Search results for: quality of food

Authors: D. Naranchimeg, G. Ulziisaikhan

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Student dropout problem has not been recently investigated within the Mongolian higher education. A student dropping out is a personal decision, but it may cause unemployment and other social problems including low quality of life because students who are not completed a degree cannot find better-paid jobs. The research aims to determine percentage of at-risk students, and understand reasons for dropouts and to find a way to predict. The study based on the students of the Mongolian National University of Education including its Arkhangai branch school, National University of Mongolia, Mongolian University of Life Sciences, Mongolian University of Science and Technology, Mongolian National University of Medical Science, Ikh Zasag International University, and Dornod University. We conducted the paper survey by method of random sampling and have surveyed about 100 students per university. The margin of error - 4 %, confidence level -90%, and sample size was 846, but we excluded 56 students from this study. Causes for exclusion were missing data on the questionnaire. The survey has totally 17 questions, 4 of which was demographic questions. The survey shows that 1.4% of the students always thought to dropout whereas 61.8% of them thought sometimes. Also, results of the research suggest that students’ dropouts from university do not have relationships with their sex, marital and social status, and peer and faculty climate, whereas it slightly depends on their chosen specialization. Finally, the paper presents the reasons for dropping out provided by the students. The main two reasons for dropouts are personal reasons related with choosing wrong study program, not liking the course they had chosen (50.38%), and financial difficulties (42.66%). These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to high school students in choosing right for them study program, and targeted financial support for those who are at risk.

Keywords: at risk students, dropout, faculty climate, Mongolian universities, peer climate

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Authors: Manmeet Kaur, Madhu Vij

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The Board of Directors in a firm performs the primary role of an internal control mechanism. This Study seeks to understand the relationship between internal governance and performance of banks in India. The research paper investigates the effect of board structure (proportion of nonexecutive directors, gender diversity, board size and meetings per year) on the firm performance. This paper evaluates the impact of corporate governance mechanisms on bank’s financial performance using panel data for 28 listed banks in National Stock Exchange of India for the period of 2008-2014. Returns on Asset, Return on Equity, Tobin’s Q and Net Interest Margin were used as the financial performance indicators. To estimate the relationship among governance and bank performance initially the Study uses Pooled Ordinary Least Square (OLS) Estimation and Generalized Least Square (GLS) Estimation. Then a well-developed panel Generalized Method of Moments (GMM) Estimator is developed to investigate the dynamic nature of performance and governance relationship. The Study empirically confirms that two-step system GMM approach controls the problem of unobserved heterogeneity and endogeneity as compared to the OLS and GLS approach. The result suggests that banks with small board, boards with female members, and boards that meet more frequently tend to be more efficient and subsequently have a positive impact on performance of banks. The study offers insights to policy makers interested in enhancing the quality of governance of banks in India. Also, the findings suggest that board structure plays a vital role in the improvement of corporate governance mechanism for financial institutions. There is a need to have efficient boards in banks to improve the overall health of the financial institutions and the economic development of the country.

Keywords: board of directors, corporate governance, GMM estimation, Indian banking

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Authors: Thanom Kaeniam

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ST-Elevation Myocardial Infarction (STEMI) is a state of sudden death of the heart muscle due to sudden blockage of the artery. STEMI patients are usually in critical condition and with a potential opportunity for sudden death. Therefore, management guidelines for safety in caring and referring STEMI patients are needed. The objective of this developmental research was to assess the effectiveness of using the guidelines for caring and referring STEMI patients at the Accident and Emergency Department of Songkhla Hospital. The subjects of the study were 22 nurses in the emergency room, and doctors on duty in the accident and emergency room selected using purposive sampling with inclusion criteria. The research instruments were the guidelines for caring and referring STEMI patients, and record forms for the effectiveness of using the guidelines for caring and referring STEMI patients (a general record form for STEMI patients, a record form for SK administering, a referring record form for PCI, and a record form for dead patient in the accident and emergency room and during referring). The instruments were tested for content validity by three experts, and the reliability was tested using Kuder-Richardson 20 (KR20). The descriptive statistic employed was the percentage. The outcomes of using the guidelines for caring and referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department revealed that before using the guidelines in 2009, 2010, and 2011, there were 84, 73, and 138 STEMI patients receiving services at the accident and emergency room, of which, only 9, 32, and 48 patients were referred for PCI/SK medications, or 10.74; 43.84; and 34.78 percent, and the death rates were 10.71; 10.95; and 11.59 percent, respectively. However, after the use of the guidelines in 2012, 2013, and 2014, there were 97, 77, and 57 patients, of which, the increases to 77, 72, and 55 patients were referred for PCI /SK medications or 79.37; 93.51; and 96.49 percent, and the death rates were reduced to 10.30; 6.49; and 1.76 percent, respectively. The results of the study revealed that the use of the guidelines for caring and referring STEMI patients at the Accident and Emergency Department increased the effectiveness and quality of nursing, especially in terms of SK medication, caring and referring patients for PCI to reduce the death rate.

Keywords: outcomes, guidelines for caring, referring, myocardial infarction, STEMI

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Authors: Amal Sellami, Ahlem Ammar

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Writing is acknowledged to be a cognitively demanding and complex task. Indeed, the writing process is composed of three iterative sub-processes, namely planning, translating (writing), and reviewing. Not only do second or foreign language learners need to write according to this process, but they also need to respect the norms and rules of language and writing in the text to-be-produced. Accordingly, researchers have suggested to approach writing as a collaborative task in order to al leviate its complexity. Consequently, collaboration has been implemented during the whole writing process or only during planning orreviewing. Researchers report that implementing collaboration during the whole process might be demanding in terms of time in comparison to individual writing tasks. Consequently, because of time constraints, teachers may avoid it. For this reason, it might be pedagogically more realistic to limit collaboration to one of the writing sub-processes(i.e., planning or reviewing). However, previous research implementing collaboration in planning or reviewing is limited and fails to explore the effects of the seconditionson the written text. Consequently, the present study examines the effects of collaboration in planning and collaboration in reviewing on the written text. To reach this objective, quantitative as well as qualitative methods are deployed to examine the written texts holistically and in terms of fluency, complexity, and accuracy. Participants of the study include 4 pairs in each group (n=8). They participated in two experimental conditions, which are: (1) collaborative planning followed by individual writing and individual reviewing and (2) individual planning followed by individual writing and collaborative reviewing. The comparative research findings indicate that while collaborative planning resulted in better overall text quality (precisely better content and organization ratings), better fluency, better complexity, and fewer lexical errors, collaborative reviewing produces better accuracy and less syntactical and mechanical errors. The discussion of the findings suggests the need to conduct more comparative research in order to further explore the effects of collaboration in planning or in reviewing. Pedagogical implications of the current study include advising teachers to choose between implementing collaboration in planning or in reviewing depending on their students’ need and what they need to improve.

Keywords: collaboration, writing, collaborative planning, collaborative reviewing

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Authors: Matthew Armitt

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The revolutionary school of architectural teaching – VKhUTEAMAS (1923-1926) was a new approach for a new society bringing architectural education to the masses and masses to the growing industrial production. The school's pedagogical contribution of the 1920s made it an important school of the modernist movement, engaging pedagogy as a mode of experimentation. The teachers and students saw design education not just as a process of knowledge transfer but as a vehicle for design innovation developing an approach without precedent. This process of teaching and learning served as a vehicle for venturing into the unknown through a discipline of architectural teaching called “Space” developed by the Soviet architect Nikolai Ladovskii (1881-1941). The creation of “Space” was paramount not only for its innovative pedagogy but also as an experimental laboratory for developing new architectural language. This paper discusses whether the historical teaching of “Space” can function in the construction of the modern teaching identity today to promote value, richness, quality, and diversity inherent in architectural design education. The history of “Space” teaching remains unknown within academic circles and separate from the current architectural teaching debate. Using VKhUTEMAS and the teaching of “Space” as a pedagogical lens and drawing upon research carried out in the Russian Federation, America, Canada, Germany, and the UK, this paper discusses how historically different models of teaching and learning can intersect through examining historical based educational research by exploring different design studio initiatives; pedagogical methodologies; teaching and learning theories and problem-based projects. There are strong arguments and desire for pedagogical change and this paper will promote new historical and educational research to widen the current academic debate by exposing new approaches to architectural teaching today.

Keywords: VKhUTEMAS, discipline space, modernist pedagogy, teaching identity

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Authors: A. Sohouli, A. Suleman

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This study focuses on reliability analysis of variable stiffness composite laminate structures to investigate the potential structural improvement compared to conventional (straight fibers) composite laminate structures. A computational framework was developed which it consists of a deterministic design step and reliability analysis. The optimization part is Discrete Material Optimization (DMO) and the reliability of the structure is computed by Monte Carlo Simulation (MCS) after using Stochastic Response Surface Method (SRSM). The design driver in deterministic optimization is the maximum stiffness, while optimization method concerns certain manufacturing constraints to attain industrial relevance. These manufacturing constraints are the change of orientation between adjacent patches cannot be too large and the maximum number of successive plies of a particular fiber orientation should not be too high. Variable stiffness composites may be manufactured by Automated Fiber Machines (AFP) which provides consistent quality with good production rates. However, laps and gaps are the most important challenges to steer fibers that effect on the performance of the structures. In this study, the optimal curved fiber paths at each layer of composites are designed in the first step by DMO, and then the reliability analysis is applied to investigate the sensitivity of the structure with different standard deviations compared to the straight fiber angle composites. The random variables are material properties and loads on the structures. The results show that the variable stiffness composite laminate structures are much more reliable, even for high standard deviation of material properties, than the conventional composite laminate structures. The reason is that the variable stiffness composite laminates allow tailoring stiffness and provide the possibility of adjusting stress and strain distribution favorably in the structures.

Keywords: material optimization, Monte Carlo simulation, reliability analysis, response surface method, variable stiffness composite structures

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Authors: Ayesha Siddiqua

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Background: Hypertension is a silent killer disease and a common risk factor for considerable morbidity and mortality. Its effects can be seen on the organs like Heart; Brain; Kidneys. In Saudi Arabia, hypertension affects a sizeable enough proportion of the population, with a prevalence of 27.9% in urban and 22.4 in rural population. Despite these features, the magnitude and epidemiological characteristics of this disease have been rarely studied in Saudi Arabia. To fill this gap, we conducted a survey in Abha to study the KAP of hypertension. KAP study shows what people know about certain things, their feelings and behavior towards the disease management. An improvement in the Knowledge and Attitudes towards disease management can reform the kinds of practices which are followed. Objectives: To assess the level of Knowledge, Attitude and Practice of patients who suffer from Hypertension. To improve the Quality of life of patients. Methods: A prospective cross-sectional survey was conducted on a sample size of 130 Hypertensive patients of both the genders enrolled by simple random sampling technique admitted in the Aseer Central Hospital of Abha during the period from October 2016 to December 2016. Results: Altogether 130 hypertensive patients were enrolled in this study with equal no. of Males and Females. Most of the respondents were aged between 18-40 years (45%). On assessing the KAP of the patients, we found that the Knowledge and Attitude score was good but the Practice scores were moderate in both the genders. Conclusion: Our study concludes that a significant proportion of hypertensive patients show less Practice towards the disease management which can lead to severe complications in time being and also result in damage of other vital organs. So there is a need of intense educational intervention for the patients which can be done by Patient counselling by the clinical pharmacist. Strategies to modify lifestyle which help in control of hypertension can include providing leaflets as well as direct educational programs.

Keywords: Attitude, hypertension, Knowledge, practices

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Authors: Elida Tafupenji Kamanga

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Cancer of the cervix remains one of the high causes of death among Malawian women. Despite the government introduction of free screening services throughout the country, patronage still remains low and lack of knowledge high. Given the critical role mass media plays in relaying different information to the public including health and its influence on health behaviours, the study sought to analyse Malawi media coverage of the disease and its effectiveness. The findings of the study will help inform media advocacy directed at changing any coverage impeding the effective dissemination of cervical cancer message which consequently will help increase awareness and accessing of screening behaviours among women. A content analysis of 29 newspapers and promotional messages on cervical from a local radio station was conducted for the period from 2012 to 2015. Overall the results showed media coverage in terms of content and frequency increased for the four-year period. However, of concern was the quality of information both media presented to the public. The lapse in information provided means there is little education taking place through the media which could be contributing to the knowledge gap the women have thereby affecting their decision to screen. Also lack of adequate funding to media institutions and lack of collaboration between media institutions and stakeholders involved in the fight against the disease were noted as other contributing factors to low coverage of the disease. Designing messages that are not only informative and educative but also innovative may help increase awareness; improve the knowledge gap and potential adoption of preventive screening behaviour by Malawian women. Conversely, good communication between the media institutions and researchers involved in the fight against the disease through the channelling of new findings back to the public as well as increasing funding towards similar cause should be considered.

Keywords: cervical cancer, effectiveness, media coverage, screening

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Authors: Taiebe Shokri, Shahram Yazdani, Leila Afshar, Soleiman Ahmadi

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Introduction: The importance of professionalism in higher education not only determines the appropriate and inappropriate behaviors and guides faculty members in the implementation of professional responsibilities, but also guarantees faculty members' adherence to professional principles and values, ensures the quality of teaching and facilitator will be the teaching-learning process in universities and will increase the commitment to meet the needs of students as well as the development of an ethical culture based on ethics. Therefore, considering the important role of medical education teachers to prepare teachers and students in the future, the need to determine the concept of professional teacher and teacher, and the characteristics of teacher professionalism, we have explained the concept of professionalism in teachers in this study. Methods: The concept analysis method used in this study was Walker and Avant method which has eight steps. Walker and Avant state the purpose of concept analysis as follows: The process of distinguishing between the defining features of a concept and its unrelated features. The process of concept analysis includes selecting a concept, determining the purpose of the analysis, identifying the uses of the concept, determining the defining features of the concept, identifying a model, identifying boundary and adversarial items, identifying the precedents and consequences of the concept, and defining empirical references. is. Results: Professionalism in its general sense, requires deep knowledge, insight, creating a healthy and safe environment, honesty and trust, impartiality, commitment to the profession and continuous improvement, punctuality, criticism, professional competence, responsibility, and Individual accountability, especially in social interactions, is an effort for continuous improvement, the acquisition of these characteristics is not easily possible and requires education, especially continuous learning. Professionalism is a set of values, behaviors, and relationships that underpin public trust in teachers.

Keywords: concept analysis, medical education, professionalism, faculty members

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Authors: Alec Chabwinja, Cannan Tawonezvi, Jerneja Vidmar, Constance Chingwaru, Walter Chingwaru

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Objective: To evaluate the potential of commercial fermented / probiotic products available in Zimbabwe or internationally, and strains of Lactobacillus plantarum (L. plantarum) as prophylaxis and therapy against diarrhoeal and sexually transmitted infections. Methods: The antimicrobial potential of cultures of lactobacilli enriched from 4 Zimbabwean commercial food/beverage products, namely Dairibord Lacto sour milk (DLSM), Probrand sour milk (PSM), Kefalos Vuka cheese (KVC) and Chibuku opaque beer (COB); three probiotic products obtainable in Europe and internationally; and four strains of L. plantarum obtained from Balkan traditional cheeses and Zimbabwean foods against clinical strains of Escherichia coli (E. coli) and non-clinical strains of Candida albicans and Rhodotorula spp. was assayed using the well diffusion method. Three commercial Agar diffusion assay and a competitive exclusion assay were carried out on Mueller-Hinton agar. Results: Crude cultures of putative lactobacillus strains obtained from Zimbabwean dairy products (Probrand sour milk, Kefalos Vuka vuka cheese and Chibuku opaque beer) exhibited significantly greater antimicrobial activities against clinical strains of E. coli than strains of L. plantarum isolated from Balkan cheeses (CLP1, CLP2 or CLP3) or crude microbial cultures from commercial paediatric probiotic products (BG, PJ and PL) of a culture of Lactobacillus rhamnosus LGG (p < 0.05). Furthermore, the following has high antifungal activities against the two yeasts: supernatant-free microbial pellet (SFMP) from an extract of M. azedarach leaves (27mm ± 2.5) > cell-free culture supernatants (CFCS) from Maaz Dairy sour milk and Mnandi sour milk (approximately 26mm ± 1.8) > CFCS and SFMP from Amansi hodzeko (25mm ± 1.5) > CFCS from Parinari curatellifolia fruit (24mm ± 1.5), SFMP from P. curatellifolia fruit (24mm ± 1.4) and SFMP from mahewu (20mm ± 1.5). These cultures also showed high tolerance to acidic conditions (~pH4). Conclusions: The putative lactobacilli from four commercial Zimbabwean dairy products (Probrand sour milk, Kefalos Vuka vuka cheese and Chibuku opaque beer), and three strains of L. plantarum from Balkan cheeses (CLP1, CLP2 or CLP3) exhibited high antibacterial activities, while Maaz Dairy sour-, Mnandi sour- and Amansi hodzeko milk products had high antifungal activities. Our selection of Zimbabwean probiotic products has potential for further development into probiotic products for use in the control diarrhea caused by pathogenic strains of E. coli or yeast infections. Studies to characterise the probiotic potential of the live cultures in the products are underway.

Keywords: lactic acid bacteria, Staphylococcus aureus, Streptococcus spp, yeast, inhibition, acid tolerance

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Authors: B. Adini, M. Oren

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Introduction: Communicable diseases and pandemics pose a growing threat to the well-being of the global population. A vital component of protecting the public health is the creation and sustenance of a continuous preparedness for such hazards. A joint Israeli-German task force was deployed in order to develop an advanced tool for self-evaluation of emergency preparedness for variable types of biological threats. Methods: Based on a comprehensive literature review and interviews with leading content experts, an evaluation tool was developed based on quantitative and qualitative parameters and indicators. A modified Delphi process was used to achieve consensus among over 225 experts from both Germany and Israel concerning items to be included in the evaluation tool. Validity and applicability of the tool for medical institutions was examined in a series of simulation and field exercises. Results: Over 115 German and Israeli experts reviewed and examined the proposed parameters as part of the modified Delphi cycles. A consensus of over 75% of experts was attained for 183 out of 188 items. The relative importance of each parameter was rated as part of the Delphi process, in order to define its impact on the overall emergency preparedness. The parameters were integrated in computerized web-based software that enables to calculate scores of emergency preparedness for biological events. Conclusions: The parameters developed in the joint German-Israeli project serve as benchmarks that delineate actions to be implemented in order to create and maintain an ongoing preparedness for biological events. The computerized evaluation tool enables to continuously monitor the level of readiness and thus strengths and gaps can be identified and corrected appropriately. Adoption of such a tool is recommended as an integral component of quality assurance of public health and safety.

Keywords: biological events, emergency preparedness, bioterrorism, natural biological events

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Authors: Souvik Phadikar, Nidul Sinha, Rajdeep Ghosh

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In brainwaves research using electroencephalogram (EEG) signals, finding the most relevant and effective feature set for identification of activities in the human brain is a big challenge till today because of the random nature of the signals. The feature extraction method is a key issue to solve this problem. Finding those features that prove to give distinctive pictures for different activities and similar for the same activities is very difficult, especially for the number of activities. The performance of a classifier accuracy depends on this quality of feature set. Further, more number of features result in high computational complexity and less number of features compromise with the lower performance. In this paper, a novel idea of the selection of optimal feature set using a heuristically optimized deep autoencoder is presented. Using various feature extraction methods, a vast number of features are extracted from the EEG signals and fed to the autoencoder deep neural network. The autoencoder encodes the input features into a small set of codes. To avoid the gradient vanish problem and normalization of the dataset, a meta-heuristic search algorithm is used to minimize the mean square error (MSE) between encoder input and decoder output. To reduce the feature set into a smaller one, 4 hidden layers are considered in the autoencoder network; hence it is called Heuristically Optimized Deep Autoencoder (HO-DAE). In this method, no features are rejected; all the features are combined into the response of responses of the hidden layer. The results reveal that higher accuracy can be achieved using optimal reduced features. The proposed HO-DAE is also compared with the regular autoencoder to test the performance of both. The performance of the proposed method is validated and compared with the other two methods recently reported in the literature, which reveals that the proposed method is far better than the other two methods in terms of classification accuracy.

Keywords: autoencoder, brainwave signal analysis, electroencephalogram, feature extraction, feature selection, optimization

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Authors: Hussein Bizimana, Osman Sönmez

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Constructed wetlands are current the most widely recognized waste water treatment option, especially in developing countries where they have the potential for improving water quality and creating valuable wildlife habitat in ecosystem with treatment requirement relatively simple for operation and maintenance cost. Lack of grey waste water treatment facilities in Kigali İnstitute of Science and Technology in Rwanda, causes pollution in the surrounding localities of Rugunga sector, where already a problem of poor sanitation is found. In order to treat grey water produced at Kigali İnstitute of Science and Technology, with high BOD concentration, high nutrients concentration and high alkalinity; a Horizontal Sub-surface Flow pilot-scale constructed wetland was designed and can operate in Kigali İnstitute of Science and Technology. The study was carried out in a sedimentation tank of 5.5 m x 1.42 m x 1.2 m deep and a Horizontal Sub-surface constructed wetland of 4.5 m x 2.5 m x 1.42 m deep. The grey waste water flow rate of 2.5 m3/d flew through vegetated wetland and sandy pilot plant. The filter media consisted of 0.6 to 2 mm of coarse sand, 0.00003472 m/s of hydraulic conductivity and cattails (Typha latifolia spp) were used as plants species. The effluent flow rate of the plant is designed to be 1.5 m3/ day and the retention time will be 24 hrs. 72% to 79% of BOD, COD, and TSS removals are estimated to be achieved, while the nutrients (Nitrogen and Phosphate) removal is estimated to be in the range of 34% to 53%. Every effluent characteristic will meet exactly the Rwanda Utility Regulatory Agency guidelines primarily because the retention time allowed is enough to make the reduction of contaminants within effluent raw waste water. Treated water reuse system was developed where water will be used in the campus irrigation system again.

Keywords: constructed wetlands, hydraulic conductivity, grey waste water, cattails

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Authors: Odaleia de O. Farias, Suzelene C. Marinho, Ecleidson B. Fragoso, Daniel S. Lima, Francisco R. S. Lira, Lara S. Araújo, Gabriel dos S. D. Soares

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In populous cities, prehospital care services that use vehicles alternative to ambulances are needed in order to reduce costs and improve response time to occurrences in areas with large concentration of people, such as leisure and tourism spaces. In this context, it was implanted a program called BIKE VIDA, that is innovative quick access and assistance program. The aim of this study is to describe the implantation and initial profile of occurrences performed by an urgency/emergency pre-hospital care service through paramedics on bicycles. It is a cross-sectional, descriptive study carried out in the city of Fortaleza, Ceara, Brazil. The data included service records from July to August 2017. Ethical aspects were respected. The service covers a perimeter of 4.5 km, divided into three areas with perimeter of 1.5 km for each paramedic, attending from 5 am to 9 pm. Materials transported by bicycles include External Automated Defibrillator - DEA, portable oxygen, oximeter, cervical collar, stethoscope, sphygmomanometer, dressing and immobilization materials and personal protective equipment. Occurrences are requested directly by calling the emergency number 192 or through direct approach to the professional. In the first month of the program, there were 93 emergencies/urgencies, mainly in the daytime period (71,0%), in males (59,7%), in the age range of 26 to 45 years (46,2%). The main nature was traumatic incidents (53.3%). Most of the cases (88,2%) did not require ambulance transport to the hospital, and there were two deaths. Pre-hospital service through bicycles is an innovative strategy in Brazil and has shown to be promising in terms of reducing costs and improving the quality of the services offered.

Keywords: emergency, response time, prehospital care, urgency

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Authors: Sujosh Nandi, Proshanta Guha

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Synthetic plastics are preferred for food packaging due to high strength, stretch-ability, good water vapor and gas barrier properties, transparency and low cost. However, environmental pollution generated by these synthetic plastics is a major concern of modern human civilization. Therefore, use of biodegradable polymers as a substitute for synthetic non-biodegradable polymers are encouraged to be used even after considering drawbacks related to mechanical and barrier properties of the films. Starch is considered one of the potential raw material for the biodegradable polymer, encounters poor water barrier property and mechanical properties due to its hydrophilic nature. That apart, recrystallization of starch molecules occurs during aging which decreases flexibility and increases elastic modulus of the film. The recrystallization process can be minimized by blending of other hydrocolloids having similar structural compatibility, into the starch matrix. Therefore, incorporation of guar gum having a similar structural backbone, into the starch matrix can introduce a potential film into the realm of biodegradable polymer. However, hydrophilic nature of both starch and guar gum, water barrier property of the film is low. One of the prospective solution to enhance this could be modification of the potato starch/guar gum (PSGG) composite film using cross-linker. Over the years, several cross-linking agents such as phosphorus oxychloride, sodium trimetaphosphate, etc. have been used to improve water vapor permeability (WVP) of the films. However, these chemical cross-linking agents are toxic, expensive and take longer time to degrade. Therefore, naturally available carboxylic acid (tartaric acid, malonic acid, succinic acid, etc.) had been used as a cross-linker and found that water barrier property enhanced substantially. As per our knowledge, no works have been reported with tartaric acid and succinic acid as a cross-linking agent blended with the PSGG films. Therefore, the objective of the present study was to examine the changes in water vapor barrier property and mechanical properties of the PSGG films after cross-linked with tartaric acid (TA) and succinic acid (SA). The cross-linkers were blended with PSGG film-forming solution at four different concentrations (4, 8, 12 & 16%) and cast on teflon plate at 37°C for 20 h. From the fourier-transform infrared spectroscopy (FTIR) study of the developed films, a band at 1720cm-1 was observed which is attributed to the formation of ester group in the developed films. On the other hand, it was observed that tensile strength (TS) of the cross-linked film decreased compared to non-cross linked films, whereas strain at break increased by several folds. Moreover, the results depicted that tensile strength diminished with increasing the concentration of TA or SA and lowest TS (1.62 MPa) was observed for 16% SA. That apart, maximum strain at break was also observed for TA at 16% and the reason behind this could be a lesser degree of crystallinity of the TA cross-linked films compared to SA. However, water vapor permeability of succinic acid cross-linked film was reduced significantly, but it was enhanced significantly by addition of tartaric acid.

Keywords: cross linking agent, guar gum, organic acids, potato starch

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Authors: Dukali Abujnah

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This study was undertaken to knowledge the chemical composition of some farm animals (cows ) by using ultrasonic milk analyzer. This method was used first time in our country in the field of milk hygiene to determine and comparison the composition percent of raw milk for farm animals as attempt to protect the health of consumers 240 raw milk samples for each species of animals included in this study for two different season of year first (Novembe 2014 - January 2015) , second from (May – Novembe2015) .The chemical analysis. In this way, a range of building suitable to put in the Libyan market product structures, and milk, for use as a new product or exposure to treatment such as pasteurized milk and long-life may be wider study project..Controls have been implemented in operating in Libya, companies which are part of the business created by the Libyan state. It was created only after the companies that made many of the studies and research carried out on areas of Libya which it was possible to intervene. Although troops spent in recent years, companies have not yet found their balance and milk production has not yet come to those set forth in the action plans, due to problems of various types that will be discussed in this study. We believe that these data have been taken in four years if analyzed properly, can provide more accurate information to farmers in their companies want to take dairy cattle breeding. The total bacterial count was 76 and 38 cfu/ml for locally produced and imported UHT milk respectively. Coliforms were negative for all examined locally produce and imported samples. E. coli were not isolated from any of the examined UHT samples. Aerobic spore-formers count mean count was 49 and 27 cfu/ml for both examined samples respectively. Obtained results show that most of the locally produced UHT milk does not satisfy the suggested Libyan Standards for UHT milk for fat% as well as total bacterial count/ml. Economical and public health importance of the obtained results were discussed, and control measures for improving the quality of UHT locally made milk were also discussed.

Keywords: locally, UHT milks, farms animals, raw milk analysis milk

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Authors: Jaime Pizarro, Ximena Castillo

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The intensive use of water in agriculture, industry, human consumption and increasing pollution are factors that reduce the availability of water for future generations; the challenge is to advance in sustainable and low-cost solutions to reuse water and to facilitate the availability of the resource in quality and quantity. The use of new low-cost materials with sorbent capacity for pollutants is a solution that contributes to the improvement and expansion of water treatment and reuse systems. Fly ash, a residue from the combustion of coal in power plants that is produced in large quantities in newly industrialized countries, contains a high amount of silicon oxides and aluminum oxides, whose properties can be used for the synthesis of mesoporous materials. Properly functionalized, this material allows obtaining matrixes with high sorption capacity. The mesoporous materials have a large surface area, thermal and mechanical stability, uniform porous structure, and high sorption and functionalization capacities. The goal of this study was to develop hexagonal mesoporous siliceous material (HMS) for the adsorption of sulphate from industrial and mining waters. The silica was extracted from fly ash after calcination at 850 ° C, followed by the addition of water. The mesoporous structure has a surface area of 282 m2 g-1 and a size of 5.7 nm and was functionalized with ethylene diamine through of a self-assembly method. The material was characterized by Diffuse Reflectance Infrared Fourier Transform Spectroscopy (DRIFTS). The capacity of sulphate sorption was evaluated according to pH, maximum load capacity and contact time. The sulphate maximum adsorption capacity was 146.1 mg g-1, which is three times higher than commercial sorbents. The kinetic data were fitted according to a pseudo-second order model with a high coefficient of linear regression at different initial concentrations. The adsorption isotherm that best fitted the experimental data was the Freundlich model.

Keywords: fly ash, mesoporous siliceous, sorption, sulphate

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Authors: Ali̇ Bayram, Semih Dalkilic, Remzi Yigiter

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N-methyl-D-aspartate (NMDA) receptor is a subtype of glutamate receptor and plays a pivotal role in learning, memory, neuronal plasticity, neurotoxicity and synaptic mechanisms. Animal experiments were suggested that glutamate-induced excitotoxic injuriy and NMDA receptor blockage lead to amnesia and other neurodegenerative diseases including Alzheimer’s disease (AD), Huntington’s disease, amyotrophic lateral sclerosis. Aim of this study is to investigate association between NMDA receptor coding gene GRIN2B expression level and Alzheimer disease. The study was approved by the local ethics committees, and it was conducted according to the principles of the Declaration of Helsinki and guidelines for the Good Clinical Practice. Peripheral blood was collected 50 patients who diagnosed AD and 49 healthy control individuals. Total RNA was isolated with RNeasy midi kit (Qiagen) according to manufacturer’s instructions. After checked RNA quality and quantity with spectrophotometer, GRIN2B expression levels were detected by quantitative real time PCR (QRT-PCR). Statistical analyses were performed, variance between two groups were compared with Mann Whitney U test in GraphpadInstat algorithm with 95 % confidence interval and p < 0.05. After statistical analyses, we have determined that GRIN2B expression levels were down regulated in AD patients group with respect to control group. But expression level of this gene in each group was showed high variability. İn this study, we have determined that NMDA receptor coding gene GRIN2B expression level was down regulated in AD patients when compared with healthy control individuals. According to our results, we have speculated that GRIN2B expression level was associated with AD. But it is necessary to validate these results with bigger sample size.

Keywords: Alzheimer’s disease, N-methyl-d-aspartate receptor, NR2B, GRIN2B, mRNA expression, RT-PCR

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Authors: Adnan I. O. Zaid

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Zinc aluminum alloys are versatile materials which are widely used in manufacturing several parts in the automobile and aircraft industries. The effect of grain refinement of these alloys by rare earth elements on their mechanical characteristics is scarce. The equal channel angular pressing is relatively recent method for producing severe plastic deformation in materials subjected to it resulting in refinement of their structure and enhancement of their mechanical characteristics. The phase diagram of these alloys indicates that large dendrites of large grain size can be formed during their solidification of the cast which tends to deteriorate their mechanical strength and surface quality. To overcome this problem they are normally grain refined by either titanium or titanium + boron to their melt prior to solidification. In this paper, comparison between the effect of adding either titanium, (Ti), titanium+boron, (Ti+B), or Molybdenum, Mo, to zinc-aluminum22, alloy, (ZA22) on its metallurgical and mechanical characteristics in the cast condition and after pressing by the ECAP process is investigated. It was found that addition of either Ti, Ti+B, or Mo to the ZA22 alloy in the cast condition resulted in refining of their structure being more refined by the addition of Mo, then .Ti+B and less refining by Ti addition. Furthermore, the ECAP process resulted in further refinement of the alloy micro structure except in case of Ti+B addition where poisoning i.e. coarsening of the grains has occurred. Regarding the addition of these element on the mechanical behavior; it was found that addition of Ti Or Ti+B resulted in little enhancement of the alloy strength factor and its flow stress at 20% true strain; whereas, the addition of resulted in deteriorating of its mechanical behavior as % decrease in the strength factor and % in its flow stress of 20%. As for the strain hardening index; addition of any of these elements resulted in decreasing the strain hardening index.

Keywords: addition, grain refinement, mechanical characteristics, microstructure, rare earth elements, ZA-22, Zinc- aluminum alloy

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Authors: Ziyad S. Haidar

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

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

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Authors: Azadeh Yasari, Michael Ganzle, Stephen Strelkov, Nuanyi Liang, Jonathan Curtis, Nat N. V. Kav

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Pathogenic fungi cause significant yield losses and quality reductions to major crops including wheat, canola, and barley. Toxic metabolites produced by phytopathogenic fungi also pose significant risks to animal and human health. Extensive application of synthetic fungicides is not a sustainable solution since it poses risks to human, animal and environmental health. Unsaturated fatty acids may provide an environmentally friendly alternative because of their direct antifungal activity against phytopathogens as well as through the stimulation of plant defense pathways. The present study assessed the in vitro and in vivo efficacy of two hydroxy fatty acids, coriolic acid and ricinoleic acid, against the phytopathogens Fusarium graminearum, Pyrenophora tritici-repentis, Pyrenophora teres f. teres, Sclerotinia sclerotiorum, and Leptosphaeria maculans. Antifungal activity of coriolic acid and ricinoleic acid was evaluated using broth micro-dilution method to determine the minimum inhibitory concentration (MIC). Results indicated that both ricinoleic acid and coriolic acid showed antifungal activity against phytopathogens, with the strongest inhibitory activity against L. maculans, but the MIC varied greatly between species. An antifungal effect was observed for coriolic acid in vivo against pathogenic fungi of wheat and barley. This effect was not correlated to the in vitro activity because ricinoleic acid with equivalent in vitro antifungal activity showed no protective effect in vivo. Moreover, neither coriolic acid nor ricinoleic acid controlled fungal pathogens of canola. In conclusion, coriolic acid inhibits some phytopathogens in vivo and may have the potential to be an effective crop protection agent.

Keywords: coriolic acid, minimum inhibitory concentration, pathogenic fungi, ricinoleic acid

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Authors: Luc de Brabandere

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Searchers in various disciplines have long tried to understand how a human being thinks. Most of them seem to agree that the brain works in two very different modes. For us, the first phase of thought imagines, diverges, and unlocks the field of possibilities. The second phase, judges converge and choose. But if we were to stop there, that would give the impression that thought is essentially an individual effort that seldom depends on context. This is, however, not the case. Whether we be a champion in creativity, so primarily in induction, or a master in logic where we are confronted with reality, the ideas we layout are indeed destined to be presented to third parties. They should therefore be exposed, defended, communicated, negotiated, or even sold. Regardless of the quality of the concepts we craft (creative thinking) and the interferences we build (logical thinking) we will take one day, or another, be confronted by people whose beliefs, opinions and ideas differ from ours (critical thinking). Logic and critique: The shared characteristics of logical and critical thoughts include a three-level structure of reasoning invented by the Greeks. For the first time in history, Aristotle tried to model thought deployable in three stages: the concept, the statement, and the reasoning. The three levels can be assessed according to different criteria. A concept is more or less useful, a statement is true or false, and reasoning is right or wrong. This three-level structure allows us to differentiate logic and critique, where the intention and words used are not the same. Logic only deals with the structure of reasoning and exhausts the problem. It regards premises as acquired and excludes the debate. Logic is in all certainty and pursues the truth. Critique is most probably searching for the plausible. Logic and creativity: Many known models present the brain as a two-stroke engine (divergence vs convergence, fast vs. slow, left-brain vs right-brain, Yin vs Yang, etc.). But that’s not the only thing. “Why didn’t we think of that before?” How often have we heard that sentence? A creative idea is the outcome of logic, but you can only understand it afterward! Through the use of exercises, we will witness how logic and creativity work together. A third theme is hidden behind the two main themes of the conference: logical thought, which the author can shed some light on.

Keywords: creativity, logic, critique, digital

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Authors: Marine Hascoet, Valentina Giaconi, Ludivine Jamain

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The aim of our study is to examine if the family socio-economic status (SES) has an influence on students’ academic achievement. We first make the hypothesis that the more their families have financial and social resources, the more students succeed at school. We second make the hypothesis that this family SES has also an impact on parents’ expectations about their children educational outcomes. Moreover, we want to study if that parents’ expectations play the role of mediator between parents’ socio-economic status and the student’ self-concept and academic outcome. We test this model with a longitudinal design thanks to the census-based assessment from the System of Measurement of the Quality of Education (SIMCE). The SIMCE tests aim to assess all the students attending to regular education in a defined level. The sample used in this study came from the SIMCE assessments done three times: in 4th, 8th and 11th grade during the years 2007, 2011 and 2014 respectively. It includes 156.619 students (75.084 boys and 81.535 girls) that had valid responses for the three years. The family socio-economic status was measured at the first assessment (in 4th grade). The parents’ educational expectations and the students’ self-concept were measured at the second assessment (in 8th grade). The achievement score was measured twice; once when children were in 4th grade and a second time when they were in 11th grade. To test our hypothesis, we have defined a structural equation model. We found that our model fit well the data (CFI = 0.96, TLI = 0.95, RMSEA = 0.05, SRMR = 0.05). Both family SES and prior achievements predict parents’ educational expectations and effect of SES is important in comparison to the other coefficients. These expectations predict students’ achievement three years later (with prior achievement controlled) but not their self-concept. Our model explains 51.9% of the achievement in the 11th grade. Our results confirm the importance of the parents’ expectations and the significant role of socio-economic status in students’ academic achievement in Chile.

Keywords: Chilean context, parent’s expectations, school achievement, self-concept, socio-economic status

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Authors: Gheorghiţa Mitran, Adriana Urdă, Mihaela Florea, Octavian Dumitru Pavel, Florentina Neaţu

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Oxidative dehydrogenation and hydrogenation reactions of L-malic acid are interesting ways for its transformation into valuable products, including oxaloacetic, pyruvic and malonic acids but also 1,4-butanediol and 1,2,4-butanetriol. Keto acids have a range of applicationsin many chemical syntheses as pharmaceuticals, food additives and cosmetics. 3-Hydroxybutyrolactone and 1,2,4-butanetriol are used for the synthesis of chiral pharmaceuticals and other fine chemicals, while 1,4-butanediol can be used for organic syntheses, such as polybutylene succinate (PBS), polybutylene terephthalate (PBT), and for production of tetrahydrofuran (THF). L-malic acid is a non-toxic and natural organic acid present in fruits, and it is the main component of wine alongside tartaric acid representing about 90% of the wine total acidity. Iron oxides dopped with cobalt (CoxFe3-xO4; x= 0; 0.05; 0.1; 0.15) were studied as catalysts in these reactions. There is no mention in the literature of non-noble transition metal catalysts for these reactions. The method used for catalysts preparation was coprecipitation, whileBET XRD, XPS, FTIR and UV-VIS spectroscopy were used for the physicochemical properties evaluation.TheXRD patterns revealed the presence of α-Fe2O3 rhombohedral hematite structure, with cobalt atoms well dispersed and embedded in this structure. The studied samples are highly crystalline, with a crystallite size ranged from 58 to 65 nm. The optical absorption properties were investigated using UV-Vis spectroscopy, emphasizing the presence of bands that correspond with the reported hematite nanoparticle. Likewise, the presence of bands corresponding to lattice vibration of hexagonal hematite structurehas been evidenced in DRIFT spectra. Oxidative dehydrogenation of malic acid was studied using as solvents for malic acid ethanol or water(2, 5 and 10% malic acid in 5 mL solvent)at room temperature, while the hydrogenation reaction was evaluated in water as solvent (5%), in the presence of 1% catalyst. The oxidation of malic acid into oxaloacetic acid is the first step, after that, oxaloacetic acid is rapidly decarboxylated to malonic acid or pyruvic acid, depending on the active site. The concentration of malic acid in solution, it, in turn, has an influence on conversionthis decreases when the concentration of malic acid in the solution is high. The spent catalysts after the oxidative dehydrogenation of malic acid in ethanol were characterized by DRIFT spectroscopy and the presence of oxaloacetic, pyruvic and malonicacids, along with unreacted malic acidwere observed on the surface. The increase of the ratio of Co/Fe on the surface has an influence on the malic acid conversion and on the pyruvic acid yield, while the yield of malonic acid is influenced by the percentage of iron on the surface (determined from XPS). Oxaloacetic acid yield reaches a maximumat one hour of reaction, being higher when ethanol is used as a solvent, after which it suddenly decreases. The hydrogenation of malic acid occurs by consecutive reactions with the production of 3-hydroxy-butyrolactone, 1,2,4-butanetriol and 1,4-butanediol. Malic acid conversion increases with cobalt loading increasing up to Co/Fe ratio of 0.1, after which it has a slight decrease, while the yield in 1,4-butanediol is directly proportional to the cobalt content.

Keywords: malic acid, oxidative dehydrogenation, hydrogenation, oxaloacetic acid

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Authors: Maria I. Nuñez-Hernández, Maria L. Riesco

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Background: Exclusive breastfeeding (EBF) up to 6 months old infant have been considered one of the most important factors in the overall development of children. Nevertheless, as resources are scarce, it is essential to identify the most vulnerable groups that have major risk of EBF abandonment, in order to deliver the best strategies. Children of adolescent mothers are within these groups. Aims: To determine the EBF abandonment rate among adolescent mothers and to analyze the associated factors. Methods: Prospective cohort study of adolescent mothers in the southern area of Santiago, Chile, conducted in primary care services of public health system. The cohort was established from 2014 to 2015, with a sample of 105 adolescent mothers and their children at 2 months of life. The inclusion criteria were: adolescent mother from 14 to 19 years old; not twin babies; mother and baby leaving the hospital together after birthchild; correct attachment of the baby to the breast; no difficulty understanding the Spanish language or communicating. Follow-up was performed at 4 and 6 months old infant. Data were collected by interviews, considering EBF as breastfeeding only, without adding other milk, tea, juice, water or other product that not breast milk, except drugs. Data were analyzed by descriptive and inferential statistics, by Kaplan-Meier estimator and Log-Rank test, admitting the probability of occurrence of type I error of 5% (p-value = 0.05). Results: The cumulative EBF abandonment rate at 2, 4 and 6 months was 33.3%, 52.2% and 63.8%, respectively. Factors associated with EBF abandonment were maternal perception of the quality of milk as poor (p < 0.001), maternal perception that the child was not satisfied after breastfeeding (p < 0.001), use of pacifier (p < 0.001), maternal consumption of illicit drugs after delivery (p < 0.001), mother return to school (p = 0.040) and presence of nipple trauma (p = 0.045). Conclusion: EBF abandonment rate was higher in the first 4 months of life and is superior to the population of women who breastfeed. Among the EBF abandonment factors, one of them is related to the adolescent condition, and two are related to the maternal subjective perception.

Keywords: adolescent, breastfeeding, midwifery, nursing

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Authors: Charirat Kusonwiriyawong, Supha Photichan, Wannarut Chutibutr

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Soil test kits for rapid analysis of the organic matter, available phosphorus and exchangeable potassium were developed to drive a low-cost field testing kit to farmers. The objective was to provide a decision tool for improving soil fertility. One aspect of soil test kit development was ease of use which is a time requirement for completing organic matter, available phosphorus and exchangeable potassium test in one soil sample. This testing kit required only two extractions and utilized no filtration consuming approximately 15 minutes per sample. Organic matter was principally created by oxidizing carbon KMnO₄ using the standard color chart. In addition, modified single extractant (Mehlich I) was applied to extract available phosphorus and exchangeable potassium. Molybdenum blue method and turbidimetric method using standard color chart were adapted to analyze available phosphorus and exchangeable potassium, respectively. Modified single extractant using in soil test kits were highly significant matching with analytical laboratory results (r=0.959** and 0.945** for available phosphorus and exchangeable potassium, respectively). Linear regressions were statistically calculated between modified single extractant and standard laboratory analysis (y=0.9581x-12.973 for available phosphorus and y=0.5372x+15.283 for exchangeable potassium, respectively). These equations were calibrated to formulate a fertilizer rate recommendation for specific corps. To validate quality, soil test kits were distributed to farmers and extension workers. We found that the accuracy of soil test kits were 71.0%, 63.9% and 65.5% for organic matter, available phosphorus, and exchangeable potassium, respectively. The quantitative survey was also conducted in order to assess their satisfaction with soil test kits. The survey showed that more than 85% of respondents said these testing kits were more convenient, economical and reliable than the other commercial soil test kits. Based upon the finding of this study, soil test kits can be another alternative for providing soil analysis and fertility recommendations when a soil testing laboratory is not available.

Keywords: available phosphorus, exchangeable potassium, modified single extractant, organic matter, soil test kits

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Authors: Nejla Fourati, Zied Fessi, Fatma Dhouib, Wicem Siala, Leila Farhat, Afef Khanfir, Wafa Mnejja, Jamel Daoud

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Purpose: Radiation induced hypothyroidism in nasopharyngeal cancer (NPC) ranged from 15% to 55%. In reported data, it is considered as a common late complication of definitive radiation and is mainly observed 2 years after the end of treatment. The aim of this study was to evaluate the incidence of early hypothyroidism within 6 months after radiotherapy. Patients and methods: From June 2017 to February 2020, 35 patients treated with concurrent chemo-radiotherapy (CCR) for NPC were included in this prospective study. Median age was 49 years [23-68] with a sex ratio of 2.88. All patients received intensity modulated radiotherapy (IMRT) at a dose of 69.96 Gy in 33 daily fractions with weekly cisplatin (40mg/m²) chemotherapy. Thyroid stimulating hormone (TSH) and Free Thyroxine 4 (FT4) dosage was performed before the start of radiotherapy and 6 months after. Different dosimetric parameters for the thyroid gland were reported: the volume (cc); the mean dose (Dmean) and the %age of volume receiving more than 45 Gy (V45Gy). Wilcoxon Test was used to compare these different parameters between patients with or without hypothyroidism. Results: At baseline, 5 patients (14.3%) had hypothyroidism and were excluded from the analysis. For the remaining 30 patients, 9 patients (30%) developed a hypothyroidism 6 months after the end of radiotherapy. The median thyroid volume was 10.3 cc [4.6-23]. The median Dmean and V45Gy were 48.3 Gy [43.15-55.4] and 74.8 [38.2-97.9] respectively. No significant difference was noted for all studied parameters. Conclusion: Early hypothyroidism occurring within 6 months after CCR for NPC seems to be a common complication (30%) that should be screened. Good patient monitoring with regular dosage of TSH and FT4 makes it possible to treat hypothyroidism in asymptomatic phase. This would be correlated with an improvement in the quality of life of these patients. The results of our study do not show a correlation between the thyroid doses and the occurrence of hypothyroidism. This is probably related to the high doses received by the thyroid in our series. These findings encourage more optimization to limit thyroid doses and then the risk of radiation-induced hypothyroidism

Keywords: nasopharyngeal carcinoma, hypothyroidism, early complication, thyroid dose

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Authors: Anne Heirman, Vincent van der Noort, Rob van Son, Marije Petersen, Lisette van der Molen, Gyorgy Halmos, Richard Dirven, Michiel van den Brekel

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Objective: Voice prosthesis leakage significantly impacts laryngectomies patients' quality of life, causing insecurity and frequent unplanned hospital visits and costs. In this study, the concept of prophylactic voice prosthesis replacement was explored to prevent leakages. Study Design: A retrospective cohort study. Setting: Tertiary hospital. Methods: Device lifetimes and voice prosthesis replacements of a retrospective cohort, including all patients with laryngectomies between 2000 and 2012 in the Netherlands Cancer Institute, were used to calculate the number of needed voice prostheses per patient per year when preventing 70% of the leakages by prophylactic replacement. Various strategies for the timing of prophylactic replacement were considered: Adaptive strategies based on the individual patient’s history of replacement and fixed strategies based on the results of patients with similar voice prosthesis or treatment characteristics. Results: Patients used a median of 3.4 voice prostheses per year (range 0.1-48.1). We found a high inter-and intrapatient variability in device lifetime. When applying prophylactic replacement, this would become a median of 9.4 voice prostheses per year, which means replacement every 38 days, implying more than six additional voice prostheses per patient per year. The individual adaptive model showed that preventing 70% of the leakages was impossible for most patients, and only a median of 25% can be prevented. Monte-Carlo simulations showed that prophylactic replacement is not feasible due to the high Coefficient of Variation (Standard Deviation/Mean) in device lifetime. Conclusion: Based on our simulations, prophylactic replacement of voice prostheses is not feasible due to high inter-and intrapatient variation in device lifetime.

Keywords: voice prosthesis, voice rehabilitation, total laryngectomy, prosthetic leakage, device lifetime

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Authors: Monika Patel, Kazuaki Matsumura

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Synthetic hydrogels, with their unique properties such as porosity, strength, and swelling in aqueous environment, are being used in many fields from food additives to regenerative medicines, from diagnostic and pharmaceuticals to drug delivery systems (DDS). But, hydrogels also have some limitations in terms of homogeneity of drug distribution and quantity of loaded drugs. As an alternate, polymeric micelles are extensively used as DDS. With the ease of self-assembly, and distinct stability they remarkably improve the solubility of hydrophobic drugs. However, presently, combinational therapy is the need of time and so are systems which are capable of releasing more than one drug. And it is one of the major challenges towards DDS to control the release of each drug independently, which simple DDS cannot meet. In this work, we present an amphiphilic polypeptide based micelle hydrogel composite to study the dual drug release for wound healing purposes using Amphotericin B (AmpB) and Curcumin as model drugs. Firstly, two differently charged amphiphilic polypeptide chains were prepared namely, poly L-Lysine-b-poly phenyl alanine (PLL-PPA) and poly Glutamic acid-b-poly phenyl alanine (PGA-PPA) through ring opening polymerization of amino acid N-carboxyanhydride. These polymers readily self-assemble to form micelles with hydrophobic PPA block as core and hydrophilic PLL/PGA as shell with an average diameter of about 280nm. The thus formed micelles were loaded with the model drugs. The PLL-PPA micelle was loaded with curcumin and PGA-PPA was loaded with AmpB by dialysis method. Drug loaded micelles showed a slight increase in the mean diameter and were fairly stable in solution and lyophilized forms. For forming the micelles hydrogel composite, the drug loaded micelles were dissolved and were cross linked using genipin. Genipin uses the free –NH2 groups in the PLL-PPA micelles to form a hydrogel network with free PGA-PPA micelles trapped in between the 3D scaffold formed. Different composites were tested by changing the weight ratios of the both micelles and were seen to alter its resulting surface charge from positive to negative with increase in PGA-PPA ratio. The composites with high surface charge showed a burst release of drug in initial phase, were as the composites with relatively low net charge showed a sustained release. Thus the resultant surface charge of the composite can be tuned to tune its drug release profile. Also, while studying the degree of cross linking among the PLL-PPA particles for effect on dual drug release, it was seen that as the degree of crosslinking increases, an increase in the tendency to burst release the drug (AmpB) is seen in PGA-PPA particle, were as on the contrary the PLL-PPA particles showed a slower release of Curcumin with increasing the cross linking density. Thus, two different pharmacokinetic profile of drugs were seen by changing the cross linking degree. In conclusion, a unique charged amphiphilic polypeptide based micelle hydrogel composite for dual drug delivery. This composite can be finely tuned on the basis of need of drug release profiles by changing simple parameters such as composition, cross linking and pH.

Keywords: amphiphilic polypeptide, dual drug release, micelle hydrogel composite, tunable DDS

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Authors: Moshmi Sangavarapu

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The US healthcare industry has undergone tremendous digital transformation in recent years, but critical care access to lower-income ethnicities is still in its nascency. This population has historically showcased substantial hesitation to seek any medical assistance. While the lack of sufficient financial resources plays a critical role, the existing cultural and knowledge barriers also contribute significantly to widening the access gap. It is imperative to break these barriers to ensure timely access to therapeutic procedures that can save important lives! Based on ongoing research, healthcare access barriers can be best addressed by tapping the untapped potential of caregiver communities first. They play a critical role in patients’ diagnoses, building healthcare knowledge and instilling confidence in required therapeutic procedures. Recent technological advancements have opened many avenues by developing smart ways of reaching the large caregiver community. A digitized go-to-market strategy featuring connected media coupled with smart IoT devices and geo-location targeting can be collectively leveraged to reach this key audience group. AI/ML algorithms can be thoroughly trained to identify relevant data signals from users' location and browsing behavior and determine useful marketing touchpoints. The web behavior can be further assimilated with natural language processing to identify contextually relevant interest topics and decipher potential caregivers on digital avenues to serve that brand message. In conclusion, grasping the true health access journey of any lower-income ethnic group is important to design beneficial touchpoints that can alleviate patients’ concerns and allow them to break their own access barriers and opt for timely and quality healthcare.

Keywords: healthcare access, market access, diversity barriers, patient journey

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