Search results for: intracellular delivery

Authors: Reem Abou Refaie, Christoph Meinel

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The paper explores the impact of the COVID-19 crisis on the internal as well as external digitalized work practices of public service providers as part of a Public-Private Partnership Model. It focuses on the effect of uncertainty on generating Open Innovation practices. Our inquiry relies on semi-structured interviews (n=14) from a case study of Rwanda’s Public Service Delivery System in the context of research cooperation with IremboGov, the country’s One-Stop-Shop Platform for public services. It presents four propositions on harnessing opportunities for OI in the context of the public sector beyond the pandemic response. Practitioners can find characterizations of OI opportunities and gain insights on fostering OI in Public Sector Organizations.

Keywords: open innovation, digital transformation, public sector, Rwanda

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Authors: Jasbir Singh, Devender Kumar, Davender Redhu, Surender Kumar, Vandana Bhardwaj

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Single Nucleotide polymorphism (SNP) of proteosomal gene complex is involved in the pathogenesis of hepatitis B Virus (HBV) infection. Some of such proteosomal gene complex are large multifunctional proteins (LMP) and antigen associated transporters that help in antigen presentation. Both are involved in intracellular processing and presentation of viral antigens in association with Major Histocompatability Complex (MHC) Class I molecules. A total of hundred each of hepatitis B virus infected and control samples from northern India were studied. Genomic DNA was extracted from all studied samples and PCR-RFLP method was used for genotyping at different positions of LMP genes. Genotypes at a given position were inferred from the pattern of bands and genotype frequencies and haplotype frequencies were also calculated. Homozygous SNP {A>C} was observed at codon 145 of LMP7 gene and having a protective role against HBV as there was statistically significant high distribution of this SNP among controls than cases. Heterozygous SNP {A>C} was observed at codon 145 of LMP7 gene and made individuals more susceptible to HBV infection as there was statistically significant high distribution of this SNP among cases than control. SNP {T>C} was observed at codon 60 of LMP2 gene but statistically significant differences were not observed among controls and cases. For codon 145 of LMP7 and codon 60 of LMP2 genes, four haplotypes were constructed. Haplotype I (LMP2 ‘C’ and LMP7 ‘A’) made individuals carrying it more susceptible to HBV infection as there was statistically significant high distribution of this haplotype among cases than control. Haplotype II (LMP2 ‘C’ and LMP7 ‘C’) made individuals carrying it more immune to HBV infection as there was statistically significant high distribution of this haplotype among control than cases. Thus it can be concluded that homozygous SNP {A>C} at codon 145 of LMP7 and Haplotype II (LMP2 ‘C’ and LMP7 ‘C’) has a protective role against HBV infection whereas heterozygous SNP {A>C} at codon 145 of LMP7 and Haplotype I (LMP2 ‘C’ and LMP7 ‘A’) made individuals more susceptible to HBV infection.

Keywords: Hepatitis B Virus, single nucleotide polymorphism, low molecular weight proteins, transporters associated with antigen presentation

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Authors: Amina Aloui, Jalila Ben Salah-Abbès, Abdellah Zinedine, Amar Riba, Noel Durand, Catherine Brabet, Didier Montet, Samir Abbès

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Mycotoxin contamination of food and feed-isa globaconcern, both economically and for public health. Aflatoxin M1 (AFM1) is the principal hydroxylated metabolite of aflatoxin B1. It is frequently found in milk and other dairy products. It is responsible for the development of hepatocellular carcinoma and immunotoxic in humans and animals. The reduction of its bioavailabilitybecomesa great demand in order to protect human and animal health. The use of probiotic bacteria and clay are demonstrated to be able to bind AFM1 in vitro. This study aimed to investigate, in vivo, the activity of two-component mixture: L. rhamnosusGAF06 (LR) and bentonite for reducing the oxidative stress and the histological alterationsinduced by AFM1 in the liver andkidneys. For the experiment, male mice were divided into 7 groups (6 mice/group) and treated, orally, by AFM1, alone or in combination with LR and/or bentonite, for 10 days as follows: group 1 control, group 2 treated with LR alone (2.108 CFU/ml), group 3 treated with bentonite alone (1g/kg), group 4 treated with AFM1 alone (100μg/kg), group 5 co-treated with LR+AFM1, group 6 co-treated with bentonite+AFM1, group 7 co-treated with bentonite+LR+AFM1. At the end of the treatment, the mice were sacrificed, and the livers and kidneys were collected for histological assays. Intracellular antioxidant activities and lipid peroxidation were also studied. The results showed that AFM1causeddamage in liver and kidney tissues, being evidence of hepatotoxicity and nephrotoxicity marked by necrotic cells. It increased the MDA level and decreased the antioxidant enzyme activities (SOD) in both organs. In contrast, the co-treatment with AFM1 plus LR and/or bentonitesignificantly improved the hepatic and renal tissues, regulated kidney, and liver antioxidant enzyme activities. This improvement was more remarkable with the administration of LR-bentonite mixture with AFM1.LR and bentonite alone showed to be safe during the treatment. This mixture can be a promising candidate for future applications in biotechnological processes that aimed to detoxify AFM1in food and feed.

Keywords: aflatoxin M1, bentonite, L. rhamnosus GAF06, oxidative stress, prevention

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Authors: Evgeny E. Tereshatov

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Astatine-211 is considered one of the most promising radionuclides for Targeted Alpha Therapy. In order to develop reliable procedures to label biomolecules and utilize efficient delivery vehicle principles, one should understand the main chemical characteristics of astatine. The short half-life of 211At (~7.2 h) and absence of any stable isotopes of this element are limiting factors towards studying the behavior of astatine. Our team has developed a procedure for rapid and efficient isolation of astatine from irradiated bismuth material in nitric acid media based on 3-octanone and 1-octanol extraction chromatography resins. This process has been automated and it takes 20 min from the beginning of the target dissolution to the At-211 fraction elution. Our next step is to consider commercially available chromatography resins and their applicability in astatine purification in the same media. Results obtained along with the corresponding sorption mechanisms will be discussed.

Keywords: astatine-211, chromatography, automation, mechanism, radiopharmaceuticals

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Authors: Afif Saleh Abugharsa

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The IEEE 802.15.4 standard is designed for low-rate wireless personal area networks (LR-WPAN) with focus on enabling wireless sensor networks. It aims to give a low data rate, low power consumption, and low cost wireless networking on the device-level communication. The objective of this study is to investigate the performance of IEEE 802.15.4 based networks using simulation tool. In this project the network simulator 2 NS2 was used to several performance measures of wireless sensor networks. Three scenarios were considered, multi hop network with a single coordinator, star topology, and an ad hoc on demand distance vector AODV. Results such as packet delivery ratio, hop delay, and number of collisions are obtained from these scenarios.

Keywords: ZigBee, wireless sensor networks, IEEE 802.15.4, low power, low data rate

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Authors: Pelin Balcik Ercin

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Introduction: ZEB transcription factor family member ZEB2, has a role in epithelial to mesenchymal transition during development and metastasis. The altered circulating extracellular miRNAs expression is observed in diseases, and extracellular miRNAs have an important role in cancer cell microenvironment. In ChIP-Seq study, the expression of miR-2110 was found to be regulated by ZEB2. In this study, the effects of miR2110 on cell proliferation and migration of hepatocellular carcinoma (HCC) cells were examined. Material and Methods: SNU398 cells transfected with mimic miR2110 (20nM) (HMI0375, Sigma-Aldrich) and negative control miR (HMC0002, Sigma-Aldrich). MicroRNA isolation was accomplished with miRVANA isolation kit according to manufacturer instructions. cDNA synthesis was performed expression, respectively, and calibrated with Ct of controls. The real-time quantitative PCR (RT-qPCR) reaction was performed using the TaqMan Fast Advanced Master Mix (Thermo Sci.). Ct values of miR2110 were normalized to miR-186-5p and miR16-5p for the intracellular gene. Cell proliferation analysis was analyzed with the xCELLigence RTCA System. Wound healing assay was analyzed with the ImageJ program and relative fold change calculated. Results: The mimic-miR-2110 transfected SNU398 cells nearly nine-fold (log2) more miR-2110 expressed compared to negative control transfected cells. The mimic-miR-2110 transfected HCC cell proliferation significantly inhibited compared to the negative control cells. Furthermore, miR-2110-SNU398 cell migration capacity was relatively four-fold decreased compared to negative control-miR-SNU398 cells. Conclusion: Our results suggest the miR-2110 inhibited cell proliferation and also miR-2110 negatively affect cell migration compared to control groups in HCC cells. These data suggest the complexity of microRNA EMT transcription factors regulation. These initial results are pointed out the predictive biomarker capacity of miR-2110 in HCC.

Keywords: epithelial to mesenchymal transition, EMT, hepatocellular carcinoma cells, micro-RNA-2110, ZEB2

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Authors: S. M. Hashemy Shahdany

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Equitable water delivery becomes one of the main concerns for water authorities in arid regions. Due to water scarcity, providing reliable amount of water is not possible for most of the irrigation districts in arid regions. In this paper, water level difference control is applied to keep the water level errors equal in adjacent reaches. Distant downstream decentralized configurations of the control method are designed and tested under a realistic scenario shows canal operation under water shortage. The simulation results show that the difference controllers share the water level error among all of the users in a fair way. Therefore, water deficit has a similar influence on downstream as well as upstream and water offtakes.

Keywords: equitable water distribution, precise agriculture, sustainable agriculture, water shortage

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Authors: Shadan Dwairi

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Defining proper requirements is one of the key factors for a successful construction projects. Although there have been many attempts put forward in assist in identifying requirements, but still this area is under developed. In Buildings Information Modelling (BIM) projects. The Employer Information Requirements (EIR) is the fundamental requirements document and a necessary ingredient in achieving a successful BIM project. The provision on full and clear EIR is essential to achieving BIM Level-2. As Defined by PAS 1192-2, EIR is a “pre-tender document that sets out the information to be delivered and the standards and processes to be adopted by the supplier as part of the project delivery process”. It also notes that “EIR should be incorporated into tender documentation to enable suppliers to produce an initial BIM Execution Plan (BEP)”. The importance of effective definition of EIR lies in its contribution to a better productivity during the construction process in terms of cost and time, in addition to improving the quality of the built asset. Proper and clear information is a key aspect of the EIR, in terms of the information it contains and more importantly the information the client receives at the end of the project that will enable the effective management and operation of the asset, where typically about 60%-80% of the cost is spent. This paper reports on the research done in developing the Ontology-based tool for Employer Information Requirements (OntEIR). OntEIR has proven the ability to produce a full and complete set of EIRs, which ensures that the clients’ information needs for the final model delivered by BIM is clearly defined from the beginning of the process. It also reports on the work being done into transforming OntEIR into a smart tool for Defining Employer Information Requirements (smartEIR). smartEIR transforms the OntEIR tool into enabling it to develop custom EIR- tailored for the: Project Type, Project Requirements, and the Client Capabilities. The initial idea behind smartEIR is moving away from the notion “One EIR fits All”. smartEIR utilizes the links made in OntEIR and creating a 3D matrix that transforms it into a smart tool. The OntEIR tool is based on the OntEIR framework that utilizes both Ontology and the Decomposition of Goals to elicit and extract the complete set of requirements needed for a full and comprehensive EIR. A new ctaegorisation system for requirements is also introduced in the framework and tool, which facilitates the understanding and enhances the clarification of the requirements especially for novice clients. Findings of the evaluation of the tool that was done with experts in the industry, showed that the OntEIR tool contributes towards effective and efficient development of EIRs that provide a better understanding of the information requirements as requested by BIM, and support the production of a complete BIM Execution Plan (BEP) and a Master Information Delivery Plan (MIDP).

Keywords: building information modelling, employer information requirements, ontology, web-based, tool

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Authors: Temitope O. Tokosi, Visvanathan Naicker

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Patient health records contain sensitive information for which an electronic patient record (EPR) system can safely secure and transmit amongst clinicians for use in improving health delivery. Clinician’s use of the behaviour of these systems is under scrutiny to assess their attributes towards health technology. South Africa (SA) clinicians responded to a pilot study survey to assess their understanding of EPR, what attributes are important towards technology use and more importantly streamlining the survey for a larger study. Descriptive statistics using mean scores was used because of the small sample size of 11 clinicians who completed the survey. Nine (9) constructs comprising 62 items were used and a Cronbach alpha score of 0.883 was obtained. Limitations and discussions conclude the study.

Keywords: EPR, clinicians, pilot study, South Africa

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Authors: Ma. Cecilia D. Licuan

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The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

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Authors: Nitin Jadhav, Pradeep R. Vavia

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Poor water soluble drugs are difficult to promote for oral drug delivery as they demonstrate poor and variable bioavailability because of its poor solubility and dissolution in GIT fluid. Nowadays lipid based formulations especially self microemulsifying drug delivery system (SMEDDS) is found as the most effective technique. With all the impressive advantages, the need of high amount of surfactant (50% - 80%) is the major drawback of SMEDDS. High concentration of synthetic surfactant is known for irritation in GIT and also interference with the function of intestinal transporters causes changes in drug absorption. Surfactant may also reduce drug activity and subsequently bioavailability due to the enhanced entrapment of drug in micelles. In chronic treatment these issues are very conspicuous due to the long exposure. In addition the liquid self microemulsifying system also suffers from stability issues. Recently one novel approach of solid stabilized micro and nano emulsion (Pickering emulsion) has very admirable properties such as high stability, absence or very less concentration of surfactant and easily converts into the dry form. So here we are exploring pickering dry emulsion system for dissolution enhancement of anti-lipemic, extremely poorly water soluble drug (Fenofibrate). Oil moiety for emulsion preparation was selected mainly on the basis of higher solubility of drug. Captex 300 was showed higher solubility for fenofibrate, hence selected as oil for emulsion. With Silica (solid stabilizer); Span 20 was selected to improve the wetting property of it. Emulsion formed by Silica and Span20 as stabilizer at the ratio 2.5:1 (silica: span 20) was found very stable at the particle size 410 nm. The prepared emulsion was further preceded for spray drying and formed microcapsule evaluated for in-vitro dissolution study, in-vivo pharmacodynamic study and characterized for DSC, XRD, FTIR, SEM, optical microscopy etc. The in vitro study exhibits significant dissolution enhancement of formulation (85 % in 45 minutes) as compared to plain drug (14 % in 45 minutes). In-vivo study (Triton based hyperlipidaemia model) exhibits significant reduction in triglyceride and cholesterol with formulation as compared to plain drug indicating increasing in fenofibrate bioavailability. DSC and XRD study exhibit loss of crystallinity of drug in microcapsule form. FTIR study exhibit chemical stability of fenofibrate. SEM and optical microscopy study exhibit spherical structure of globule coated with solid particles.

Keywords: captex 300, fenofibrate, pickering dry emulsion, silica, span20, stability, surfactant

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Authors: Sanchayan Banerjee, Peter John

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Nudge plus is a modification of the toolkit of behavioural public policy. It incorporates an element of reflection¾the plus¾into the delivery of a nudge, either blended in or made proximate. Nudge plus builds on recent work combining heuristics and deliberation. It may be used to design pro-social interventions that help preserve the autonomy of the agent. The argument turns on seminal work on dual systems, which presents a subtler relationship between fast and slow thinking than commonly assumed in the classic literature in behavioural public policy. We review classic and recent work on dual processes to show that a hybrid is more plausible than the default interventionist or parallel competitive framework. We define nudge plus, set out what reflection could entail, provide examples, outline causal mechanisms, and draw testable implications.

Keywords: nudge, nudge plus, think, dual process theory

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Authors: Glenda B. Minguito, Jenith L. Banluta

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One of the critical aspects of humanitarian operations is the distribution of relief goods to the affected community. The common assumption is that relief goods are prepositioned during disasters which are not applicable in developing countries like the Philippines. During disasters, the on-the-ground government agencies and responders have to procure, sort, weigh and pack the relief goods. There is a need to review the relief goods preparation as it seriously affects the delivery of necessary aid for human survival. This study also identifies the ideal location of the assembly hub to minimize the distance to the affected community. This paper reveals that location and resources are dependent on the type of disasters encountered at the local level. The Center-of-Gravity method and Multiple Activity Chart were applied in the analysis.

Keywords: humanitarian supply chain, location decision, resource allocation, local level

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Authors: Bijan Gillani, Roya Gillani

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The purpose of this paper is to propose a pedagogical model where engineering provides the interconnection to integrate the other topics of science, technology, engineering, and mathematics. The author(s) will first present a brief discussion of cognitive theory and then derive an integrated pedagogy to use engineering and technology, such as drones, sensors, camera, iPhone, radio waves as the nexus to an integrated curriculum development for the other topics of STEM. Based on this pedagogy, one example developed by the author(s) called “Drones and Environmental Science,” will be presented that uses a drone and related technology as an appropriate instructional delivery medium to apply Piaget’s cognitive theory to create environments that promote the integration of different STEM subjects that relate to environmental science.

Keywords: cogntive theories, drone, environmental science, pedagogy

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Authors: Lubowa Samuel

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Health information systems, often known as HIS, are critical components of the healthcare system to improve health policies and promote global health development. In a broader sense, HIS as a system integrates data collecting, processing, reporting, and making use of various types of data to improve healthcare efficacy and efficiency through better management at all levels of healthcare delivery. The aim of this study is to assess the adoption of health information systems (HIS) in a resource-constrained country drawing from the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model. The results indicate that the user's perception of the technology and the poor information technology infrastructures contribute a lot to the low adoption of HIS in resource-constrained countries.

Keywords: health information systems, resource-constrained countries, health information systems

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Authors: George Oliveira, Luana D. Fronza, Luiza Medeiros, Patricia D. M. Plentz

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The research presented in this article is part of a wide project that proposes a scheduling system for multi-robots in intelligent warehouses employing multi-robot path-planning (MPP) and multi-robot task allocation (MRTA) to reconcile multiple restrictions (task delivery time, task priorities, charging capacity, and robots battery capacity). We present the software component capable of interconnecting an open streaming processing architecture and robot operating system (ROS), ensuring communication and message exchange between robots and the environment in which they are inserted. Simulation results show the good performance of our proposed technique for connecting ROS and streaming platforms.

Keywords: complex distributed systems, mobile robots, smart warehouses, streaming platforms

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Authors: Shiksha Thakur, Rashmi Jain

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Maternal health is the most crucial element in the primary health care delivery system of any healthy society. We aware that the maternal health situation in India has been a cause of concern for us, in spite of the rapidly progressing socio-economic environment overall. India has realized impressive gains in Mother & Child survival over the last two decades. MMR as per 2012-2013 in India is 167 as per MMR bulletin, though there are variations between states in the Country. In 2013, an estimated 2,89,000 women worldwide died from complications arising from pregnancy & childbirth. In view of the above facts, a study was conducted in Indore to analyse the maternal health status among urban slums and non-slums women.

Keywords: antenatal care, postnatal care, JSY, maternal health, child health, reproductive health

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Authors: Mark Jackson

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Description: This paper is based on an theoretical analysis of the efficacy of the dominant model of policing in western jurisdictions. Those results are then compared with a similar analysis of a traditional reactive model. It is found that neither model provides for optimal delivery of services. Instead optimal service can be achieved by a synchronous hybrid model, termed the Convectory Policing approach. Methodology and Findings: For over three decades problem oriented policing (PO) has been the dominant model for western police agencies. Initially based on the work of Goldstein during the 1970s the problem oriented framework has spawned endless variants and approaches, most of which embrace a problem solving rather than a reactive approach to policing. This has included the Area Policing Concept (APC) applied in many smaller jurisdictions in the USA, the Scaled Response Policing Model (SRPM) currently under trial in Western Australia and the Proactive Pre-Response Approach (PPRA) which has also seen some success. All of these, in some way or another, are largely based on a model that eschews a traditional reactive model of policing. Convectory Policing (CP) is an alternative model which challenges the underpinning assumptions which have seen proliferation of the PO approach in the last three decades and commences by questioning the economics on which PO is based. It is argued that in essence, the PO relies on an unstated, and often unrecognised assumption that resources will be available to meet demand for policing services, while at the same time maintaining the capacity to deploy staff to develop solutions to the problems which were ultimately manifested in those same calls for service. The CP model relies on the observations from a numerous western jurisdictions to challenge the validity of that underpinning assumption, particularly in fiscally tight environment. In deploying staff to pursue and develop solutions to underpinning problems, there is clearly an opportunity cost. Those same staff cannot be allocated to alternative duties while engaged in a problem solution role. At the same time, resources in use responding to calls for service are unavailable, while committed to that role, to pursue solutions to the problems giving rise to those same calls for service. The two approaches, reactive and PO are therefore dichotomous. One cannot be optimised while the other is being pursued. Convectory Policing is a pragmatic response to the schism between the competing traditional and contemporary models. If it is not possible to serve either model with any real rigour, it becomes necessary to taper an approach to deliver specific outcomes against which success or otherwise might be measured. CP proposes that a structured roster-driven approach to calls for service, combined with the application of what is termed a resource-effect response capacity has the potential to resolve the inherent conflict between traditional and models of policing and the expectations of the community in terms of community policing based problem solving models.

Keywords: policing, reactive, proactive, models, efficacy

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Authors: Sperisa Distantina, Fadilah, Mujtahid Kaavessina

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Crosslinked konjac glucomannan and kappa carrageenan film were prepared by chemical crosslinking using glutaraldehyde (GA) as the crosslinking agent. The effect crosslinking on the swelling degree was investigated. Konjac glucomanan and its mixture with kappa carragenan film was immersed in GA solution and then thermally cured. The obtained crosslinked film was washed and soaked in the ethanol to remove the unreacted GA. The obtained film was air dried at room temperature to a constant weight. The infrared spectra and the value of swelling degree of obtained crosslinked film showed that glucomannan and kappa carrageenan was able to be crosslinked using glutaraldehyde by film immersion and curing method without catalyst. The crosslinked films were found to be pH sensitive, indicating a potential to be used in drug delivery polymer system.

Keywords: crosslinking, glucomannan, carrageenan, swelling

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: ethics, medical student, doubt, medical education, faith

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Authors: Juliette MacDonald, Jun Li, Wenji Xiang, Mingwei Zhao

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Shanghai International College of Fashion and Innovation (SCF) was created as a result of a collaborative partnership agreement between the University of Edinburgh and Donghua University. The College provides two programmes: Fashion Innovation and Fashion Interior Design and the overarching curriculum has the intention of developing innovation and creativity within an international learning, teaching, knowledge exchange and research context. The research problem presented here focuses on the multi-national/cultural faculty in the team, the challenges arising from difficulties in communication and the associated limitations of management frameworks. The teaching faculty at SCF are drawn from China, Finland, Korea, Singapore and the UK with input from Flying Faculty from Fashion and Interior Design, Edinburgh College of Art (ECA), for 5 weeks each semester. Rather than fully replicating the administrative and pedagogical style of one or other of the institutions within this joint partnership the aim from the outset was to create a third way which acknowledges the quality assurance requirements of both Donghua and Edinburgh, the academic and technical needs of the students and provides relevant development and support for all the SCF-based staff and Flying Academics. It has been well acknowledged by those who are involved in teaching across cultures that there is often a culture shock associated with transnational education but that the experience of being involved in the delivery of a curriculum at a Joint Institution can also be very rewarding for staff and students. It became clear at SCF that if a third way might be achieved which encourages innovative approaches to fashion education whilst balancing the expectations of Chinese and western concepts of education and the aims of two institutions, then it was going to be necessary to construct a framework which developed close working relationships for the entire teaching team, so not only between academics and students but also between technicians and administrators at ECA and SCF. The attempts at co-construction and integration are built on the sharing of cultural and educational experiences and knowledge as well as provision of opportunities for reflection on the pedagogical purpose of the curriculum and its delivery. Methods on evaluating the effectiveness of these aims include a series of surveys and interviews and analysis of data drawn from teaching projects delivered to the students along with graduate successes from the last five years, since SCF first opened its doors. This paper will provide examples of best practice developed by SCF which have helped guide the faculty and embed common core values and aims of co-construction regulations and management, whilst building a pro-active TNE (Trans-National Education) team which enhances the learning experience for staff and students alike.

Keywords: cultural co-construction, educational team management, multi-cultural challenges, TNE integration for teaching teams

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Authors: Les Moncrieff

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In a world awash with potent opioids flaming an international crisis, the need to explore safe alternatives has never been more urgent. Bio-electrode Therapy is a novel adjunctive treatment method for relieving acute opioid withdrawal symptoms and many types of complex acute and chronic pain (often the underlying cause of opioid dependence). By combining the science of developmental bioelectricity with Traditional Chinese Medicine’s theory of meridians, rapid relief from pain is routinely being achieved in the clinical setting. Human body functions are dependent on electrical factors, and acupuncture points on the body are known to have higher electrical conductivity than surrounding skin tissue. When tiny gold- and silver-plated electrodes are secured to the skin at specific acupuncture points using established Chinese Medicine principles and protocols, an enhanced microcurrent and electrical field are created between the electrodes, influencing the entire meridian and connecting meridians. No external power source or electrical devices are required. Endogenous DC electric fields are an essential fundamental component for development, regeneration, and wound healing. Disruptions in the normal ion-charge in the meridians and circulation of blood will manifest as pain and development of disease. With the application of these simple electrodes (gold acting as cathode and silver as anode) according to protocols, the resulting microcurrent is directed along the selected meridians to target injured or diseased organs and tissues. When injured or diseased cells have been stimulated by the microcurrent and electrical fields, the permeability of the cell membrane is affected, resulting in an immediate relief of pain, a rapid balancing of positive and negative ions (sodium, potassium, etc.) in the cells, the restoration of intracellular fluid levels, replenishment of electrolyte levels, pH balance, removal of toxins, and a re-establishment of homeostasis.

Keywords: bioelectricity, electrodes, electrical fields, acupuncture meridians, complex pain, opioid withdrawal management

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Authors: G. Usha, S. Kannimuthu, K. Mahalakshmi

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Mobile Adhoc Network (MANET) is one of the most promising technologies that have applications ranging from various portable devices to military networks. MANET has no fixed infrastructure and the security of such network is a big concern. Therefore, in order to operate MANET’s securely, the misbehavior and intrusions should be detected before the attackers affect the network communication. In this article, we make a comprehensive survey against black hole attack that is a serious threat against MANET that exploits the routing behavior of the MANET. We have given broad survey solutions that detect black hole attacks in MANET. This is achieved by analyzing the techniques involved in detecting the attacks in each scheme. Furthermore, we examine about the challenges to the researchers for constructing an in-depth solution against black hole attack.

Keywords: AODV, cross layer security, mobile Adhoc network (MANET), packet delivery ratio, single layer security

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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Authors: K.-H. Yang

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In the past, there was a lot of excellent research studies conducted on topics related to supplier selection. Because the considered factors of supplier selection are complicated and difficult to be quantified, most researchers deal supplier selection issues by qualitative approaches. Compared to qualitative approaches, quantitative approaches are less applicable in the real world. This study tried to apply the quantitative approach to study a supplier selection problem with considering operation cost and delivery reliability. By those factors, this study applies Normalized Normal Constraint Method to solve the dual objectives mixed integer program of the supplier selection problem.

Keywords: bi-objectives MIP, normalized normal constraint method, supplier selection, quantitative approach

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Authors: Thorben Kuprat, Julian Becker, Jonas Mayer, Peter Nyhuis

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For years now, it has been recognized that logistic performance capability contributes enormously to a production enterprise’s competitiveness and as such is a critical control lever. In doing so, the orientation on customer wishes (e.g. delivery dates) represents a key parameter not only in the value-adding production but also in product regeneration. Since production and regeneration processes have different characteristics, production planning and control measures cannot be directly transferred to regeneration processes. As part of a special research project, the Institute of Production Systems and Logistics Hannover is focused on increasing the logistic performance capability of regeneration processes for complex capital goods. The aim is to ensure logistic targets are met by implementing a model specifically designed to align the capacities and load in regeneration processes.

Keywords: capacity planning, complex capital goods, logistic performance, regeneration process

Procedia PDF Downloads 485

Authors: Tassana Boontong, Vilaivan Thongcharoen, Orapan Thosingha, Suphamon Chansakul, Anorut Jenwitheesuk, Chanin Chakkrapopyodhin, Isara Phiwchai, Mattika Chaichan, Rungnapha Khiewchaum

Abstract:

According to Thailand health policy, subdistrict health promoting hospitals (SHPHs) serve as forefront facilities for inclusive health care service. Those services include health promotion, disease prevention, primary medical care and rehabilitation. However, SHPHs residing in some distant area, such as SHPHs residing on the islands, would deliver different services relevant to health needs of the local people and the tourists. This research aimed to study health care delivery services at SHPHs on the islands in Thailand. Data were collected using questionnaires. The result revealed that in Thailand, there are 58 SHPHs on the islands. During data collection process, the researchers were not allowed to collect data in 5 SHPHs in the southern part due to Covid-19 pandemic. The report is based on 53 SHPHs on the islands. Numbers of health care personnel were 201, 72.14 % were female, with the ages ranged from 22 to 60 years (mean = 35.56 years). About 53% were community health personnel, while 26.08% were professional nurses. In regard to work experiences, the range of year varied from less than 1 year to 30 years, with the mean of 8.36 years. The majority of their responsibilities focused on providing primary medical care (86.34%), caring of people with chronic illnesses (85.30%) and providing medical care procedures for patients with chronic illnesses at home (84.36%). Nurses were main health care personnel in performing primary medical care. Due to difficulty transportation from the islands to the mainland, nurses had to provide prompt emergency medical care while the patients arrived with emergency and critical illnesses such as severe head trauma, stroke or coronary artery disease. Although some medical procedures were complex and not covered by nursing and midwifery license, they decided to protect patients from life- threatening conditions and make them stable before transportation. In SHPHs, the workload exceeded manpower, health care personnel had to work overtime almost every day. In the famous tourist islands, health care personnel had to carry 3-4 folds of their workload during the holidays because of the large crowds of foreign and Thai tourists. It is recommended that SHPHs on the islands should scale up the level of services to cover advanced medical care. Health care personnel, in particular, professional nurses, should be equipped with emergency and critical care skills. The expected outcomes of the services should emphasize on rescuing patients with emergency and life-threatening illnesses and providing comprehensive care for people living on or visiting the islands.

Keywords: distant area, islands, sub district health promoting hospital, heath care services, Thailand

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Authors: Mihika Shivkumar, Krishna Kumar, C. Perisamy

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3D printing is a method of manufacturing wherein materials, such as plastic or metal, are deposited in layers one on top of the other to produce a three dimensional object. 3D printing is most commonly associated with creating engineering prototypes. However, its applications in the field of human health care have been frequently disregarded. Medical applications for 3D printing are expanding rapidly and are envisaged to revolutionize health care. Medical applications for 3D printing, both present and its potential, can be categorized broadly, including: creation of customized prosthetics tissue and organ fabrication; creation of implants, and anatomical models and pharmaceutical research regarding drug dosage forms. This piece breaks down bioprinting in the healthcare sector. It focuses on the better subtle elements of every particular point, including how 3D printing functions in the present, its impediments, and future applications in the health care sector.

Keywords: bio-printing, prototype, drug delivery, organ regeneration

Procedia PDF Downloads 268

Authors: Ziyad S. Haidar

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Background: Saliva plays a major role in maintaining oral and dental health (consequently, general health and well-being). Where it normally bathes the oral cavity and acts as a clearing agent. This becomes more apparent when the amount and quality of salivare significantly reduced due to medications, salivary gland neoplasms, disorders such as Sjögren’s syndrome, and especially ionizing radiation therapy for tumors of the head and neck, the fifth most common malignancy worldwide, during which the salivary glands are included within the radiation field or zone. Clinically, patients affected by salivary gland dysfunction often opt to terminate their radiotherapy course prematurely because they become malnourished and experience a significant decrease in their quality of life. Accordingly, the development of an alternative treatment to restore or regenerate damaged salivary gland tissue is eagerly awaited. Likewise, the formulation of a radioprotection modality and early damage prevention strategy is also highly desirable. Objectives: To assess the pre-clinical radio-protective effect as well as the reparative/regenerative potential of layer-by-layer self-assembled lipid-polymer-based core-shell nanocapsules designed and fine-tuned in this experimental work for the sequential (ordered) release of dual cytokines, following a single local administration (direct injection) into a murine sub-mandibular salivary gland model of irradiation. Methods: The formulated core-shell nanocapsules were characterized by physical-chemical-mechanically pre-/post-loading with the drugs (in solution and powder formats), followed by optimizing the pharmaco-kinetic profile. Then, nanosuspensions were administered directly into the salivary glands, 24hrs pre-irradiation (PBS, un-loaded nanocapsules, and individual and combined vehicle-free cytokines were injected into the control glands for an in-depth comparative analysis). External irradiation at an elevated dose of 18Gy (revised from our previous 15Gy model) was exposed to the head-and-neck region of C57BL/6 mice. Salivary flow rate (un-stimulated) and salivary protein content/excretion were regularly assessed using an enzyme-linked immunosorbent assay (3-month period). Histological and histomorphometric evaluation and apoptosis/proliferation analysis followed by local versus systemic bio-distribution and immuno-histochemical assays were then performed on all harvested major organs (at the distinct experimental end-points). Results: Monodisperse, stable, and cytocompatible nanocapsules capable of maintaining the bioactivity of the encapsulant within the different compartments with the core and shell and with controlled/customizable pharmaco-kinetics, resulted, as is illustrated in the graphical abstract (Figure) below. The experimental animals demonstrated a significant increase in salivary flow rates when compared to the controls. Herein, salivary protein content was comparable to the pre-irradiation (baseline) level. Histomorphometry further confirmed the biocompatibility and localization of the nanocapsules, in vivo, into the site of injection. Acinar cells showed fewer vacuoles and nuclear aberration in the experimental group, while the amount of mucin was higher in controls. Overall, fewer apoptotic activities were detected by a Terminal deoxynucleotidyl Transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay and proliferative rates were similar to the controls, suggesting an interesting reparative and regenerative potential of irradiation-damaged/-dysfunctional salivary glands. The Figure below exemplifies some of these findings. Conclusions: Biocompatible, reproducible, and customizable self-assembling layer-by-layer core-shell delivery system is formulated and presented. Our findings suggest that localized sequential bioactive delivery of dual cytokines (in specific dose and order) can prevent irradiation-induced damage via reducing apoptosis and also has the potential to promote in situ proliferation of salivary gland cells; maxSALIVA is scalable (Good Manufacturing Practice or GMP production for human clinical trials) and patent-pending.

Keywords: saliva, head and neck cancer, nanotechnology, controlled drug delivery, xerostomia, mucositis, biopolymers, innovation

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Authors: Chinelo Igwenagu

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Teenage childbearing in developing countries has been a thing of great concern as it has often led to a number of socioeconomic problems both to the society and to the families affected. The outcome of teenage pregnancy has been generally associated with higher rates of maternal morbidity and mortality, greater risks for delivery complications, low-birth weight infants and child mortality. As a result of teenagers’ physiological and social immaturity and their lack of adequate prenatal care, health risks associated with their pregnancies and childbearing are more pronounced than those of older women. Therefore this study has examined the relationship between the age of teenagers and the outcome of teenage pregnancy. Based on this study, the result of the analysis shows that both teenagers and older mothers suffer similarly during child bearing. Hence improve medical care is paramount in all the situations.

Keywords: childbearing, mortality, Nigeria, pregnancy, prematurity, teenagers

Procedia PDF Downloads 416