Search results for: philosophy of medicine

Authors: Zhuang Yiwen

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The paper examines the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. One of the major challenges identified is the lack of a standard coding system for medical devices, which makes it difficult to track them effectively. The paper suggests the use of the Unique Device Identifier (UDI) as a single standard for medical devices to improve tracking and reduce errors. The paper also explores the use of barcoding and image recognition to identify and document medical devices in nursing practices. In nursing practices, the use of barcodes for identifying medical devices is common. However, the information contained in these barcodes is often inconsistent, making it challenging to identify which segment contains the model identifier. Moreover, the use of barcodes may be improved with the use of UDI, but many subsidized accessories may still lack barcodes. The paper suggests that the readiness for UDI and barcode standardization requires standardized information, fields, and logic in electronic medical record (EMR), operating theatre (OT), and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. Nursing workflow and data flow also need to be taken into account. The paper also explores the use of image recognition, specifically the Tesseract OCR engine, to identify and document implants in public hospitals due to limitations in barcode scanning. The study found that the solution requires an implant information database and checking output against the database. The solution also requires customization of the algorithm, cropping out objects affecting text recognition, and applying adjustments. The solution requires additional resources and costs for a mobile/hardware device, which may pose space constraints and require maintenance of sterile criteria. The integration with EMR is also necessary, and the solution require changes in the user's workflow. The paper suggests that the long-term use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) as a supporting terminology to improve clinical documentation and data exchange in healthcare. SNOMED CT provides a standardized way of documenting and sharing clinical information with respect to procedure, patient and device documentation, which can facilitate interoperability and data exchange. In conclusion, the paper highlights the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. The paper suggests the use of UDI and barcode standardization to improve tracking and reduce errors. It also explores the use of image recognition to identify and document medical devices in nursing practices. The paper emphasizes the importance of standardized information, fields, and logic in EMR, OT, and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. These recommendations could help the Singapore healthcare system to improve tracking and traceability of medical devices and ultimately enhance patient safety.

Keywords: medical device tracking, unique device identifier, barcoding and image recognition, systematized nomenclature of medicine clinical terms

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Authors: W. Promprom, W. Chatan

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Leguminosae is a large plant family and its members are important for local people utilization in the Northeast of Thailand. This research aimed to survey medicinal plants in this family in Kantharalak Community forest. The plant collection and exploration were made from October 2017 to September 2018. Folk medicinal uses were studied by interviewing villagers and folk medicine healers living around the community forest by asking about local names, using parts, preparation and properties. The results showed that 65 species belonging to 40 genera were found. Among these, 30 species were medicinal plant. The most used plant parts were leaf. Decoction and drinking were mostly preparation method and administration mode used. All medicinal plants could be categorized into 17 diseases/symptoms. Most plant (56.66%) were used for fever. The voucher specimens were deposited in Department of Biology, Faculty of Science, Mahasarakham University, Thailand. Therefore, the data from this study might be widely used by the local area and further scientific study.

Keywords: ethnobotany, ethnophamacology, medicinal plant, taxonomy, utilization

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Authors: Emrah Caylak

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The aim of this study is to investigate the effect of iron therapy on oxidative stress, ghrelin, and nesfatin-1 levels in patients with iron deficiency anemia (IDA). Thirty patients who applied to Internal Medicine Clinic and were diagnosed with IDA and also 30 healthy individuals as a control were included in the study. The samples were collected from IDA patients before and after treatment. Differences in serum MDA, TAC, and plasma ghrelin, nesfatin-1 were analyzed among the three groups. Serum MDA and TAC levels were found higher and lower in IDA patients before the treatment group compared to the controls (p < 0.05). After the iron therapy, plasma acylated ghrelin and nesfatin-1 levels in IDA patients were found higher in IDA patients before the treatment group and controls (p < 0.05). Plasma ghrelin and nesfatin-1 levels increase with iron treatment in IDA patients. The iron therapy induces the synthesis of ghrelin and nesfatin-1 in human body, thus causes increased appetite and food intake.

Keywords: anemia, oxidative stress, ghrelin, nesfatin-1

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Authors: Yunus Doğan, Ahmet Durap

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Coastal regions are the one of the most commonly used places by the natural balance and the growing population. In coastal engineering, the most valuable data is wave behaviors. The amount of this data becomes very big because of observations that take place for periods of hours, days and months. In this study, some statistical methods such as the wave spectrum analysis methods and the standard statistical methods have been used. The goal of this study is the discovery profiles of the different coast areas by using these statistical methods, and thus, obtaining an instance based data set from the big data to analysis by using data mining algorithms. In the experimental studies, the six sample data sets about the wave behaviors obtained by 20 minutes of observations from Mersin Bay in Turkey and converted to an instance based form, while different clustering techniques in data mining algorithms were used to discover similar coastal places. Moreover, this study discusses that this summarization approach can be used in other branches collecting big data such as medicine.

Keywords: clustering algorithms, coastal engineering, data mining, data summarization, statistical methods

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Authors: S. Boulenouar, A. Boukli Hacene, S. Brahmi

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Quality is an old concept but which recently became omnipresent in the society. It is a pledge of the well done job and therefore the satisfaction of the customer. Now, dispensing pharmacies seem to be held away from this approach. Officinal staff is called to dispense drugs. However this essential function is rarely studied and taken into account. To contribute to the good use of medicines and to reduce the dangers, it is important to consider the dispensation of drugs practised in the pharmacies. It is a both descriptive and retrospective study .The descriptive part is to conduct a survey near to the dispensary pharmacists. The retrospective section concentrates on the analysis of medicine prescriptions dispensed to patients. Following the survey that we carried out near the pharmacists of dispensary of the town of Oran, it appears that in majority, they are not inclined, by themselves, to take up the challenge of quality at the dispensary. The approach requires time and a motivation that pharmacists do not have for the moment. Efforts are still needed on the part of pharmacists, but also of authorities and organizations in charge of quality in the dispensary. At the end of this work, it seems to us that the implementation of a quality approach is part of our reflection on the added value of the pharmacist of dispensary in the drug chain.

Keywords: customer satisfaction, dispensary, dispensing of the drug, quality approach

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Authors: Felix Olajide Ibikunle

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Introductory Statement: Sustainable participation of teenagers in sports requires deliberate and concerted plans and managerial policy rooted in the “philosophy of catch them young.” At risk, teenagers need proper integration into societal aspiration: This direction will go a long way to streamline them into security breaches and attractive nuisance free lifestyles. Basic Methodology: The population consists of children between 13-19 years old. A proportionate sampling size technique of 60% was adopted to select seven zones out of 11 geo-political zones in the Ibadan metropolis. Qualitative information and interview were used to collect needed information. The majority of the teenagers were out of school, street hawkers, motor pack touts and unserious vocation apprentices. These groups have the potential for security breaches in the metropolis and beyond. Five hundred and thirty-four (534) respondents were used for the study. They were drawn from Ojoo, Akingbile and Moniya axis = 72; Agbowo, Ajibode and Apete axis = 74; Akobo, Basorun and Idi-ape axis 79; Wofun, Monatan and Iyana-Church axis = 78; Molete, Oke-ado and Oke-Bola axis = 75; Beere, Odinjo, Elekuro axis = 77; Eleyele, Ologuneru and Alesinloye axis = 79. Major Findings: Multiple regression was used to analyze the independent variables and percentages. The respondents' average age was 15.6 years old, and 100% were male. The instrument (questionnaire) used yielded; sport preference (r = 0.72), intervention (r = 0.68), and sustainable participation (r = 0.70). The relative contributions of sport preference on the participation of at risk teenagers was (F-ratio = 1.067); Intervention contribution of sport on the participation of at risk teenagers = produced (F-ratio of 12.095) was significant while, sustainable participation of at risk teenagers produced (F-ratio = 1.062) was significant. Closing Statement: The respondents’ sport preference stimulated their participation in sports. The intervention exposed at risk-teenagers to coaching, which activated their interest and participation in sports. At the same time, sustainable participation contributed positively to evolving at risk teenagers' participation in their preferred sport.

Keywords: sport, preference, intervention, teenagers, sustainable, participation and risk teenagers

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Authors: Dandan Shen, Hui-zhu Wang, Xi Yu, LiLi Gui, Xiao Wei, Xiao-yan Jiang, Da-wei Wang, Min Hong

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Yu-ping-feng-san (YPFS) is a clinical medicine for asthma and other allergic diseases, but the mechanism of YPFS on relapse of allergy is unclear. Currently, people come to realize the epithelial cells(EC) play a key role in stimulating and regulating local immune response. The study of thymic stromal lymphopoietin（TSLP derived from EC provides an important evidence that the EC can regulate immune response to stimulate allergic response. In this study, we observed the effect of YPFS on TSLP in vivo and in vitro. We established a method by using bronchial epithelial cells (16HBE) for screening potential bioactive components by HPLC-MS in YPFS and then analyzed the components in serum containing YPFS by UPLC-MS. The results showed that YPFS could decrease TSLP protein level in OVA-sensitized mice and 16HBE cells. Five components combing with the 16HBE cells were both detected in the serum.

Keywords: TSLP, bronchial epithelial cells, cell-binding, drug-containing serum

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Authors: Omid Ghollipoor Bashiri, Farzam Hatefi

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Dichlorvos a synthetic organophosphate poisons are used as insecticide. These toxins can be used insecticides in agriculture and medicine for destruction and/or eradication of ectoparasites of animals. Studies have shown that Dichlorvos creation seizure effects in different animals. Amlodipine, dihydropyridine calcium channel blockers, widely used for treatment of cardiovascular diseases. Studies have shown that the calcium channel blockers are anticonvulsant effects in different animal models. The aim of this study was to determine the effect of Amlodipine on Dichlorvos-induced seizures in mice. In this experiment, the animals were received different doses of Amlodipine (2.5, 5, 10, 20 and 40 mg/ kg b.wt.) intraperitoneally 30 min before intraperitoneal injection of Dichlorvos (50 mg/kg b.wt). After Dichlorvos injection, clonic and tonic seizures, and finally was the fate was investigated. Results showed that Amlodipine dose-dependently reduced the severity of Dichlorvos-induced seizures, so that Amlodipine at a dose of 5mg (The lowest, p<0.05) and 40 mg/kg b.wt. (The highest, p<0.001) which had anticonvulsant effects. The anticonvulsant activity of Amlodipine suggests that possibly due to the antagonistic effect on voltage-dependent calcium channel.

Keywords: dichlorvos, amlodipine, seizures, mice

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Authors: Bayan Almofty, Yuto Yamaki, Tadamasa Terai, Sadahito Uto

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Culture techniques of skeletal muscle cells are advanced in the field of regenerative medicine and applied research of cultured muscle. As applied research of cultured muscle, myopathy (muscles disease) treatment is expected and development bio of actuator is also expected in biomedical engineering. Grayanotoxins (GTXs) is known as neurotoxins that enhance the permeability of cell membrane for Na ions. Grayanotoxins are extracted from a famous Pieris japonica and Ericaceae as well as a phytotoxin. In this study, we investigated the effect of GTXs on muscle cells (C2C12) contraction and membrane potential. Contraction of myotubes is induced by applied external electrical stimulation. Contraction and membrane potential change of skeletal muscle cells are induced by injection of current. We, therefore, concluded that effect of Grayanotoxins on contraction and membrane potential of C2C12 relate to acute toxicity of GTXs.

Keywords: skeletal muscle cells C2C12, grayanotoxins, contraction, membrane potential, acute toxicity, pytotoxin, motubes

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Authors: Mircan Kaya

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A multi-disciplinary approach is required in any intervention project for historical monuments. Due to the complexity of their geometry, the variable and unpredictable characteristics of original materials used in their creation, heritage structures are peculiar. Their histories are often complex, and they require correct diagnoses to decide on the techniques of intervention. This approach should not only combine technical aspects but also historical research that may help discover phenomena involving structural issues, and acquire a knowledge of the structure on its concept, method of construction, previous interventions, process of damage, and its current state. In addition to the traditional techniques like bed joint reinforcement, the repairing, strengthening and restoration of historical buildings may require several other modern methods which may be described as innovative techniques like pre-stressing and post-tensioning, use of shape memory alloy devices and shock transmission units, shoring, drilling, and the use of stainless steel or titanium. Regardless of the method to be incorporated in the strengthening process, which can be traditional or innovative, it is crucial to recognize that structural strengthening is the process of upgrading the structural system of the existing building with the aim of improving its performance under existing and additional loads like seismic loads. This process is much more complex than dealing with a new construction, owing to the fact that there are several unknown factors associated with the structural system. Material properties, load paths, previous interventions, existing reinforcement are especially important matters to be considered. There are several examples of seismic strengthening with traditional and innovative techniques around the world, which will be discussed in this paper in detail, including their pros and cons. Ultimately, however, the main idea underlying the philosophy of a successful intervention with the most appropriate techniques of strengthening a historic monument should be decided by a proper assessment of the specific needs of the building.

Keywords: bed joint reinforcement, historical monuments, post-tensioning, pre-stressing, seismic strengthening, shape memory alloy devices, shock transmitters, tie rods

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Authors: P. S. Surya Meghana, K. Lingeshwaran, C. Kannan, V. Raghavendran, C. Priya

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One of the most basic and powerful tools in all of science and medicine is the light microscope, the fundamental device for laboratory as well as research purposes. With the improving technology, the need for portable, economic and user-friendly instruments is in high demand. The conventional microscope fails to live up to the emerging trend. Also, adequate access to healthcare is not widely available, especially in developing countries. The most basic step towards the curing of a malady is the diagnosis of the disease itself. The main aim of this paper is to diagnose Malaria with the most common device, cell phones, which prove to be the immediate solution for most of the modern day needs with the development of wireless infrastructure allowing to compute and communicate on the move. This opened up the opportunity to develop novel imaging, sensing, and diagnostics platforms using mobile phones as an underlying platform to address the global demand for accurate, sensitive, cost-effective, and field-portable measurement devices for use in remote and resource-limited settings around the world.

Keywords: cellular, hand-held, health care, image processing, malarial parasites, microscope

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Authors: Smriti Pahwa, Karishma Vats, Aditi Macwan, Jija Dutt, Sumukhi Vaid

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Age approporiate complementary feeding has been stressed upon for sound young child nutrition and appropriate growth. National Infant and Young Child Feeding guidelines, policies and programs indicate cognizance of the issue taken by the country’s government, policy makers and technical experts. However, it is important that ordinary people, the caregivers of young children too understand the importance of appropriate feeding. For this, an interface might be required where ordinary people could participate in assessing the gaps in IYCF as a first step to take subsequent action. In this context an attempt was made to extrapolate a citizen led learning level survey that has been involving around 25000 ordinary citizens to reach out to 600,000 children annually for over a decade in India. Based on this philosophy of involving ordinary people in simple assessments to produce understandable actionable evidence, a rapid diet assessment tool was developed and collected from caregivers of 90 < 3year children from two urban clusters in Ahmedabad and Baroda, Gujarat. Target sample for pilot was selected after cluster census. Around half the mothers reported that they had not yet introduced water or other fluids to their < 6 month babies. However, about a third were already feeding them food other than mother’s milk. Although complementary feeding was initiated in almost all (95%) children more than 6 months old, frequency was suboptimal in 60%; in 80% cases no measure was taken to either improve energy or nutrient density; only 33% were fed protective foods; Green Leafy Vegetables consumption was negligible (1.4%). Anganwadi food was not consumed. By engaging ordinary people to generate evidence and understand the gaps, such assessments have the potential to be used to generate useful evidence for action at scale as well as locally.

Keywords: citizen led, grass root engagement, IYCF (Infant and Young Child Feeding), rapid diet assessment, under nutrition

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: J. Desbrieres, M. Popa, C. Peptu, S. Bacaita

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Because of their favorable properties (non-toxicity, biodegradability, mucoadhesivity etc.), polysaccharides were studied as biomaterials and as pharmaceutical excipients in drug formulations. These formulations may be produced in a wide variety of forms including hydrogels, hydrogel based particles (or capsules), films etc. In these formulations, the polysaccharide based materials are able to provide local delivery of loaded therapeutic agents but their delivery can be rapid and not easily time-controllable due to, particularly, the burst effect. This leads to a loss in drug efficiency and lifetime. To overcome the consequences of burst effect, systems involving liposomes incorporated into polysaccharide hydrogels may appear as a promising material in tissue engineering, regenerative medicine and drug loading systems. Liposomes are spherical self-closed structures, composed of curved lipid bilayers, which enclose part of the surrounding solvent into their structure. The simplicity of production, their biocompatibility, the size and similar composition of cells, the possibility of size adjustment for specific applications, the ability of hydrophilic or/and hydrophobic drug loading make them a revolutionary tool in nanomedicine and biomedical domain. Drug delivery systems were developed as hydrogels containing chitosan or carboxymethylcellulose (CMC) as polysaccharides and gelatin (GEL) as polypeptide, and phosphatidylcholine or phosphatidylcholine/cholesterol liposomes able to accurately control this delivery, without any burst effect. Hydrogels based on CMC were covalently crosslinked using glutaraldehyde, whereas chitosan based hydrogels were double crosslinked (ionically using sodium tripolyphosphate or sodium sulphate and covalently using glutaraldehyde). It has been proven that the liposome integrity is highly protected during the crosslinking procedure for the formation of the film network. Calcein was used as model active matter for delivery experiments. Multi-Lamellar vesicles (MLV) and Small Uni-Lamellar Vesicles (SUV) were prepared and compared. The liposomes are well distributed throughout the whole area of the film, and the vesicle distribution is equivalent (for both types of liposomes evaluated) on the film surface as well as deeper (100 microns) in the film matrix. An obvious decrease of the burst effect was observed in presence of liposomes as well as a uniform increase of calcein release that continues even at large time scales. Liposomes act as an extra barrier for calcein release. Systems containing MLVs release higher amounts of calcein compared to systems containing SUVs, although these liposomes are more stable in the matrix and diffuse with difficulty. This difference comes from the higher quantity of calcein present within the MLV in relation with their size. Modeling of release kinetics curves was performed and the release of hydrophilic drugs may be described by a multi-scale mechanism characterized by four distinct phases, each of them being characterized by a different kinetics model (Higuchi equation, Korsmeyer-Peppas model etc.). Knowledge of such models will be a very interesting tool for designing new formulations for tissue engineering, regenerative medicine and drug delivery systems.

Keywords: controlled and delayed release, hydrogels, liposomes, polysaccharides

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Authors: Abubakar Bello Usman, Alhassan Muhammad Gani, Kolo Ibrahim

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The use of botanical raw materials to produce pharmaceuticals, herbal remedies, teas, spirits, cosmetics, sweets, dietary supplements, special industrial compounds and crude materials constitute an important global resource in terms of healthcare and economy. In Nigeria and other developing countries, the indigenous knowledge on the uses of plants lies with the older generation and the traditional healers. However, these custodians are decreasing in number due to death and other unforeseen occurrences. An Ethno-botanical survey was carried out to obtain information on the ethno medical values of wide range of plants used by the people of Gombe State, North-Eastern Nigeria, in the practice of healing and cure of typhoid (enteric) fever. Oral interviews were conducted so as to consider those with low literacy level who are involved in the practice of traditional medicine and thirty four (34) informants availed themselves for the interview and were consulted. All relevant information obtained from the respondents was recorded. A recent and valid nomenclature, along with local names, family names, part of the plant(s) used, methods of preparation and administration and fifty four (54) plant species belonging to 27 families as well as 7 unidentified species that are commonly used by the people of the state in ethnomedical treatment of the ailment were tabulated. Those interviewed included traditional practitioners, local herb sellers, traditional rulers, hunters, farmers and patients. Specific questions were asked and information supplied by informants was promptly documented. Results showed that the people of Gombe State are knowledgeable on herbal medicine in the treatment of diseases and ailments. Furthermore, the aqueous leaf extracts of Senna siamea, the plant species with the highest PPK (percentage of people who have knowledge about the use of a species for treating typhoid fever) in this ethnobotanical survey, was tested for its activity against clinical isolates of Salmonella typhi using the agar well diffusion method. The aqueous extracts showed some activity (zones of inhibition 11, 9, 7.5, 3.5, 1.3 mm) at 2000, 1800, 1600, 1400, 1200 µg/ml concentrations respectively. Preliminary phytochemical studies of the aqueous leaf extracts of the plant revealed the presence of secondary metabolites such as alkaloids, saponins, tannins, flavonoids and cardiac glycosides. Though a large number of traditionally used plants for the treatment of enteric fever were identified, further scientific validation of the traditional claims of anti-typhoid properties is imperative. This would establish their candidature for any possible future research for active principles and the possible development of new cheaper and more effective anti-typhoid drugs, as well as in the conservation of this rich diversity of medicinal plants.

Keywords: antimicrobial activities, ethnobotany, gombe state, north-eastern Nigeria, phytochemical screening, senna siamea, typhoid fever

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Authors: Sadiah Baharom, Che Nidzam Che Ahmad, Saipol Barin Ramli, Asmayati Yahaya, Sopia Md Yassin

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The early childhood care and education (ECCE) in Malaysia aspire to develop children who are intellectually, emotionally, physically and spiritually balanced. This aspiration can only materialise if the early childhood program developed comprehensive and is of high quality comparable to international standards. As such, there is a pressing need to assess the quality of the program in an all-encompassing manner. The overall research project aims at developing a comprehensive and integrated model of high-quality Malaysian ECCE. One of the major objectives of this project is to assess and evaluate the scope and quality of the existing ECCE programs in Malaysia. To this end, a specific aspect of this objective is to develop and validate an instrument to assess and evaluate the ECCE curriculum of the country. Thus this paper describes the development and validation of an instrument to explore the quality of early childhood care and education curriculum currently implemented in the country’s ECCE centres. The generation of the constructs and items were based on a set of criteria mapped against existing ECCE practice, document analyses, expert interviews and panel discussions. The items went through expert validation and were field tested on 597 ECCE teachers. The data obtained went through an exploratory factor analysis to validate the constructs of the instrument followed by reliability studies on internal consistency based on the Cronbach Alpha values. The final set of items for the ECCE curriculum instrument, earmarked for the main study, consists of four constructs namely philosophy and core values, curriculum content, curriculum review and unique features. Each construct consists of between 21 to 3 items with a total of 36 items in all. The reliability coefficients for each construct range from 0.65 to 0.961. These values are within the acceptable limits for a reliable instrument to be used in the main study.

Keywords: early childhood and care education, instrument development, reliability studies, validity studies

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Authors: Miriam I. Jimenez-Perez, Mariana C. Orellana-Haro, Carolina Guzman-Brambila

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As part of microbiology and dietetics courses, students of medicine and nutrition analyze the main pathogenic microorganisms and perform dietary analyzes. The course of microbiology describes in a general way the main pathogens including bacteria, viruses, fungi, and parasites, as well as their interaction with the human species. We hypothesize that lack of practical application of the course causes the students not to find the value and the clinical application of it when in reality it is a matter of great importance for healthcare in our country. The courses of the medical microbiology and dietetics are mostly theoretical and only a few hours of laboratory practices. Therefore, it is necessary the incorporation of new innovative techniques that involve more practices and community fieldwork, real cases analysis and real-life situations. The purpose of this intervention was to incorporate real-world learning experiences in the instruction of medical microbiology and dietetics courses, in order to improve the learning process, understanding and the application in the field. During a period of 6 months, medicine and nutrition students worked in a community of urban poverty. We worked with 90 children between 4 and 6 years of age from low-income families with no access to medical services, to give an infectious diagnosis related to nutritional status in these children. We expect that this intervention would give a different kind of context to medical microbiology and dietetics students improving their learning process, applying their knowledge and laboratory practices to help a needed community. First, students learned basic skills in microbiology diagnosis test during laboratory sessions. Once, students acquired abilities to make biochemical probes and handle biological samples, they went to the community and took stool samples from children (with the corresponding informed consent). Students processed the samples in the laboratory, searching for enteropathogenic microorganism with RapID™ ONE system (Thermo Scientific™) and parasites using Willis and Malloy modified technique. Finally, they compared the results with the nutritional status of the children, previously measured by anthropometric indicators. The anthropometric results were interpreted by the OMS Anthro software (WHO, 2011). The microbiological result was interpreted by ERIC® Electronic RapID™ Code Compendium software and validated by a physician. The results were analyses of infectious outcomes and nutritional status. Related to fieldwork community learning experiences, our students improved their knowledge in microbiology and were capable of applying this knowledge in a real-life situation. They found this kind of learning useful when they translate theory to a real-life situation. For most of our students, this is their first contact as health caregivers with real population, and this contact is very important to help them understand the reality of many people in Mexico. In conclusion, real-world or fieldwork learning experiences empower our students to have a real and better understanding of how they can apply their knowledge in microbiology and dietetics and help a much- needed population, this is the kind of reality that many people live in our country.

Keywords: real-world learning experiences, medical microbiology, dietetics, nutritional status, infectious status.

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Authors: Renjith George Pallivathukal, Preethy Mary Donald

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Asymptomatic oral lesions are often ignored by the patients and usually will be identified only in advanced stages. Early detection of precancerous lesions is important for better prognosis. It is also important for the oral health care person to be aware of the regional prevalence of oral lesions in order to provide early care for the same. We conducted a retrospective study to assess the prevalence of oral lesions based on the information available from patient records in a teaching dental school. Dental records of patients who attended the department of Oral medicine and diagnosis between September 2014 and September 2016 were retrieved and verified for oral lesions. Results: The ages of the patients ranged from 13 to 38 years with a mean age of 21.8 years. The lesions were classified as white (40.5%), red (23%), ulcerated (10.5%), pigmented (15.2%) and soft tissue enlargements (10.8%). 52% of the patients were unaware of the oral lesions before the dental visit. Overall, the prevalence of lesions in dental patients lower to national estimates, but the prevalence of some lesions showed variations.

Keywords: oral mucosal lesion, pre-cancer, prevalence, soft tissue lesion

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Authors: R. S. Fisca, Y. R. Elox, L. Umi, U. Z. Luttfia, Kun Harismah

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Petai (Parkia speciosa) is a plant indigenous to Southeast Asia. It is consumed either raw or cooked. It has been used in folk medicine to treat diabetes, hypertension, and kidney problems. It contains minerals and vitamins. Petai contains a lot of chemical compounds that are beneficial for health, including antioxidants, Vitamin B6 0,9mg, energy 142 g. cal, 10.4 g protein. 2 g fat, 22 g carbohydrates, 95 mg calcium, phosphorus 115 mg, 1 mg iron, 200 IU of vitamin A, vitamin B1 0.17 mg, 36 mg of vitamin C that can resolve various health problems. These chips are the result of innovation from petai packaged in such a way becomes a tasty snack chips and can be enjoyed by many people to relax and also nutritious for health. In the manufacture of petai chips require several steps of them start by boiling, flating, drying and the last frying. In introducing the products widely we sell petai chips with several methods. Some of these methods include direct sales, delivery order, online/social media, and open some booth at a few places and the car free day in Solo every sunday. Opportunity in selling petai chips is very wide because there is no competitors with similar business. With the innovation of petai chips become healthy snacks can be introduced to the public and can even be exported out of the country as one of the extraordinary snacks from Indonesia.

Keywords: antioxidants, chips, healty, petai

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Authors: Sunita Makchuchit, Arunporn Itharat

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Prasaprohyai, a Thai traditional medicine preparation listed in the Thai National List of Essential Medicines, is commonly used for treatment of fever and colds. Prasaprohyai preparation consists of 21 different plants, with Kaempferia galanga (50% w/w) as the main ingredient. The objective of this study was to investigate the anti-allergic activity of the crude extract from Prasaprohyai after accelerated stability test procedure. The method of extract used maceration in 95% ethanol and the crude extract was kept under accelerated condition at 40 ± 2 oC and 75 ± 5% relative humidity (RH) for six months. After six months of storage at 40 oC, the crude sample in various storage times (0, 15, 30, 45, 60, 90, 120, 150 and 180 days) were investigated for anti-allergic activity using IgE-sensitized RBL-2H3 cell lines. The results showed that the stability of crude ethanolic extract from Prasaprohyai under accelerated testing had no significant effect of anti-allergic activity when compared with day 0. The results showed that the ethanolic extract could be stored for two years at room temperature without loss of activity.

Keywords: accelerated stability, anti-allergy, prasaprohyai, RBL-2H3 cell lines

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Authors: Liza Meutia Sari, Gus Permana Subita, Elza Ibrahim Auerkari

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Background: Many herbs have been discovered to be potential sources of anticancer drugs. Biji Pinang or areca nut (Areca catechu Linn.) has a high content of phenolics and flavonoids, and which is related to antioxidant activity. However, data on its effects on oral squamous cell carcinoma is not available. Objectives: Identification of the cytotoxicity and apoptosis activity in HSC-2 and HSC-3. Methods: The areca nut was extracted by ethanol 96%, MTS assay and apoptosis activity with flow cytometry. Results: The extract of areca nut showed higher toxicity on HSC-3 cell compared to HSC-2. The IC₅₀ of HSC-3 was 164.06 μg/ml vs. 629.50 μg/ml in HSC-2. There was an increase in late apoptosis percentage after 24 and 48 hours in HSC-2. There was a significant increase in early apoptosis percentage after 24 hours and late in 48 hours in HSC-3. Conclusion: The antioxidant activity of the extract of areca nut might be associated with the selective cytotoxicity on HSC-2 and HSC-3. Apoptosis is the major cell death mechanism involved. The areca nut may play an important role in anticancer herb medicine.

Keywords: areca nut, cytotoxicity, apoptosis, oral carcinoma

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Authors: Basant Kumar Singh, S. Subhachandhar, Vineet Ranjan Tripathi, Amit Kumar Singh, Uttam Singh, Santosh Kumar Lal

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Productivity of Blast Furnace is largely impacted by fuel efficiency and controlling heat loss is one of the enabling parameters for achieving lower fuel rate. 'I' Blast Furnace is the latest and largest Blast Furnace of Tata Steel Jamshedpur with working volume of 3230 m³ and with rated capacity of 3.055 million tons per annum. Optimizing heat losses in Belly and Bosh zone remained major challenge for blast furnace operators after its commissioning. 'I' Blast has installed Cast Iron & Copper Staves cooling members where copper staves are installed in Belly, Bosh & Lower Stack whereas cast iron staves are installed in upper stack area. Stave cooled Blast Furnaces are prone to higher heat losses in Belly and Bosh region with an increase in coal injection rate as Bosh gas volume increases. Under these conditions, managing gas flow pattern through proper burden distribution, casting techniques & by maintaining desired raw material qualities are of utmost importance for sustaining high injection rates. This study details, the burden distribution control by Ore & Coke ratio adjustment at wall and center of Blast Furnace as the coal injection rates increased from 140 kg/thm to 210 kg/thm. Control of blowing parameters, casting philosophy, specification for raw materials & devising operational practice for controlling heat losses is also elaborated with the model that is used to visualize heat loss pattern in different zones of Blast Furnace.

Keywords: blast furnace, staves, gas flow pattern, belly/bosh heat losses, ore/coke ratio, blowing parameters, casting, operation practice

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Authors: H. Zouar, I. Kassous, F. Benzert

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The relentless pace of technology development in the last two decades has pervaded much of the recent educational discourse on a nation-wide scale. The rippling echoes of the buzz that account for the myriad of advantages the new technologies bring to the pedagogical activity has inevitably transcended from the western world to the Algerian educational contexts. Attempts have been made by Algerian practitioners to heed this digital advancement and push their instructional practices forward. However, due to the still largely existing first-order barriers as exemplified in the forms of deficient institutional infrastructure and unavailability of sufficient digital materials, the results of those attempts have polarised the views of Algerian academics regarding technology integration within higher education context. Hence, this study aims at measuring the possibility of integrating technology in our classrooms in a way that conforms to the philosophy of hybrid education. It also attempts to re-consider teachers’ understanding of technology integration in our context. Furthermore, the purpose of this research is also to reveal the level of teachers’ awareness regarding the distinction between technology integration and instrumental use. In view of the nature of these aims, a mixed-methods mode of investigation has been adopted to collect both qualitative and quantitative data from different perspectives. The data collection tools comprise of an observation as well as students’ and teachers’ questionnaires. The findings show that despite the fact that the examined context is not without its technological limitations, technology integration can be successfully incorporated contingent on teachers' level of knowledge and agency. Technology integration in Algerian universities does not proceed as the bedrock theory of it entails due to issues within teachers' general understanding of utilizing technology in class. It seems that technology is a means to an end, depending on the teachers who make use of it in order to deliver lessons (PowerPoint presentation) and issue commands (Facebook posting). Teachers' ability to clearly discern between integrating technology in their practices versus employing it as an instrument of instruction needs further consideration in order to establish a solid understanding of technology integration within higher education context.

Keywords: technology integration, hybrid education, teachers' understanding, teachers' awareness, instrumental use

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Authors: Monika Przeor

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The pace of life of modern society promotes the occurrence of affluence diseases. Functional food, which design and consumption by the consumer may be useful in the prevention of occurrence of different diseases, is becoming the alternative of food products available in the market. Design and determination of properties of flat bread of paratha type with the addition of an extract from the leaves of white mulberry became the overriding objective in the presented study. The centuries-old use of mulberry leaves in alternative medicine gave hope to obtain positive effects of the undertaken activity. In the designed product, stability, and content of polyphenols as well as their antioxidant properties were tested. Moreover, in the paper an aqueous extract of mulberry leaves obtained on semi-technical scale was described. It is rich in polyphenols, which results in its antioxidant activity. The addition of the extract significantly increased health-promoting qualities of paratha. The 3% extract addition to the dough turned out to be the most desired by the consumer group.

Keywords: mulberry leaves extract, flat bread, paratha, antioxidant activity

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Authors: Sami Michael Ayodele

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Cordyceps are members of the fungi family Cordycepitaceae which are formally in Clavicipitaceae. They parasitize the larvae and adults of different susceptible arthropods. They are highly priced and have been reported to be highly medicinal. Cordyceps have been used for centuries in traditional medicine in China and other Asian countries. Survey studies were carried out to determine the presence of Cordyceps and another entomopathogenic fungal floral in North Central Nigeria for two consecutive years. Thirty samples were collected, twenty-eight were identified, and two were unidentified. Most identified species belong to Ophiocordyceps species (20samples), Cordyceps species (4samples) and Isaria species (4samples). The species identified were: Cordyceps pseudomilitaris, Cordyceps tuberculata, Cordyceps cylindrical, Ophiocordyceps nutans, O. criminals, O. oxycephala, O. kniphofioides and Isaria sinclairii. The morphological and microscopic features of the collected and identified species were similar to those reported in other countries. This is the first official report on the presence of Cordyceps species in Nigeria. Further collections from different ecological regions of Nigeria will show the richness of the floral diversity of these entomopathogenic and medicinal mushrooms in Nigeria.

Keywords: cordyceps, entomopathogenic, medicinal, North Central, Nigeria

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Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

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Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

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Authors: Lima Antony

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In G. M. Hopkins’s poetics and aesthetics there is scope for a comparative study with Indian discourses on aesthetics, an area not adequately explored so far. This exploration will enrich the field of comparative study of diverse cultural expressions and their areas of similarity. A comparative study of aesthetic and religious experiences in diverse cultures will open up avenues for the discovery of similarities in self-experiences and their transcendence. Such explorations will reveal similar patterns in aesthetic and religious experiences. The present paper intends to prove this in the theories of Hopkins and Indian aesthetics. From the time of the Vedas Indian sages have believed that aesthetic enjoyment could develop into a spiritual realm. From the Natyasastra of Bharata, Indian aesthetics develops and reaches its culmination in later centuries into a consciousness of union with the mystery of the Ultimate Being, especially in Dhvanaāloka of Anandavardhana and Locana of Abhinavagupta. Dhvanyaloka elaborates the original ideas of rasa (mood or flavor) and dhvani (power of suggestion) in Indian literary theory and aesthetics. Hopkins was successful, like the ancient Indian alankarikas, in creating aesthetically superb patterns at various levels of sound and sense for which he coined the term ‘inscape’. So Hopkins’s aesthetic theory becomes suitable for transcultural comparative study with Indian aesthetics especially the dhvani theories of Anandavardhana and Abhinavagupta. Hopkins’s innovative approach to poetics and his selection of themes are quite suitable for analysis in the light of Indian literary theories. Indian philosophy views the ultimate reality called Brahman, as the 'soul,' or inner essence, of all reality. We see in Hopkins also a search for the essence of things and the chiming of their individuality with the Ultimate Being in multidimensional patterns of sound, sense and ecstatic experience. This search culminates in the realization of a synthesis of the individual self with the Ultimate Being. This is achieved through an act of surrender of the individuality of the self before the Supreme Being. Attempts to reconcile the immanent and transcendent aspects of the Ultimate Being can be traced in the Indian as well as Hopkins’s aesthetics which can contribute to greater understanding and harmony between cultures.

Keywords: Dhvani, Indian aesthetics, transcultural studies, Rasa

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Authors: Beata Grymska

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The research studies on academic discourse focus in general on lexical bundles, epistemic modality markers, or interactions between writers and readers. Following the research into the written forms of the academic community, this study concentrates on adjectives in research articles. The study investigates the distribution of adjectives in research articles in two academic disciplines: linguistics and medicine. It is corpus-based in design and consists of 100 linguistic and 100 medical research articles all written in English. The aim of the study is to compare the distribution of adjectives between the two corpora and four main parts of articles: IMRD (Introduction, Methods, Results, and Discussion). The second aim is to see if the two corpora share common core adjectives, e.g., different, important, specific, and if there are discipline-specific adjectives. The further part of the paper elaborates on adjectives use in the corpora together with examples. The results indicate that the two corpora do not differ in the distribution of adjectives to a great extent. The occurrences of the most frequently used adjectives depend on the academic discipline of the research articles. The concluding part reflects upon the role of adjectives in academic discourse and also presents how corpora can be helpful in composing academic texts.

Keywords: academic discourse, academic texts, adjectives, corpus analysis, research articles

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Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

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Authors: Alireza Moghtaderi, Negin Khakpour

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Disc Herniation is a common complication in the society and it is one of the main reasons for referring to physical medicine and rehabilitation clinics. Despite of various methods proposed for treatingthis disease, still there is disagreement on success of these methods especially in non-surgical methods, and thus current study aims at determining effect of laser beam and magnet on treatment of Intervertebral Disc Herniation. During a clinical trial study, 80 patients with Intervertebral Disc Herniation underwent a combined package of treatment including magnet, laser beam, PRP and Prolotherapy during 6 months. Average age of patients was 51.25 ± 10.7 with range of 25 – 71 years. 30 men (37.5%) and 50 women (62.5%) took part in the study. average weight of patients was 64.3 ± 7.2 with range of 49 – 79 kg. highest level of Disc Herniation was L5 – S1 with frequency of 17 cases (21.3%). Disc Herniation was severe in 30 cases before treatment, but it reduced to 3 casesafter treatment. This study indicates effect of combined treatment using non-invasive laser beam and magnet therapy on disco genic diseases and mechanical pains of spine is highly effective.

Keywords: hallux, valgus, botulinum toxin a, pain

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