparent communication in UICs for entrepreneurial development in CDD.

Keywords: collaborative learning, curriculum co-design and co-delivery, entrepreneurial skills, problem-based learning, university-industry collaborations

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