Search results for: medication use self efficacy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2361

Search results for: medication use self efficacy

1401 Robust Pattern Recognition via Correntropy Generalized Orthogonal Matching Pursuit

Authors: Yulong Wang, Yuan Yan Tang, Cuiming Zou, Lina Yang

Abstract:

This paper presents a novel sparse representation method for robust pattern classification. Generalized orthogonal matching pursuit (GOMP) is a recently proposed efficient sparse representation technique. However, GOMP adopts the mean square error (MSE) criterion and assign the same weights to all measurements, including both severely and slightly corrupted ones. To reduce the limitation, we propose an information-theoretic GOMP (ITGOMP) method by exploiting the correntropy induced metric. The results show that ITGOMP can adaptively assign small weights on severely contaminated measurements and large weights on clean ones, respectively. An ITGOMP based classifier is further developed for robust pattern classification. The experiments on public real datasets demonstrate the efficacy of the proposed approach.

Keywords: correntropy induced metric, matching pursuit, pattern classification, sparse representation

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1400 Evaluation of South African Plants with Acaricide Activity against Ticks

Authors: G. Fouché, J. N. Eloff, K. Wellington

Abstract:

Acaricides are commonly used to control ticks but are toxic, harmful to the environment and too expensive to resource-limited farmers. Traditionally, many communities in South Africa rely on a wide range of indigenous practices to keep their livestock healthy. One of these health care practices includes the use of medicinal plants and this offers an alternative to conventional medicine. An investigation was conducted at the CSIR in South Africa, and selected indigenous plants used in communities were scientifically evaluated for the management of ticks in animals. 17 plants were selected from 239 plants used traditionally in South Africa. Two different organic extracts were prepared from the 17 samples, resulting in 34 plant samples. These were tested for efficacy against two tick species, namely Rhipicephalus microplus and Rhipicephalus turanicus. The plant extracts were also screened against Vero cells and most were found to have low cytotoxicity. This study has shown that there is potential for the development of botanicals as natural acaricides against ticks that are non-toxic and environmentally benign.

Keywords: South Africa, ticks, plant extracts, Rhipicephalus (Boophilus) microplus

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1399 Remote Electroacupuncture Analgesia at Contralateral LI4 Acupoint in Complete Freund's Adjuvant-Induced Inflammatory Hindpaw Pain

Authors: Tong-Chien Wu, Ching-Liang Hsieh, Yi-Wen Lin

Abstract:

There are accumulating evidences surrounding the therapeutic effect of electroacupuncture (EA). Local EA can reliably attenuate inflammatory pain in mouse with unclear mechanisms. However, the effect of EA on distal and contralateral acupoint for pain control has been rarely studied and the result was controversial. Here in our study, we found that inflammatory hindpaw pain in mouth, which was induced by injecting the complete Freund’s adjuvant (CFA) 2 days ago can be alleviated immediately after 2Hz 15mins EA treatment at contralateral forefoot acupoint LI4 through both mechanic and thermal behavior test, while sham acupoint group is not. The efficacy was observed to be more obvious after the second round of EA treatment on the following day. This analgesic effect is produced by applying EA to a site remote from the painful area. The present study provides a powerful experimental animal model that can be used for investigating the unique physiological mechanisms involved in acupuncture analgesia.

Keywords: remote electroacupuncture, distal EA, pain control, anti-inflammation

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1398 A Randomised Controlled Trial and Process Evaluation of the Lifestart Parenting Programme

Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson

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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.

Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness

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1397 Accumulation of Heavy Metals in Safflower (Carthamus tinctorius L.)

Authors: Violina R. Angelova, Mariana N. Perifanova-Nemska, Galina P. Uzunova, Elitsa N. Kolentsova

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Comparative research has been conducted to allow us to determine the accumulation of heavy metals (Pb, Zn and Cd) in the vegetative and reproductive organs of safflower, and to identify the possibility of its growth on soils contaminated by heavy metals and efficacy for phytoremediation. The experiment was performed on an agricultural field contaminated by the Non-Ferrous-Metal Works (MFMW) near Plovdiv, Bulgaria. The experimental plots were situated at different distances (0.1, 0.5, 2.0, and 15 km) from the source of pollution. The contents of heavy metals in plant materials (roots, stems, leaves, seeds) were determined. The quality of safflower oils (heavy metals and fatty acid composition) was also determined. The quantitative measurements were carried out with inductively-coupled plasma (ICP). Safflower is a plant that is tolerant to heavy metals and can be referred to the hyperaccumulators of lead and cadmium and the accumulators of zinc. The plant can be successfully used in the phytoremediation of heavy metal contaminated soils. The processing of safflower seeds into oil and the use of the obtained oil will greatly reduce the cost of phytoremediation.

Keywords: heavy metals, accumulation, safflower, polluted soils, phytoremediation

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1396 Antibacterial Activity of Nisin: Comparison the Role of Free and Encapsulated Nisin to Control Staphylococcus Aureus Inoculated in Minced Beef

Authors: Zh. Ghasemi, S. Nouri Saeedlou, A. Ghasemi, SL. Nasiri, P. Ayremlou, P. Mahasti

Abstract:

The use of nisin is successfully used as antibacterial agent in various food products. Although the conclusions of the previous studies were that nisin is not very effective in meat environments. The reduced antimicrobial efficacy of nisin when applied in food has been frequently observed. The aim of this study is to evaluate the potential of free and encapsulated nisin to inhibit the growth of staphylococcus aureus in minced beef. The minimum inhibitory concentration (MIC) of nisin is determined against S. aureus using the agar dilution method. Nisin is encapsulated by spray drying, and encapsulation efficiency, mass yield and total solids content values are 47.79%, 61%, and 96.41 respectively. The study in vitro release kinetics shows highest release of nisin from zein capsules is obtained after 72 hour. This work shows that an appropriate delivery system is necessary to obtain desirable effect of nisin in meat and meat product.

Keywords: nisin, encapsulation, Staphylococcus aureus, minced beef, antibacterial activity

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1395 Parents, Carers and Young Persons’ Views Regarding Nursing ‘Workarounds’ Within Clinical Electronic Patient Record Systems

Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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1394 Thermal Transformation of Zn-Bi Double Hydroxide Lamellar in ZnO Doped with Bismuth in Application for Photo Catalysis under Visible Light

Authors: Benyamina Imane, Benalioua Bahia, Mansour Meriem, Bentouami Abdelhadi

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The objective of this study is to use a synthetic route of the layered double hydroxide as a method of zinc oxide by doping a transition metal. The material is heat-treated at different temperatures then tested on the photo-fading of acid dye indigo carmine under visible radiation compared with ZnO. The material having a better efficacy was characterized by XRD and thereafter SEM. The result of XRD untreated Bi-Zn-LDH material thermally revealed peaks characteristic lamellar materials. Indeed, the lamellar morphology is very visible, observed by scanning electron microscopy (SEM). Furthermore, the lamellar character partially disappears when the material is treated at 550 °C in a muffle furnace. Thus obtained, a zinc oxide doped with bismuth confirmed by XRD. The photocatalytic efficiency of Bi-ZnO in a visible light of 500 W at 114,6 µw/cm2 as maximum of irradiance was tested on photo-bleaching of an indigoid dye in comparison with the commercial ZnO. Indeed, a complete discoloration of indigo carmine solution of 16 mg / L was obtained after 40 and 120 minutes of irradiation in the presence of Bi-ZnO and ZnO respectively.

Keywords: photocatalysis, Bi-ZnO-LDH, doping, ZnO

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1393 Efficacy of Sea Water with Reduced Rate Herbicide to Control Weeds in Tropical Turf

Authors: Md. Kamal Uddin, Abdul Shukor Juraimi, Md. Parvez Anwar

Abstract:

Seawater with reduced herbicide could be considered as a low cost environment friendly alternative method for weed control in turfgrass. Different concentration of sea water in combination with trifloxysulfuron-sodium and quinclorac were used to determine weed control level in turfgrass field. The weed species S. diander, C. aromaticus, and C. rotundus except E. atrovirens were fully controlled when treated with ¾ recommended trifloxysulfuron–sodium with sea water, ¾ recommended trifloxysulfuron–sodium with ¾ sea water, ½ recommended trifloxysulfuron–sodium with sea water, ¾ recommended quinclorac with sea water and ¾ recommended quinclorac with ¾ sea water. Eragrostis atrovirens showed maximum 48% injury when treated with ¾ recommended trifloxysulfuron–sodium and sea water. Among the tested turf grasses, P. vaginatum showed only 8% injury to sea water in combination with ¾ recommended quinclorac, indicating greater salt tolerance. Zoysia japonica also showed no more than 14% injury when treated with sea water in combination with ¾ recommended trifloxysulfuron–sodium or quinclorac.

Keywords: sea water, trifloxysulfuron–sodium, quinclorac, turf

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1392 Feedback of an Automated Hospital about the Performance of an Automated Drug Dispensing System’s Implementation

Authors: Bouami Hind, Millot Patrick

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The implementation of automated devices in life-critical systems such as hospitals can bring a new set of challenges related to automation malfunctions. While automation has been identified as great leverage for the medication dispensing system’s security and efficiency, it also increases the complexity of the organization. In particular, the installation and operation stage of automated devices can be complex when malfunctions related to automated systems occur. This paper aims to document operators’ situation awareness about the malfunctions of automated drug delivery systems (ADCs) during their implementation through Saint Brieuc hospital’s feedback. Our evaluation approach has been deployed in Saint Brieuc hospital center’s pharmacy, which has been equipped with automated nominative drug dispensing systems since January of 2021. The analysis of Saint Brieuc hospital center pharmacy’s automation revealed numerous malfunctions related to the implementation of Automated Delivery Cabinets. It appears that the targeted performance is not reached in the first year of implementation in this case study. Also, errors have been collected in patients' automated treatments’ production such as lack of drugs in pill boxes or nominative carnets, excess of drugs, wrong location of the drug, drug blister damaged, non-compliant sachet, or ticket errors. Saint Brieuc hospital center’s pharmacy is doing a tremendous job of setting up and monitoring performance indicators from the beginning of automation and throughout ADC’s operation to control ADC’s malfunctions and meet the performance targeted by the hospital. Health professionals, including pharmacists, biomedical engineers and directors of work, technical services and safety, are heavily involved in an automation project. This study highlights the importance of the evaluation of ADCs’ performance throughout the implementation process and the hospital’s team involvement in automation supervision and management.

Keywords: life-critical systems, situation awareness, automated delivery cabinets, implementation, risks and malfunctions

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1391 Outcomes of Pain Management for Patients in Srinagarind Hospital: Acute Pain Indicator

Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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1390 Optimal Cropping Pattern in an Irrigation Project: A Hybrid Model of Artificial Neural Network and Modified Simplex Algorithm

Authors: Safayat Ali Shaikh

Abstract:

Software has been developed for optimal cropping pattern in an irrigation project considering land constraint, water availability constraint and pick up flow constraint using modified Simplex Algorithm. Artificial Neural Network Models (ANN) have been developed to predict rainfall. AR (1) model used to generate 1000 years rainfall data to train the ANN. Simulation has been done with expected rainfall data. Eight number crops and three types of soil class have been considered for optimization model. Area under each crop and each soil class have been quantified using Modified Simplex Algorithm to get optimum net return. Efficacy of the software has been tested using data of large irrigation project in India.

Keywords: artificial neural network, large irrigation project, modified simplex algorithm, optimal cropping pattern

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1389 Mediating Role of Burnout in Personality and Marital Satisfaction of Single and Dual Career Couples

Authors: Sara Subhan

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Married couples tend to experience various bio-psycho-social issues that may eventually impact the quality of their marital relationship and mental wellbeing. This study aimed to find out the comparison between the single and dual-career couples’ personality, burnout and marital satisfaction. For that purpose Big Five Inventory, Couple Satisfaction Inventory, and Maslach Burnout Inventory-General Survey was used to measure the relationship between variables. The main study was carried out on 200 samples of single and dual-earner couples with the age range of 23-52 (mean= 34.58; standard deviation= 6.51) by using a purposive sampling strategy. The results showed that burnout tendencies like exhaustion, cynicism and professional efficacy are playing a mediation role between the personality and marital satisfaction of both single and dual career couples. Also, the results revealed that dual-career couples are more likely to have marital satisfaction as compared to single career couples. The results were further discussed in the light of its implications in its cultural context and counseling areas.

Keywords: dual career couples, marital satisfaction, burnout tendencies, personality

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1388 Leadership Dynamics and Teacher Engagement in Greek Education

Authors: Vasileios Floros

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This article delves into the intricate interplay between leadership styles and teacher satisfaction within the Greek educational framework, underscoring the pivotal role of school leadership in shaping educational success and fostering a conducive school culture. Through a comprehensive analysis, the study explores various leadership theories, the psychological contract between teachers and leaders, and the impact of leadership on teacher job satisfaction and group dynamics within educational institutions. It highlights how leadership efficacy can significantly influence the organizational climate, teacher motivation, and, ultimately, educational outcomes. The findings suggest that effective leadership, characterized by a deep understanding of teacher psychology, thoughtful engagement with the school culture, and strategic application of leadership styles, can lead to heightened teacher satisfaction and enhanced educational performance. This research offers valuable insights for educational policymakers, school leaders, and the broader academic community interested in optimizing leadership practices to foster an enriching educational environment in Greece.

Keywords: educational leadership, teacher satisfaction, school culture, leadership styles, Greek education

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1387 Beneficial Effect of Biotin in Combination with Canagliflozin on High Fat Diet Induced Diabetes in Rats

Authors: Rayhana Begum, HongBin Wang, Nur Alam Siddiquee, Md.Yasin Ahmed

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Biotin treatment has significant effects on blood glucose, and pharmacological doses of biotin improve hyperglycemia. The present study was aimed to investigate the efficacy and safety of biotin in combination with canagliflozin in improving glycemic control on High Fat Diet-induced diabetes in Rats. Thirty male rats were divided into five groups (six rats /group): control, high fat diet (HFD), canagliflozin (CAG), biotin (BIO), and CAG + BIO. The treatments with CAG and /or BIO significantly reduced the body weight gain, blood glucose and HbA1c levels, whereas CAG in combination with BIO revealed greater glycemic improvement than CAG monotherapy. The treatment with CAG and /or BIO causes significant change in lipid profile and CK level while the treatment with CAG in combination with BIO showed better results as compared with CAG monotherapy. Furthermore, combination of biotin with CAG improved the pancreatic and cardiac damage when compared with other treated groups.

Keywords: canagliflozin, biotin, HbA1c, lipid profile

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1386 Hardware Implementation and Real-time Experimental Validation of a Direction of Arrival Estimation Algorithm

Authors: Nizar Tayem, AbuMuhammad Moinuddeen, Ahmed A. Hussain, Redha M. Radaydeh

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This research paper introduces an approach for estimating the direction of arrival (DOA) of multiple RF noncoherent sources in a uniform linear array (ULA). The proposed method utilizes a Capon-like estimation algorithm and incorporates LU decomposition to enhance the accuracy of DOA estimation while significantly reducing computational complexity compared to existing methods like the Capon method. Notably, the proposed method does not require prior knowledge of the number of sources. To validate its effectiveness, the proposed method undergoes validation through both software simulations and practical experimentation on a prototype testbed constructed using a software-defined radio (SDR) platform and GNU Radio software. The results obtained from MATLAB simulations and real-time experiments provide compelling evidence of the proposed method's efficacy.

Keywords: DOA estimation, real-time validation, software defined radio, computational complexity, Capon's method, GNU radio

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1385 Bone Mineral Density in Long-Living Patients with Coronary Artery Disease

Authors: Svetlana V. Topolyanskaya, Tatyana A. Eliseeva, Olga N. Vakulenko, Leonid I. Dvoretski

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Introduction: Limited data are available on osteoporosis in centenarians. Therefore, we evaluated bone mineral density in long-living patients with coronary artery disease (CAD). Methods: 202 patients hospitalized with CAD were enrolled in this cross-sectional study. The patients' age ranged from 90 to 101 years. The majority of study participants (64.4%) were women. The main exclusion criteria were any disease or medication that can lead to secondary osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Normal lumbar spine BMD was observed in 40.9%, osteoporosis – in 26.9%, osteopenia – in 32.2% of patients. Normal proximal femur BMD values were observed in 21.3%, osteoporosis – in 39.9%, and osteopenia – in 38.8% of patients. Normal femoral neck BMD was registered only in 10.4% of patients, osteoporosis was observed in 60.4%, osteopenia in 29.2%. Significant positive correlation was found between all BMD values and body mass index of patients (p < 0.001). Positive correlation was registered between BMD values and serum uric acid (p=0.0005). The likelihood of normal BMD values with hyperuricemia increased 3.8 times, compared to patients with normal uric acid, who often have osteoporosis (Odds Ratio=3.84; p = 0.009). Positive correlation was registered between all BMD values and body mass index (p < 0.001). Positive correlation between triglycerides levels and T-score (p=0.02), but negative correlation between BMD and HDL-cholesterol (p=0.02) were revealed. Negative correlation between frailty severity and BMD values (p=0.01) was found. Positive correlation between BMD values and functional abilities of patients assessed using Barthel index (r=0,44; p=0,000002) and IADL scale (r=0,36; p=0,00008) was registered. Fractures in history were observed in 27.6% of patients. Conclusions: The study results indicate some features of BMD in long-livers. In the study group, significant relationships were found between bone mineral density on the one hand, and patients' functional abilities on the other. It is advisable to further study the state of bone tissue in long-livers involving a large sample of patients.

Keywords: osteoporosis, bone mineral density, centenarians, coronary artery disease

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1384 Scientific and Regulatory Challenges of Advanced Therapy Medicinal Products

Authors: Alaa Abdellatif, Gabrièle Breda

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Background. Advanced therapy medicinal products (ATMPs) are innovative therapies that mainly target orphan diseases and high unmet medical needs. ATMP includes gene therapy medicinal products (GTMP), somatic cell therapy medicinal products (CTMP), and tissue-engineered therapies (TEP). Since legislation opened the way in 2007, 25 ATMPs have been approved in the EU, which is about the same amount as the U.S. Food and Drug Administration. However, not all of the ATMPs that have been approved have successfully reached the market and retained their approval. Objectives. We aim to understand all the factors limiting the market access to very promising therapies in a systemic approach, to be able to overcome these problems, in the future, with scientific, regulatory and commercial innovations. Further to recent reviews that focus either on specific countries, products, or dimensions, we will address all the challenges faced by ATMP development today. Methodology. We used mixed methods and a multi-level approach for data collection. First, we performed an updated academic literature review on ATMP development and their scientific and market access challenges (papers published between 2018 and April 2023). Second, we analyzed industry feedback from cell and gene therapy webinars and white papers published by providers and pharmaceutical industries. Finally, we established a comparative analysis of the regulatory guidelines published by EMA and the FDA for ATMP approval. Results: The main challenges in bringing these therapies to market are the high development costs. Developing ATMPs is expensive due to the need for specialized manufacturing processes. Furthermore, the regulatory pathways for ATMPs are often complex and can vary between countries, making it challenging to obtain approval and ensure compliance with different regulations. As a result of the high costs associated with ATMPs, challenges in obtaining reimbursement from healthcare payers lead to limited patient access to these treatments. ATMPs are often developed for orphan diseases, which means that the patient population is limited for clinical trials which can make it challenging to demonstrate their safety and efficacy. In addition, the complex manufacturing processes required for ATMPs can make it challenging to scale up production to meet demand, which can limit their availability and increase costs. Finally, ATMPs face safety and efficacy challenges: dangerous adverse events of these therapies like toxicity related to the use of viral vectors or cell therapy, starting material and donor-related aspects. Conclusion. As a result of our mixed method analysis, we found that ATMPs face a number of challenges in their development, regulatory approval, and commercialization and that addressing these challenges requires collaboration between industry, regulators, healthcare providers, and patient groups. This first analysis will help us to address, for each challenge, proper and innovative solution(s) in order to increase the number of ATMPs approved and reach the patients

Keywords: advanced therapy medicinal products (ATMPs), product development, market access, innovation

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1383 Effect of Diazepam on Internal Organs of Chrysomya megacephala Using Micro-Computed Tomograph

Authors: Sangkhao M., Butcher B. A.

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Diazepam (known as valium) is a medication for calming effect. Many reports on committed suicide cases shown that diazepam is frequently used for this purpose. This research aims to study effect of diazepam on the development of forensically important blowflies, Chrysomya megacephala (Diptera: Calliphoridae) using micro-computed tomography (micro CT). In this study, four rabbits were treated with three different lethal doses of diazepam and one control (LD₀, LD₅₀, LD₁₀₀ and LC). The rabbit’s livers were removed for rearing the blowflies. Pupae were sampled for two series (ages; S1: 24h and S2: 120h) of development. After preparing the specimens, all samples were performed Micro CT using Skyscan 1172. The results shown the effect of diazepam on internal organs and tissues such as brain, cavity of the body, gas bubble, meconium and especially fat body. In the control group, in series 1 (LCS1), fat body was equally dispersed in the head, thorax, and abdomen, development of internal organs were not completed, however, brain, thoracic muscle, wings, legs and rectum were able to observe at 24h after developing into the pupal stage. Development of each organ in the control group in the series two was completed. In the treatment groups, LD₀, LD₅₀, LD₁₀₀ (Series 1 and Series 2), tissues are different, such as gas bubble in LD₀S1, was observed due to rapidity morphological changes during the metamorphosis of blowfly’s pupa in this treatment. Meconium was observed in LD₅₀S2 group because excretion of metabolic waste was not completed. All of the samples in the treatment groups had differentiation of fat bodies because metabolic activities were not completed and these changes affected on functions of every internal system. Discovering of differentiated fat bodies are important results because fat bodies of insect functions as liver in human, therefore it is shown that toxin eliminates from blowfly’s body and homeostatic maintenance of the hemolymph proteins, lipid and carbohydrates in each treatment group are abnormal.

Keywords: forensic toxicology, forensic entomology, diptera, diazepam

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1382 Sleep Health Management in Residential Aged Care Facilities

Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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1381 Liaison Psychiatry in Baixo Alentejo, Portugal: Reality and Perspectives

Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

Abstract:

Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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1380 Creation and Implementation of A New Palliative Care Drug Chart, via A Closed-Loop Audit

Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

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1379 A Review of the Effects of Exercise in Preventing Migraine Headaches

Authors: Afsaneh Soltani, Zahra Mohajer

Abstract:

Migraine is one of the most common chronic neurological diseases. Migraines affect different aspects of life. Severe migraine headaches lead to dysfunction, a reduced presence at work, and decreased ability to think and make decisions. Non-pharmacological treatments play a very important role in controlling and preventing migraine headaches. A healthy lifestyle helps control migraine headaches. Migraine headaches can be reduced by following these steps: Avoiding stress, eating regularly and avoiding hunger and thirst, avoiding stimulants such as chocolate, caffeine, and cigarettes, following a regular bedtime routine, or avoiding sleep deprivation. Exercise a lot, and do regular exercise (and prevent obesity). Non-pharmacological treatment is especially important in pregnant women and children because in these cases, medical treatments are not preferred due to the many side effects. Exercise is one of the most effective and uncomplicated non-pharmacological alternatives in the treatment of migraine headaches. Exercising for episodic migraines is a safe, effective, and promising complementary treatment option. Numerous studies have shown that aerobic exercise reduces the severity and duration of migraine headaches. Effective aerobic exercise includes cycling and brisk walking. Exercise improves the quality of life and reduces the use of medication in people with migraines. Patients who exercise have fewer migraine days, resulting in better personal, social, and occupational performance. Several studies have shown that pain intensity and frequency in patients who exercise regularly decreased significantly after exercise compared to controls who did not exercise. According to a study, regular exercise reduces the levels of interleukins, especially IL-12P70, which reduces anxiety and reduces the number of days of migraine in patients. An article has shown that endurance exercise reduces the number of migraine days and also increases cerebrovascular health in migraine patients. According to studies, the minimum duration of exercise to achieve a positive effect of exercise in patients with migraine is 3 months (12 weeks) and 40 minutes three times a week.

Keywords: exercise, headache, migraine, physical activity

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1378 The Analgesic Effect of Electroacupuncture in a Murine Fibromyalgia Model

Authors: Bernice Jeanne Lottering, Yi-Wen Lin

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Introduction: Chronic pain has a definitive lack of objective parameters in the measurement and treatment efficacy of diseases such as Fibromyalgia (FM). Persistent widespread pain and generalized tenderness are the characteristic symptoms affecting a large majority of the global population, particularly females. This disease has indicated a refractory tendency to conventional treatment ventures, largely resultant from a lack of etiological and pathogenic understanding of the disease development. Emerging evidence indicates that the central nervous system (CNS) plays a critical role in the amplification of pain signals and the neurotransmitters associated therewith. Various stimuli have been found to activate the channels existent on nociceptor terminals, thereby actuating nociceptive impulses along the pain pathways. The transient receptor potential vanalloid 1 (TRPV1) channel functions as a molecular integrator for numerous sensory inputs, such as nociception, and was explored in the current study. Current intervention approaches face a multitude challenges, ranging from effective therapeutic interventions to the limitation of pathognomonic criteria resultant from incomplete understanding and partial evidence on the mechanisms of action of FM. It remains unclear whether electroacupuncture (EA) plays an integral role in the functioning of the TRPV1 pathway, and whether or not it can reduce the chronic pain induced by FM. Aims: The aim of this study was to explore the mechanisms underlying the activation and modulation of the TRPV1 channel pathway in a cold stress model of FM applied to a murine model. Furthermore, the effect of EA in the treatment of mechanical and thermal pain, as expressed in FM was also to be investigated. Methods: 18 C57BL/6 wild type and 6 TRPV1 knockout (KO) mice, aged 8-12 weeks, were exposed to an intermittent cold stress-induced fibromyalgia-like pain model, with or without EA treatment at ZusanLi ST36 (2Hz/20min) on day 3 to 5. Von Frey and Hargreaves behaviour tests were implemented in order to analyze the mechanical and thermal pain thresholds on day 0, 3 and 5 in control group (C), FM group (FM), FM mice with EA treated group (FM + EA) and FM in KO group. Results: An increase in mechanical and thermal hyperalgesia was observed in the FM, EA and KO groups when compared to the control group. This initial increase was reduced in the EA group, which directs focus at the treatment efficacy of EA in nociceptive sensitization, and the analgesic effect EA has attenuating FM associated pain. Discussion: An increase in the nociceptive sensitization was observed through higher withdrawal thresholds in the von Frey mechanical test and the Hargreaves thermal test. TRPV1 function in mice has been scientifically associated with these nociceptive conduits, and the increased behaviour test results suggest that TRPV1 upregulation is central to the FM induced hyperalgesia. This data was supported by the decrease in sensitivity observed in results of the TRPV1 KO group. Moreover, the treatment of EA showed a decrease in this FM induced nociceptive sensitization, suggesting TRPV1 upregulation and overexpression can be attenuated by EA at bilateral ST36. This evidence compellingly implies that the analgesic effect of EA is associated with TRPV1 downregulation.

Keywords: fibromyalgia, electroacupuncture, TRPV1, nociception

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1377 Design and Simulation of Variable Air Volume Air Conditioning System Based on Improved Sliding Mode Control

Authors: Abbas Anser, Ahmad Irfan

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The main purpose of the VAV (Variable Air Volume) in Heating, Ventilation, and Air Conditioning (HVAC) system is to reduce energy consumption and make the buildings comfortable for the occupants. For better performance of the air conditioning system, different control techniques have been developed. In this paper, an Improved Sliding Mode Control (ISMC), based on Power Rate Exponential Reaching Law (PRERL), has been implemented on a VAV air conditioning system. Through the proposed technique, fast response and robustness have been achieved. To verify the efficacy of ISMC, a comparison of the suggested control technique has been made with Exponential Reaching Law (ERL) based SMC. And secondly, chattering, which is unfavorable as it deteriorates the mechanical parts of the air conditioning system by the continuous movement of the mechanical parts and consequently it increases the energy loss in the air conditioning system, has been alleviated. MATLAB/SIMULINK results show the effectiveness of the utilized scheme, which ensures the enhancement of the energy efficiency of the VAV air conditioning system.

Keywords: PID, SMC, HVAC, PRERL, feedback linearization, VAV, chattering

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1376 Efficacy of Sparganium stoloniferum–Derived Compound in the Treatment of Acne Vulgaris: A Pilot Study

Authors: Wanvipa Thongborisute, Punyaphat Sirithanabadeekul, Pichit Suvanprakorn, Anan Jiraviroon

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Background: Acne vulgaris is one of the most common dermatologic problems, and can have a significant psychological and physical effect on patients. Propionibacterium acnes' roles in acne vulgaris involve the activation of toll-like receptor 4 (TLR4), and toll-like receptor 2 (TLR2) pathways. By activating these pathways, inflammatory events of acne lesions, comedogenesis and sebaceous lipogenesis can occur. Currently, there are several topical agents commonly use in treating acne vulgaris that are known to have an effect on TLRs, such as retinoic acid and adapalene, but these drugs still have some irritating effects. At present, there is an alarming increase in rate of bacterial resistance due to irrational used of antibiotics both orally and topically. For this reason, acne treatments should contain bioactive molecules targeting at the site of action for the most effective therapeutic effect with the least side effects. Sparganium stoloniferumis a Chinese aquatic herb containing a compound called Sparstolonin B (SsnB), which has been reported to selectively blocks Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4)-mediated inflammatory signals. Therefore, this topical TLR2 and TLR4 antagonist, in a form of Sparganium stoloniferum-derived compound containing SsnB, should give a benefit in reducing inflammation of acne vulgaris lesions and providing an alternative treatments for patients with this condition. Materials and Methods: The objectives of this randomized double blinded split faced placebo controlled trial is to study the safety and efficacy of the Sparganium stoloniferum-derived compound. 32 volunteered patients with mild to moderate degree of acne vulgaris according to global acne grading system were included in the study. After being informed and consented the subjects were given 2 topical treatments for acne vulgaris, one being topical 2.40% Sparganium stoloniferum extraction (containing Sparstolonin B) and the other, placebo. The subjects were asked to apply each treatment to either half of the face daily morning and night by randomization for 8 weeks, and come in for a weekly follow up. For each visit, the patients went through a procedure of lesion counting, including comedones, papules, nodules, pustules, and cystic lesions. Results: During 8 weeks of experimentation, the result shows a reduction in total lesions number between the placebo and the treatment side show statistical significance starting at week 4, where the 95% confidence interval begin to no longer overlap, and shows a trend of continuing to be further apart. The decrease in the amount of total lesions between week 0 and week 8 of the placebo side shows no statistical significant at P value >0.05. While the decrease in the amount of total lesions of acne vulgaris of the treatment side comparing between week 0 and week 8 shows statistical significant at P value <0.001. Conclusion: The data demonstrates that 2.40% Sparganium stoloniferum extraction (containing Sparstolonin B) is more effective in treating acne vulgaris comparing to topical placebo in treating acne vulgaris, by showing significant reduction in the total numbers of acne lesions. Therefore, this topical Sparganium stoloniferum extraction could become a potential alternative treatment for acne vulgaris.

Keywords: acne vulgaris, sparganium stoloniferum, sparstolonin B, toll-like receptor 2, toll-like receptor 4

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1375 Genetic Polymorphisms of the Human Organic Cation Transporter 2 gene, SLC22A2, in the Zulu population

Authors: N. Hoosain, S. Nene, B. Pearce, C. Jacobs, M. Du Plessis, M. Benjeddou

Abstract:

Organic Cation Transporters play a vital role in the absorption, tissue distribution and elimination of various substrates. Numerous studies have suggested that variations in non-synonymous single nucleotide polymorphisms (SNPs) of SLC22A2 could influence an individual’s response to various treatments, including clinically important drugs. This study is the first to determine the baseline frequency distribution for twenty SNPs of SLC22A2in the Zulu population. DNA was collected from 101 unrelated “healthy” Zulu participants. Genotypes of all samples were determined using a multiplex PCR and SNaPshot assay followed by the generation of the haplotype structure. This is the first time that the baseline frequency distribution of SNPs is reported for the Zulu population. Data from this study could be used in in vitro and in vivo pharmacogenetic and pharmacokinetic studies to evaluate the potential role the studied SNPs play in the therapeutic efficacy of clinically important drugs.

Keywords: SLC22A2 gene, SNaPshot assay, PCR, Zulu population

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1374 Pollination Effectiveness of Native Bee Species in Quality Seed Production of Berseem

Authors: Awais Ahmad, Mudssar Ali

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Berseem is the major fodder crop grown in Pakistan and is highly preferred by cattle farmers due to its multicut nature and nutritious value. The quality seed production in berseem is largely dependent upon the activities of insect pollinators, particularly bees. In order to determine the effectiveness of native bee species in quality seed production of berseem, an experiment was conducted in the research field of MNS-University of Agriculture, Multan, Pakistan. The pollinator community of berseem was composed of four bees, three syrphid fly, and two butterfly species. Pesudapis sp. was the most abundant insect visitor, followed by Apis mellifera and A. dorsata. The visitation rate of A. mellifera was found highest, followed by Pesudapis sp. and A. dorsata. Moreover, single-visit efficacy in terms of seed per head and 1000 seed weight proved A. mellifera and Pesudapis sp as the most effective pollinators. Conserving these bee species may lead to sustainable berseem seed production in Pakistan.

Keywords: honey bees, syrphid fly, visitation rate, single visit

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1373 Towards an Enhanced Compartmental Model for Profiling Malware Dynamics

Authors: Jessemyn Modiini, Timothy Lynar, Elena Sitnikova

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We present a novel enhanced compartmental model for malware spread analysis in cyber security. This paper applies cyber security data features to epidemiological compartmental models to model the infectious potential of malware. Compartmental models are most efficient for calculating the infectious potential of a disease. In this paper, we discuss and profile epidemiologically relevant data features from a Domain Name System (DNS) dataset. We then apply these features to epidemiological compartmental models to network traffic features. This paper demonstrates how epidemiological principles can be applied to the novel analysis of key cybersecurity behaviours and trends and provides insight into threat modelling above that of kill-chain analysis. In applying deterministic compartmental models to a cyber security use case, the authors analyse the deficiencies and provide an enhanced stochastic model for cyber epidemiology. This enhanced compartmental model (SUEICRN model) is contrasted with the traditional SEIR model to demonstrate its efficacy.

Keywords: cybersecurity, epidemiology, cyber epidemiology, malware

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1372 Bio-Psycho-Social Consequences and Effects in Fall-Efficacy Scale in Seniors Using Exercise Intervention of Motor Learning According to Yoga Techniques

Authors: Milada Krejci, Martin Hill, Vaclav Hosek, Dobroslava Jandova, Jiri Kajzar, Pavel Blaha

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The paper declares effects of exercise intervention of the research project “Basic research of balance changes in seniors”, granted by the Czech Science Foundation. The objective of the presented study is to define predictors, which influence bio-psycho-social consequences and effects of balance ability in senior 65 years old and above. We focused on the Fall-Efficacy Scale changes evaluation in seniors. Comprehensive hypothesis of the project declares, that motion uncertainty (dyskinesia) can negatively affect the well-being of a senior in bio-psycho-social context. In total, random selection and testing of 100 seniors (30 males, 70 females) from Prague and Central Bohemian region was provided. The sample was divided by stratified random selection into experimental and control groups, who underwent input and output testing. For diagnostics the methods of Medical Anamnesis, Functional anthropological examinations, Tinetti Balance Assessment Tool, SF-36 Health Survey, Anamnestic comparative self-assessment scale were used. Intervention method called "Life in Balance" based on yoga techniques was applied in four-week cycle. Results of multivariate regression were verified by repeated measures ANOVA: subject factor, phase of intervention (between-subject factor), body fluid (within-subject factor) and phase of intervention × body fluid interaction). ANOVA was performed with a repetition involving the factors of subjects, experimental/control group, phase of intervention (independent variable), and x phase interaction followed by Bonferroni multiple comparison assays with a test strength of at least 0.8 on the probability level p < 0.05. In the paper results of the first-year investigation of the three years running project are analysed. Results of balance tests confirmed no significant difference between females and males in pre-test. Significant improvements in balance and walking ability were observed in experimental group in females comparing to males (F = 128.4, p < 0.001). In the females control group, there was no significant change in post- test, while in the female experimental group positive changes in posture and spine flexibility in post-tests were found. It seems that females even in senior age react better to incentives of intervention in balance and spine flexibility. On the base of results analyses, we can declare the significant improvement in social balance markers after intervention in the experimental group (F = 10.5, p < 0.001). In average, seniors are used to take four drugs daily. Number of drugs can contribute to allergy symptoms and balance problems. It can be concluded that static balance and walking ability of seniors according Tinetti Balance scale correlate significantly with psychic and social monitored markers.

Keywords: exercises, balance, seniors 65+, health, mental and social balance

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