Search results for: intracellular delivery

Authors: Yousef S. Al-Othman

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The growth and expansion of the industrial facilities comes proportional to the market increasing demand of products and services. Furthermore, raw material producers such as oil companies usually undergo massive revamping projects to maintain a synchronized supply. These revamping projects are usually delivered through challenging construction projects held and associated with daily site risks related to the construction process. Henceforth, a case study related to these risks and corresponding on-spot corrective measurements has been made on a certain number of construction project contractors at Kuwait Oil Company (KOC) to derive the benefits and overall effectiveness of the on-spot corrective measurements during the construction phase of a project, and how would the same help in avoiding major incidents, ensuring a smooth, cost effective and on time delivery of the project. Findings of this case study shall have an added value to the overall risk management process by minimizing the daily site risks that may affect the project lead time, resulting in an undisturbed on-site construction process.

Keywords: oil and gas, risk management, construction projects, project lead time

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Authors: Narottam Puri, Bishnu Panigrahi, Narayan Pendse

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Background: Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from the patient care. Reporting of outcomes and its continuous monitoring provides an opportunity for both assessing and improving the quality of patient care. In 2012, International Consortium Of HealthCare Outcome Measurement (ICHOM) was founded which has defined global Standard Sets for measuring the outcome of various treatments. Method: Monitoring of Clinical Outcomes was identified as a pillar of Fortis’ core value of Patient Centricity. The project was started as an in-house developed Clinical Outcomes Reporting Portal by the Fortis Medical IT team. Standard sets of Outcome measurement developed by ICHOM were used. A pilot was run at Fortis Escorts Heart Institute from Aug’13 – Dec’13.Starting Jan’14, it was implemented across 11 hospitals of the group. The scope was hospital-wide and major clinical specialties: Cardiac Sciences, Orthopedics & Joint Replacement were covered. The internally developed portal had its limitations of report generation and also capturing of Patient related outcomes was restricted. A year later, the company provisioned for an ICHOM Certified Software product which could provide a platform for data capturing and reporting to ensure compliance with all ICHOM requirements. Post a year of the launch of the software; Fortis Healthcare has become the 1st Healthcare Provider in Asia to publish Clinical Outcomes data for the Coronary Artery Disease Standard Set comprising of Coronary Artery Bypass Graft and Percutaneous Coronary Interventions) in the public domain. (Jan 2016). Results: This project has helped in firmly establishing a culture of monitoring and reporting Clinical Outcomes across Fortis Hospitals. Given the diverse nature of the healthcare delivery model at Fortis Network, which comprises of hospitals of varying size and specialty-mix and practically covering the entire span of the country, standardization of data collection and reporting methodology is a huge achievement in itself. 95% case reporting was achieved with more than 90% data completion at the end of Phase 1 (March 2016). Post implementation the group now has one year of data from its own hospitals. This has helped identify the gaps and plan towards ways to bridge them and also establish internal benchmarks for continual improvement. Besides the value created for the group includes: 1. Entire Fortis community has been sensitized on the importance of Clinical Outcomes monitoring for patient centric care. Initial skepticism and cynicism has been countered by effective stakeholder engagement and automation of processes. 2. Measuring quality is the first step in improving quality. Data analysis has helped compare clinical results with best-in-class hospitals and identify improvement opportunities. 3. Clinical fraternity is extremely pleased to be part of this initiative and has taken ownership of the project. Conclusion: Fortis Healthcare is the pioneer in the monitoring of Clinical Outcomes. Implementation of ICHOM standards has helped Fortis Clinical Excellence Program in improving patient engagement and strengthening its commitment to its core value of Patient Centricity. Validation and certification of the Clinical Outcomes data by an ICHOM Certified Supplier adds confidence to its claim of being leaders in this space.

Keywords: clinical outcomes, healthcare delivery, patient centricity, ICHOM

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Authors: Bernard Doherty, Andrew Jelfs, Aveek Dasgupta, Patrick Holden

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Many companies have moved to agile and hybrid agile methodologies where portions of the Software Design Life-cycle (SDLC) and Software Test Life-cycle (STLC) can be time boxed in order to enhance delivery speed, quality and to increase flexibility to changes in software requirements. Despite widespread proliferation of agile practices, implementation often fails due to lack of adequate project management support, decreased motivation or fear of increased interaction. Consequently, few organizations effectively adopt agile processes with tailoring often required to integrate agile methodology in large scale environments. This paper provides an overview of the challenges in implementing an innovative large-scale tailored realization of the agile methodology termed the Agile Factory Model (AFM), with the aim of comparing and contrasting issues of specific importance to organizations undertaking large scale agile development. The conclusions demonstrate that agile practices can be effectively translated to a globally distributed development environment.

Keywords: agile, agile factory model, globally distributed development, large-scale agile

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Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane

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Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.

Keywords: Apremilast, introduction, Ireland, clinical audit

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Authors: Ahasanul Haque, Noor Hazilah Abd Manaf, Zohurul Anis, Tarekol Islam

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Sustainable community health (SCH) is an example of a new healthcare concept formed from applying the Maqasid al-Shariah principle to hospital management and delivery services. Because the idea is novel, it needs comprehensive and ongoing investigation to be improved. However, there is a lack of research on the necessity of developing sustainable community health (SCH), particularly its organizational structure. Furthermore, there is a misconception about the order of components in Maqasid al-Shariah, particularly in a hospital setting. Furthermore, the use of medicines and treatment by conventional recommendations to carry out the treatment by the Maqasid al Shariah. As such, this study focuses on the essential prerequisite for establishing a sustainable community health system based on Maqasid al-Shariah. This study discusses the use of Maqasid al-Shariah in administration and treatment. In this qualitative research approach, a literature search and interviews with specialists are conducted. The gathered data is examined using content analysis, emphasizing inductive and deductive reasoning. The research reveals that the Shariah Advisory Council and Shariah Critical Point are necessary for sustainable community health. In conclusion, by discussing the causes for each instance, this research adds to the creation of methods for determining the level of Maasid al-Shariah in-hospital care.

Keywords: empowering, sustainability, community health, maqasid al shariah, hospital and malaysia

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Authors: Elvin P. Chizenga, Heidi Abrahamse

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Cancer cell resistance to therapy is the main cause of treatment failures and the poor prognosis of cancer convalescence. The progression of cervical cancer to other parts of the genitourinary system and the reported recurrence rates are overwhelming. Current treatments, including surgery, chemo and radiation have been inefficient in eradicating the tumor cells. These treatments are also associated with poor prognosis and reduced quality of life, including fertility loss. This has inspired the need for the development of new treatment modalities to eradicate cervical cancer successfully. Photodynamic Therapy (PDT) is a modern treatment modality that induces cell death by photochemical interactions of light and a photosensitizer, which in the presence of molecular oxygen, yields a set of chemical reactions that generate Reactive Oxygen Species (ROS) and other free radical species causing cell damage. Enhancing PDT using modified drug delivery can increase the concentration of the photosensitizer in the tumor cells, and this has the potential to maximize its therapeutic efficacy. In cervical cancer, all infected cells constitutively express genes of the E6 and E7 HPV viral oncoproteins, resulting in high concentrations of E6 and E7 in the cytoplasm. This provides an opportunity for active targeting of cervical cancer cells using immune-mediated drug delivery to maximize therapeutic efficacy. The use of nanoparticles in PDT has also proven effective in enhancing therapeutic efficacy. Gold nanoparticles (AuNps) in particular, are explored for their use in biomedicine due to their biocompatibility, low toxicity, and enhancement of drug uptake by tumor cells. In this present study, a biomolecule comprising of AuNPs, anti-E6 monoclonal antibodies, and Aluminium Phthalocyanine photosensitizer was synthesized for use in targeted PDT of cervical cancer. The AuNp-Anti-E6-Sulfonated Aluminium Phthalocyanine mix (AlPcSmix) photosensitizing biomolecule was synthesized by coupling AuNps and anti-E6 monoclonal antibodies to the AlPcSmix via Polyethylene Glycol (PEG) chemical links. The final product was characterized using Transmission Electron Microscope (TEM), Zeta Potential, Uv-Vis Spectrophotometry, Fourier Transform Infrared Spectroscopy (FTIR), and X-ray diffraction (XRD), to confirm its chemical structure and functionality. To observe its therapeutic role in treating cervical cancer, cervical cancer cells, HeLa cells were seeded in 3.4 cm² diameter culture dishes at a concentration of 5x10⁵ cells/ml, in vitro. The cells were treated with varying concentrations of the photosensitizing biomolecule and irradiated using a 673.2 nm wavelength of laser light. Post irradiation cellular responses were performed to observe changes in morphology, viability, proliferation, cytotoxicity, and cell death pathways induced. Dose-Dependent response of the cells to treatment was demonstrated as significant morphologic changes, increased cytotoxicity, and decreased cell viability and proliferation This study presented a synthetic biomolecule for targeted PDT of cervical cancer. The study suggested that PDT using this AuNp- Anti-E6- AlPcSmix photosensitizing biomolecule is a very effective treatment method for the eradication of cervical cancer cells, in vitro. Further studies in vivo need to be conducted to support the use of this biomolecule in treating cervical cancer in clinical settings.

Keywords: anti-E6 monoclonal antibody, cervical cancer, gold nanoparticles, photodynamic therapy

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Authors: Arash Najmaei, Jo Rhodes, Peter Lok, Zahra Sadeghinejad

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In this article, we endeavor to explore how a new business model comes into existence in the Australian cloud-computing eco-system. Findings from multiple case study methodology reveal that to develop a business model new ventures adopt a three-phase approach. In the first phase, labelled as business model ideation (BMID) various ideas for a viable business model are generated from both internal and external networks of the entrepreneurial team and the most viable one is chosen. Strategic consensus and commitment are generated in the second phase. This phase is a business modelling strategic action phase. We labelled this phase as business model strategic commitment (BMSC) because through commitment and the subsequent actions of executives resources are pooled, coordinated and allocated to the business model. Three complementary sets of resources shape the business model: managerial (MnRs), marketing (MRs) and technological resources (TRs). The third phase is the market-test phase where the business model is reified through the delivery of the intended value to customers and conversion of revenue into profit. We labelled this phase business model actualization (BMAC). Theoretical and managerial implications of these findings will be discussed and several directions for future research will be illuminated.

Keywords: entrepreneur business model, high-tech venture, resources, conversion of revenue

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Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

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Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

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Authors: Nevine Henry Wasef

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The research discusses how Egyptian citizens perceive the performance of public sector officials, particularly the ethical values manifested in their behavior. It aims at answering the question of how Egyptian citizens’ perception of public officials affects citizens' trust in the government at large and the process of public service delivery specifically. The hypothesis is that public opinion about civil servants’ ethical values would be proportional to citizens’ trust in the government, which means that the more citizens regard administrators with high ethical standards, the higher trust in the government they would have and vice versa. The research would focus on the independent variable of trust in the government and the dependent variable of public perception of administrators’ ethical performance. The data would be collected through surveys designed to measure the public evaluation of public officials they are interacting with and the quality of services delivered to them. The study concludes that implementing ethical values in public administration has a crucial role in improving citizens’ trust in the government based on various case studies of governments that successfully adopted ethical training programs for their civil servants.

Keywords: trust, distrust, ethics, performance, integrity, values, public service

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Authors: Jingya Liu, Yue Wu, Jiabin Luo

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This work investigates an intermodal transportation system for delivering goods from a Regional Distribution Centre to supermarkets on the Isle of Wight (IOW) via the port of Southampton or Portsmouth in the UK. We consider this integrated logistics chain as a 3-echelon transportation system. In such a system, there are two types of transport methods used to deliver goods across the Solent Channel: one is accompanied transport, which is used by most supermarkets on the IOW, such as Spar, Lidl and Co-operative food; the other is unaccompanied transport, which is used by Aldi. Five transport scenarios are studied based on different transport modes and ferry routes. The aim is to determine an optimal delivery plan for supermarkets of different business scales on IOW, in order to minimise the total running cost, fuel consumptions and carbon emissions. The problem is modelled as a vehicle routing problem with time windows and solved by genetic algorithm. The computing results suggested that accompanied transport is more cost efficient for small and medium business-scale supermarket chains on IOW, while unaccompanied transport has the potential to improve the efficiency and effectiveness of large business scale supermarket chains.

Keywords: genetic algorithm, intermodal transport system, Isle of Wight, optimization, supermarket

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Authors: Surajj Sarode, G. Vidya Sagar, G. P. Vadnere

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The purpose of the present study was to prolong the gastric residence time of Stavudine by developing gastric floating drug delivery system (GFDDS). Moreover, to study influence of different polymers on its release rate using gas-forming agents, like sodium bicarbonate, citric acid. Floating tablets were prepared by wet granulation method using PVP K-30 as a binder and the other polymers include Pullulan Gum, HPMC K100M, six different formulations with the varying concentrations of polymers were prepared and the tablets were evaluated in terms of their pre-compression parameters like bulk density, tapped density, Haunsner ratio, angle of repose, compressibility index, post compression physical characteristics, in vitro release, buoyancy, floating lag time (FLT), total floating time (TFT) and swelling index. All the formulations showed good floating lag time i.e. less than 3 mins. The batch containing combination of Pullulan Gum and HPMC 100M (i.e. F-6) showed total floating lag time more than 12 h., the highest swelling index among all the prepared batches. The drug release was found to follow zero order kinetics.

Keywords: Suavudine, floating, total floating time (TFT), gastric residence

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Authors: L. Sudbury-Riley, P. Hunter-Jones, L. Menzies, M. Pyrah, H. Knight

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Just as manufacturing firms aim for zero defects, service providers strive to avoid service failures where customer expectations are not met. However, because services comprise unique human interactions, service failures are almost inevitable. Consequently, firms focus on service recovery strategies to fix problems and retain their customers for the future. Because a hospice offers care to terminally ill patients, it may not get the opportunity to correct a service failure. This situation makes the identification of what hospice users really need and want, and to ascertain perceptions of the hospice’s service delivery from the user’s perspective, even more important than for other service providers. A well-documented and fundamental barrier to improving end-of-life care is a lack of service quality measurement tools that capture the experiences of user’s from their own perspective. In palliative care, many quantitative measures are used and these focus on issues such as how quickly patients are assessed, whether they receive information leaflets, whether a discussion about their emotional needs is documented, and so on. Consequently, quality of service from the user’s perspective is overlooked. The current study was designed to overcome these limitations by adapting service blueprinting - never before used in the hospice sector - in order to undertake a ‘deep-dive’ to examine the impact of hospice services upon different users. Service blueprinting is a customer-focused approach for service innovation and improvement, where the ‘onstage’ visible service user and provider interactions must be supported by the ‘backstage’ employee actions and support processes. The study was conducted in conjunction with East Cheshire Hospice in England. The Hospice provides specialist palliative care for patients with progressive life-limiting illnesses, offering services to patients, carers and families via inpatient and outpatient units. Using service blueprinting to identify every service touchpoint, in-depth qualitative interviews with 38 in-patients, outpatients, visitors and bereaved families enabled a ‘deep-dive’ to uncover perceptions of the whole service experience among these diverse users. Interviews were recorded and transcribed, and thematic analysis of over 104,000 words of data revealed many excellent aspects of Hospice service. Staff frequently exceed people’s expectations. Striking gratifying comparisons to hospitals emerged. The Hospice makes people feel safe. Nevertheless, the technique uncovered many areas for improvement, including serendipity of referrals processes, the need for better communications with external agencies, improvements amid the daunting arrival and admissions process, a desperate need for more depression counselling, clarity of communication pertaining to actual end of life, and shortcomings in systems dealing with bereaved families. The study reveals that the adapted service blueprinting tool has major advantages of alternative quantitative evaluation techniques, including uncovering the complex nature of service user’s experiences in health-care service systems, highlighting more fully the interconnected configurations within the system and making greater sense of the impact of the service upon different service users. Unlike other tools, this in-depth examination reveals areas for improvement, many of which have already been implemented by the Hospice. The technique has potential to improve experiences of palliative and end-of-life care among patients and their families.

Keywords: hospices, end-of-life-care, service blueprinting, service delivery

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Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

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Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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Authors: Elriena Eksteen, Yolandi Willemse, Dawie D. J. Malan, Suria Ellis

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It is important to understand which competencies are needed for managerial and administrative effectiveness of school sport managers with regard to the design, delivery and direction of school sport programmes. The purpose of this study was to determine the competencies and training needs for secondary school sport managers in the North West Province. Data were gathered from 79 school sport managers in the North West Province by means of a validated self-compiled questionnaire. Descriptive statistics, factor analysis and a dependent t-test were used to compare which competencies school sport managers perceive as important in their work with the competencies they actually perform. Functional competencies and core competencies were both found to be important for managing school sport effectively. There were statistically significant differences between the perceived importance of competencies and the frequency with which competencies were actually performed. Respondents attached greater importance to functional and core competencies than the proportion of time spent actually performing them. Furthermore, results indicated the need to train teachers in managing sport finance, sport facilities and human resources, as well as presenting workshops in public relations, sport marketing and sport organisation.

Keywords: competencies, functional competencies, core competencies, school sport manager, training needs

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Authors: J. Suwanprateeb, F. Thammarakcharoen

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Calcium phosphate coating (CaP) has been employed for protein delivery, but the typical direct protein adsorption on the coating led to low incorporation content and fast release of the protein from the coating. By using bovine serum albumin (BSA) as a model protein, rapid biomimetic co-precipitation between calcium phosphate and BSA was employed to control the distribution of BSA within calcium phosphate coating during biomimetic formation on titanium surface for only 6 h at 50 oC in an accelerated calcium phosphate solution. As a result, the amount of BSA incorporation and release duration could be increased by using a rapid biomimetic co-precipitation technique. Up to 43 fold increases in the BSA incorporation content and the increase from 6 h to more than 360 h in release duration compared to typical direct adsorption technique were observed depending on the initial BSA concentration used during co-precipitation (1, 10, and 100 microgram/ml). From X-ray diffraction and Fourier transform infrared spectroscopy studies, the coating composition was not altered with the incorporation of BSA by this rapid biomimetic co-precipitation and mainly comprised octacalcium phosphate and hydroxyapatite. However, the microstructure of calcium phosphate crystals changed from straight, plate-like units to curved, plate-like units with increasing BSA content.

Keywords: biomimetic, Calcium Phosphate Coating, protein, titanium

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Authors: Eric Chappel, Dimitry Dumont-Fillon, Hugo Musard, Harald van Lintel

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A microfluidic radial diffuser typically comprises a hole in a membrane, a small gap and pillar centred with the hole. The fluid is forced to flow radially in this gap between the membrane and the pillar. Such diffusers are notably used to form flow control valves, wherein several holes are machined into a flexible membrane progressively deflecting against pillars as the pressure increases. The fluidic modelling of such diffuser is made difficult by the presence of a transition region between the hole and the diffuser itself. An experimental investigation has been conducted using SOI wafers to form membranes with only one centred hole and Pyrex wafers for the substrate and pillars, both wafers being anodically bonded after alignment. A simple fluidic model accounting for the specific geometry of the diffuser is proposed and compared to experimental results. A good match is obtained, for Reynolds number in the range 0.5 to 35 using the analytical formula of a radial diffuser in the laminar regime with an effective inner radius that is 40% smaller than the real radius, in order to simulate correctly the flow constriction at the entrance of the diffuser.

Keywords: radial diffuser, flow control valve, numerical modelling, drug delivery

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Authors: Atefeh Pourshafie, Homayoun Bakhtiari

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In power transmission lines, electricity conductors are main tools to carry electric power. Thus, other devices such as shield wires, insulators, towers, foundations etc. should be designed in a way that the conductors be able to successfully do their task which is appropriate power delivery to the customers. Non-stop increase of energy demand has led to saturated capacity of transmission lines which, in turn, causing line flash to exceed acceptable limits in some points. An approach which may be used to solve this issue is replacement of current conductors with new ones having the capability of withstanding higher heating such that reduced flash would be observed when heating increases. These novel conductors are able to transfer higher currents and operate in higher heating conditions while line flash will remain within standard limits. In this paper, we will attempt to introduce three types of advanced overhead conductors and analyze the replacement of current conductors by new ones technically and economically in transmission lines. In this regard, progressive conductors of transmission lines are introduced such as ACC (Aluminum Conductor Composite Core), AAAC-UHC (Ultra High Conductivity, All Aluminum Alloy Conductors), and G(Z)TACSR-Gap Type.

Keywords: ACC, AAAC-UHC, gap type, transmission lines

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Authors: Rui Sang, Fei Deng, Alexander Engel, Ewa M. Goldys, Wei Deng

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In this study, we brought together X-ray induced photodynamic therapy (X-PDT) and chemo-drug (5-FU) for the treatment on colorectal cancer cells. This was achieved by developing a lipid-polymer hybrid nanoparticle delivery system (FA-LPNPs-VP-5-FU). It was prepared by incorporating a photosensitizer (verteporfin), chemotherapy drug (5-FU), and a targeting moiety (folic acid) into one platform. The average size of these nanoparticles was around 100 nm with low polydispersity. When exposed to clinical doses of 4 Gy X-ray radiation, FA-LPNPs-VP-5-FU generated sufficient amounts of reactive oxygen species, triggering the apoptosis and necrosis pathway of cancer cells. Our combined X-PDT and chemo-drug strategy was effective in inhibiting cancer cells’ growth and proliferation. Cell cycle analyses revealed that our treatment induced G2/M and S phase arrest in HCT116 cells. Our results indicate that this combined treatment provides better antitumour effect in colorectal cancer cells than each of these modalities alone. This may offer a novel approach for effective colorectal cancer treatment with reduced off-target effect and drug toxicity.

Keywords: pdt, targeted lipid-polymer nanoparticles, verteporfin, colorectal cancer

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Authors: Tien Nguyen

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The relationship between mentors and mentees in teaching practicum has received the attention of researchers and been widely investigated. Mentors’ authority and power have captured a large and growing body of the literature in the field of teaching practicum. This article revisits mentor-mentee relationship and shifts the focus to mentees’ agency in planning and delivering lessons, an area which has been under-researched. Drawing on Vygotsky’s Zone of Proximal Development and Harré’s Positioning Theory, this qualitative study examines how mentees responded to mentors’ instructions in practicum. Interviews and classroom observations were conducted with 20 participants including both mentors and mentees across two English language teacher education programs in two different geographical locations in Vietnam. The result indicates that regardless of the similarities and/or differences of the programs, mentees’ agency varied in accordance with their identities in specific contexts. Specifically, mentees follow or resist to mentors’ feedback and instruction in revising their lesson plans and delivery these lessons, depending on their professional identities and institutional conditions. This study contributes to the importance of supporting the agency of mentees in teacher education.

Keywords: mentors, mentees, relationship, agency, professional identity, teacher education

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Authors: Surendar Vaddepalli

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Management education plays a crucial role to enable industry to cope with emerging challenges. It has spread in the last fifteen-twenty years in India and gained popularity as it was aimed at imbibing versatility and multi-tasking abilities in student community. Several management institutions started looking at upgrading their competencies in terms of faculty, research and industry interaction. The competitive business environment has been one of the drivers that paved the way for growing demand for management graduates in the employment market. Industry expects their executives to be engaged in a constant learning process. The ever-increasing demand for managers has led to establish more management institutions; however, the growth was not in line with the expectations from the industry. While top Business Schools are continuously changing the contents and delivery methodologies, academic standards of most of the other Business Schools are not up to the mark and quality of service provided by these institutes has opened various issues for discussion. On this back ground it is important to address the concerns of Indian management education experiencing with time and we have to rethink about the management education and efforts should be made to create a dynamic environment. This paper ties to study the current trends and tries to find out need for value based management education in India to rejuvenate it.

Keywords: management education, management, value based management education, business school, India

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Authors: Neda Sinaei, Davood Zare, Mehrdad Azin

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Polyhydroxyalkanoates (PHAs) are biocompatible and biodegradable polymers produced by a wide range of bacterial strains. These biopolymers are significantly studied for drug delivery and tissue engineering applications because of their fascinating physicochemical properties. Polyhydroxybutyrate (PHB) scaffold that has been extracted from a novel bacteria using oil wastewater was selected to study. Some physical parameters affecting scaffold properties such as PHB concentration, solvent evaporation speed, and ultrasonic time were investigated. Scanning electron microscopy was used to evaluate the porosity. Afterward, the biocompatibility of PHB scaffold was assessed. Initial results showed the highly porous PHB scaffold structure with a variety of pore sizes. Subsequent results indicated that more unique pore sizes can be obtained by optimizing physical factors. It would be noticed that the morphology of the pore structure was accordingly affected by ultrasonic time. Hence, In vitro cell viability tests on the PHB scaffold using human foreskin fibroblasts revealed strong cell attachment and proliferation supports. Therefore, it can be concluded that the cost-effective PHB scaffold has the potential using as a biomaterial cell adhesion substrate in therapeutic applications.

Keywords: Polyhydroxybutyrate, biocompatible, scaffold, porous, tissue engineering

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Authors: E. Benga, T. Tengen, A. Alugongo

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Periodic and continuous inventory models are the two classical management tools used to handle inventories. These models have advantages and disadvantages. The implementation of both continuous (r,Q) inventory and periodic (R, S) inventory models in most manufacturing plants comes with higher cost. Such high inventory costs are due to the fact that most manufacturing plants are not flexible enough. Since demand and lead-time are two important variables of every inventory models, their effect on the flexibility of the manufacturing plant matter most. Unfortunately, these effects are not clearly understood by managers. The reason is that the decision parameters of the continuous (r, Q) inventory and periodic (R, S) inventory models are not designed to effectively deal with the issues of uncertainties such as poor manufacturing performances, delivery performance supplies performances. There is, therefore, a need to come up with a predictive and hybrid inventory model that can combine in some sense the feature of the aforementioned inventory models. A linear combination technique is used to hybridize both continuous (r, Q) inventory and periodic (R, S) inventory models. The behavior of such hybrid inventory model is described by a differential equation and then optimized. From the results obtained after simulation, the continuous (r, Q) inventory model is more effective than the periodic (R, S) inventory models in the short run, but this difference changes as time goes by. Because the hybrid inventory model is more cost effective than the continuous (r,Q) inventory and periodic (R, S) inventory models in long run, it should be implemented for strategic decisions.

Keywords: periodic inventory, continuous inventory, hybrid inventory, optimization, manufacturing plant

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Authors: Mariam Fishere

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The proposed research study aims at developing an Internet-based transdiagnostic treatment and evaluating its efficacy. Based on the Common Elements Treatment Approach (CETA), a combined low-intensity and technology supported transdiagnostic treatment protocol will be culturally adapted for usage by nonprofessional therapists in Arabic-speaking countries. This Internet-based CETA intervention will target individuals suffering from one or more of the following disorders: depression, anxiety and posttraumatic stress disorder (PTSD), which are all major contributors to the global burden of mental illness. The growing body of research in the area of transdiagnostic treatment has proven to be effective in high-income countries (HICs), but there remain questions about its efficacy, cultural appropriateness, and validity for low- to middle-income countries (LMICs). The aim of this dissertation project is to investigate the efficacy of a newly developed Internet-delivery of an evidence-based transdiagnostic treatment – CETA – for a sample of Arabic-speaking individuals suffering from at least one of the following disorders; depression, anxiety, and PTSD.

Keywords: transdiagnostic, internet-based interventions, mental health, Arab world

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Authors: Z. Karakus, Z. Ozer

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Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement, or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery, and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: e-learning, medication administration, nursing, nursing students

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Authors: Dominik Krimpmann

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Cloud computing has provided the impetus for change in the demand, sourcing, and consumption of IT-enabled services. The technology developed from an emerging trend towards a ‘must-have’. Many organizations harnessed on the quick-wins of cloud computing within the last five years but nowadays reach a plateau when it comes to sustainable savings and performance. This study aims to investigate what is needed from an organizational perspective to make cloud computing a sustainable success. The study was carried out in Germany among senior IT professionals, both in management and delivery positions. Our research shows that IT executives must be prepared to realign their IT workforce to sustain the advantage of cloud computing for today and the near future. While new roles will undoubtedly emerge, roles alone cannot ensure the success of cloud deployments. What is needed is a change in the IT workforce’s business behaviour, or put more simply, the ways in which the IT personnel works. It gives clear guidance on which dimensions of an employees’ working behaviour need to be adapted. The practical implications are drawn from a series of semi-structured interviews, resulting in a high-level workforce enablement plan. Lastly, it elaborates on tools and gives clear guidance on which pitfalls might arise along the proposed workforce enablement process.

Keywords: cloud computing, organization design, organizational change, workforce enablement

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Authors: Annette McArthur

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The traditional model of teaching and learning, where ICT sits as a separate entity is not a model for a 21st century school. It is imperative that teaching and learning embraces technological advancements. The challenge in schools lies in shifting the mindset of teachers so they see ICT as integral to their teaching, learning and curriculum rather than a separate E-Learning curriculum stream. This research project investigates how the effective, planned, intentional integration of ICT into a STEM curriculum, can enable the shift in the teacher mindset. The project incorporated: • Developing a professional coaching relationship with key STEM teachers. • Facilitating staff professional development involving student centered project based learning pedagogy in the context of a STEM curriculum. • Facilitating staff professional development involving digital literacy. • Establishing a professional community where collaboration; sharing and reflection were part of the culture of the STEM community. • Facilitating classroom support for the effective delivery innovative STEM curriculum. • Developing STEM learning spaces where technologies were used to empower and engage learners to participate in student-centered, project-based learning.

Keywords: e-learning, ICT, project based learning, STEM

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Authors: Emmanuel Maiyanga

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Access to sufficiently good quality freshwater has been a global challenge, but more notably in low-income countries, particularly in the Sub-Saharan countries, which Nigeria is one. Urban population is soaring, especially in many low-income countries, the existing centralised water supply infrastructures are ageing and inadequate, moreover in households peoples’ lifestyles have become more water-demanding. So, people mostly device coping strategies where municipal supply is perceived to have failed. This development threatens the futures of groundwater and calls for a review of management strategy and research approach. The various issues associated with water demand management in low-income countries and Nigeria, in particular, are well documented in the literature. However, the way people use water daily in households and the reasons they do so, and how the situation is constructing demand among the middle-class population in Abuja Nigeria is poorly understood. This is what this research aims to unpack. This is achieved by using the social practices research approach (which is based on the Theory of Practices) to understand how this situation impacts on the shared groundwater resource. A qualitative method was used for data gathering. This involved audio-recorded interviews of householders and water professionals in the private and public sectors. It also involved observation, note-taking, and document study. The data were analysed thematically using NVIVO software. The research reveals the major household practices that draw on the water on a domestic scale, and they include water sourcing, body hygiene and sanitation, laundry, kitchen, and outdoor practices (car washing, domestic livestock farming, and gardening). Among all the practices, water sourcing, body hygiene, kitchen, and laundry practices, are identified to impact most on groundwater, with impact scale varying with household peculiarities. Water sourcing practices involve people sourcing mostly from personal boreholes because the municipal water supply is perceived inadequate and unreliable in terms of service delivery and water quality, and people prefer easier and unlimited access and control using boreholes. Body hygiene practices reveal that every respondent prefers bucket bathing at least once daily, and the majority bathe twice or more every day. Frequency is determined by the feeling of hotness and dirt on the skin. Thus, people bathe to cool down, stay clean, and satisfy perceived social, religious, and hygiene demand. Kitchen practice consumes water significantly as people run the tap for vegetable washing in daily food preparation and dishwashing after each meal. Laundry practice reveals that most people wash clothes most frequently (twice in a week) during hot and dusty weather, and washing with hands in basins and buckets is the most prevalent and water wasting due to soap overdose. The research also reveals poor water governance as a major cause of current inadequate municipal water delivery. The implication poor governance and widespread use of boreholes is an uncontrolled abstraction of groundwater to satisfy desired household practices, thereby putting the future of the shared aquifer at great risk of total depletion with attendant multiplying effects on the people and the environment and population continues to soar.

Keywords: boreholes, groundwater, household water practices, self-supply

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Authors: Joanna Gerszon, Aleksandra Rodacka

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In the pathogenesis of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease, protein and peptide aggregation processes play a vital role in contributing to the formation of intracellular and extracellular protein deposits. One of the major components of these deposits is the oxidatively modified glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Therefore, the purpose of this research was to answer the question whether piceatannol, a stilbene derivative, counteracts and/or slows down oxidative stress-induced GAPDH aggregation. The study also aimed to determine if this natural occurring compound prevents unfavorable nuclear translocation of GAPDH in hippocampal cells. The isothermal titration calorimetry (ITC) analysis indicated that one molecule of GAPDH can bind up to 8 molecules of piceatannol (7.3 ± 0.9). As a consequence of piceatannol binding to the enzyme, the loss of activity was observed. Parallel with GAPDH inactivation the changes in zeta potential, and loss of free thiol groups were noted. Nevertheless, the ligand-protein binding does not influence the secondary structure of the GAPDH. Precise molecular docking analysis of the interactions inside the active center allowed to presume that these effects are due to piceatannol ability to assemble a covalent binding with nucleophilic cysteine residue (Cys149) which is directly involved in the catalytic reaction. Molecular docking also showed that simultaneously 11 molecules of ligand can be bound to dehydrogenase. Taking into consideration obtained data, the influence of piceatannol on level of GAPDH aggregation induced by excessive oxidative stress was examined. The applied methods (thioflavin-T binding-dependent fluorescence as well as microscopy methods - transmission electron microscopy, Congo Red staining) revealed that piceatannol significantly diminishes level of GAPDH aggregation. Finally, studies involving cellular model (Western blot analyses of nuclear and cytosolic fractions and confocal microscopy) indicated that piceatannol-GAPDH binding prevents GAPDH from nuclear translocation induced by excessive oxidative stress in hippocampal cells. In consequence, it counteracts cell apoptosis. These studies demonstrate that by binding with GAPDH, piceatannol blocks cysteine residue and counteracts its oxidative modifications, that induce oligomerization and GAPDH aggregation as well as it prevents hippocampal cells from apoptosis by retaining GAPDH in the cytoplasm. All these findings provide a new insight into the role of piceatannol interaction with GAPDH and present a potential therapeutic strategy for some neurological disorders related to GAPDH aggregation. This work was supported by the by National Science Centre, Poland (grant number 2017/25/N/NZ1/02849).

Keywords: glyceraldehyde-3-phosphate dehydrogenase, neurodegenerative disease, neuroprotection, piceatannol, protein aggregation

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Authors: Deon Bezuidenhout

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Pre-seeding with autologous endothelial cells improves the long-term patency of synthetic vascular grafts levels obtained with autografts, but is limited to a single centre due to resource, time and other constraints. Spontaneous in vivo endothelialization would obviate the need for pre-seeding, but has been shown to be absent in man due to limited transanastomotic and fallout healing, and the lack of transmural ingrowth due to insufficient porosity. Two types of graft scaffolds with increased interconnected porosity for improved tissue ingrowth and healing are thus proposed and described. Foam-type polyurethane (PU) scaffolds with small, medium and large, interconnected pores were made by phase inversion and spherical porogen extraction, with and without additional surface modification with covalently attached heparin and subsequent loading with and delivery of growth factors. Fibrillar scaffolds were made either by standard electrospinning using degradable PU (Degrapol®), or by dual electrospinning using non-degradable PU. The latter process involves sacrificial fibres that are co-spun with structural fibres and subsequently removed to increased porosity and pore size. Degrapol samples were subjected to in vitro degradation, and all scaffold types were evaluated in vivo for tissue ingrowth and vascularization using rat subcutaneous model. The foam scaffolds were additionally evaluated in a circulatory (rat infrarenal aortic interposition) model that allows for the grafts to be anastomotically and/or ablumenally isolated to discern and determine endothelialization mode. Foam-type grafts with large (150 µm) pores showed improved subcutaneous healing in terms of vascularization and inflammatory response over smaller pore sizes (60 and 90µm), and vascularization of the large porosity scaffolds was significantly increased by more than 70% by heparin modification alone, and by 150% to 400% when combined with growth factors. In the circulatory model, extensive transmural endothelialization (95±10% at 12 w) was achieved. Fallout healing was shown to be sporadic and limited in groups that were ablumenally isolated to prevent transmural ingrowth (16±30% wrapped vs. 80±20% control; p<0.002). Heparinization and GF delivery improved both mural vascularization and lumenal endothelialization. Degrapol electrospun scaffolds showed decrease in molecular mass and corresponding tensile strength over the first 2 weeks, but very little decrease in mass over the 4w test period. Studies on the effect of tissue ingrowth with and without concomitant degradation of the scaffolds, are being used to develop material models for the finite element modelling. In the case of the dual-spun scaffolds, the PU fibre fraction could be controlled shown to vary linearly with porosity (P = −0.18FF +93.5, r2=0.91), which in turn showed inverse linear correlation with tensile strength and elastic modulus (r2 > 0.96). Calculated compliance and burst pressures of the scaffolds increased with fibre fraction, and compliances matching the human popliteal artery (5-10 %/100 mmHg), and high burst pressures (> 2000 mmHg) could be achieved. Increasing porosity (76 to 82 and 90%) resulted in increased tissue ingrowth from 33±7 to 77±20 and 98±1% after 28d. Transmural endothelialization of highly porous foamed grafts is achievable in a circulatory model, and the enhancement of porosity and tissue ingrowth may hold the key the development of spontaneously endothelializing electrospun grafts.

Keywords: electrospinning, endothelialization, porosity, scaffold, vascular graft

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Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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