Search results for: occupational therapy practitioner

Authors: G. Kontochristopoulos, T. Spiliopoulos, V. Markantoni, E. Platsidaki, A. Kouris, E. Balamoti, C. Bokotas, G. Haidemenos

Abstract:

Introduction: There is a high patient demand for periorbital rejuvenation since the facial area is often the first to show visible signs of aging. With advancing age, there are sometimes marked changes that occur in the skin, fat, muscle and bone of the periorbital region, resulting to wrinkles and skin laxity. These changes are among the easiest areas to correct using several minimally invasive techniques, which have become increasingly popular over the last decade. Lasers, radiofrequency, botulinum toxin, fat grafting and fillers are available treatments sometimes in combination to traditional blepharoplasty. This study attempts to show the benefits of a minimally invasive approach to periorbital wrinkles and skin laxity that combine microneedling and 10% trichloroacetic acid (TCA) peels. Method: Eleven female patients aged 34-72 enrolled in the study. They all gave informed consent after receiving detailed information regarding the treatment procedure. Exclusion criteria in the study were previous treatment for the same condition in the past six months, pregnancy, allergy or hypersensitivity to the components, infection, inflammation and photosensitivity on the affected region. All patients had diffuse periorbital wrinkles and mild to moderate upper or lower eyelid skin laxity. They were treated with Automatic Microneedle Therapy System-Handhold and topical application of 10% trichloroacetic acid solution to each periorbital area for five minutes. Needling at a 0,25 mm depth was performed in both latelar (x-y) directions. Subsequently, the peeling agent was applied to each periorbital area for five minutes. Patients were subjected to the above combination every two weeks for a series of four treatments. Subsequently they were followed up regularly every month for two months. The effect was photo-documented. A Physician's and a Patient's Global Assessment Scale was used to evaluate the efficacy of the treatment (0-25% indicated poor response, 25%-50% fair, 50%-75% good and 75%-100% excellent response). Safety was assessed by monitoring early and delayed adverse events. Results: At the end of the study, almost all patients demonstrated significant aesthetic improvement. Physicians assessed a fair and a good improvement in 9(81.8% of patients) and 2(18.1% of patients) participants respectively. Patients Global Assessment rated a fair and a good response in 6 (54.5%) and 5 (45.4%) participants respectively. The procedure was well tolerated and all patients were satisfied. Mild discomfort and transient erythema were quite common during or immediately after the procedure, however only temporary. During the monthly follow up, no complications or scars were observed. Conclusions: Microneedling is known as a simple, office–based collagen induction therapy. Low concentration TCA solution applied to the epidermis that has been more permeable by microneedling, can reach the dermis more effectively. In the present study, chemical peels with 10% TCA acted as an adjuvant to microneedling, as it causes controlled skin damage, promoting regeneration and rejuvenation of tissues. This combined therapy improved periorbital fine lines, wrinkles, and overall appearance of the skin. Thus it constitutes an alternative treatment of periorbital skin aging, with encouraging results and minor side-effects.

Keywords: chemical peels, microneedling, periorbital wrinkles, skin laxity

Procedia PDF Downloads 335

Authors: Guna Raj Dhungana, Roshan Nepal, Apshara Parajuli, , Archana Maharjan, Shyam K. Mishra, Pramod Aryal, Rajani Malla

Abstract:

Introduction: Klebsiella pneumoniae is a well-known opportunistic human pathogen, primarily causing healthcare-associated infections. The global emergence of carbapenemase-producing K. pneumoniaeis a major public health burden, which is often extensively multidrug resistant.Thus, because of the difficulty to treat these ‘superbug’ and menace and some term as ‘apocalypse’ of post antibiotics era, an alternative approach to controlling this pathogen is prudent and one of the approaches is phage mediated control and/or treatment. Objective: In this study, we aimed to isolate novel bacteriophage against carbapenemase-producing K. pneumoniaeand characterize for potential use inphage therapy. Material and Methods: Twenty lytic phages were isolated from river water using double layer agar assay and purified. Biological features, physiochemical characters, burst size, host specificity and activity spectrum of phages were determined. One most potent phage: Phage TU_Kle10O was selected and characterized by electron microscopy. Whole genome sequences of the phage were analyzed for presence/absence of virulent factors, and other lysin genes. Results: Novel phage TU_Kle10O showed multiple host range within own genus and did not induce any BIM up to 5th generation of host’s life cycle. Electron microscopy confirmed that the phage was tailed and belonged to Caudovirales family. Next generation sequencing revealed its genome to be 166.2 Kb. bioinformatical analysis further confirmed that the phage genome ‘did not’ contain any ‘bacterial genes’ within phage genome, which ruled out the concern for transfer of virulent genes. Specific 'lysin’ enzyme was identified phages which could be used as 'antibiotics'. Conclusion: Extensively multidrug resistant bacteria like carbapenemase-producing K. pneumoniaecould be treated efficiently by phages.Absence of ‘virulent’ genes of bacterial origin and presence of lysin proteins within phage genome makes phages an excellent candidate for therapeutics.

Keywords: bacteriophage, Klebsiella pneumoniae, MDR, phage therapy, carbapenemase,

Procedia PDF Downloads 168

Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

Abstract:

Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

Procedia PDF Downloads 85

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

Abstract:

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

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

Procedia PDF Downloads 231

Authors: Akbar Haghzadeh Saraskanroud, Amir Hossein Yahyavi Zanjani, Niloofar Kargar, Hanieh Ahrabi

Abstract:

Cervical cancer refers to an unusual growth of cells in the cervix. The cervix is the lower part of the uterus, which connects to the vagina. Various risk factors such as human papillomavirus (HPV), having a weakened immune system, smoking or breathing in secondhand smoke, reproductive factors, and obesity play important roles in causing most cervical cancers. When cervical cancer happens, surgery is often the first treatment option to remove it. Other treatments might include chemotherapy and targeted therapy medicines. Radiation therapy with high-energy photon beams also may be used. Sometimes combined treatment, including radiation with low-dose chemotherapy, was applied. Intracavitary brachytherapy is an integral part of radiotherapy for locally advanced gynecologic malignancies such as cervical cancer. In the treatment of cervical cancer, there are different tools for doing brachytherapy. Two combinations of different applicators for this purpose are Tandem and Ovoid and Tandem and Ring. This study evaluated the dose differences between these two methods in the organs at risk of the rectum, sigmoid, and bladder. In this study, the treatment planswere simulated by the Oncentra treatment planning system and Tandem, Ovid, and Rings of different sizes. CT scan images of 23 patients were treated with HDR_BT Elekta Flexitron system were used for this study. Contouring of HR-CTV, rectum and bladder was performed for all patients. Then, the received dose of 0.1 and 0.2cc volumes of organs at risk were obtained and compared for these two methods: T-Ovoid and T-Ring. By doing investigations and dose measurements of points A and B and the volumes specified by ICRU, it seems that when comparing ring and ovoid to tandem and ovoid, the total dose to the rectum was lower by about 11%, and the bladder was 7%. In the case of HR CTV, this comparison showed that this ratio is about 7% better. Figure 1 shows the amount of decrease in rectum dose in the T-Ring method compared to T-Ovoid. Figure 2 indicates the amount of decrease in bladder dose in the T-Ring method compared to T-Ovoid. Finally, figure 3 illustrates the amount of HR-CTV coverage in the T-Ring method compared to the T-Ovoid.

Keywords: cervical cancer, brachytherapy, rectum, tandem and ovoid, tandem and ring.

Procedia PDF Downloads 11

Authors: B. K. Umesh Kumar, Waleed Al Shukaili

Abstract:

Air travel is one of the safest modes of travel. Inflight injuries occur due to various factors such as air turbulence, spillage of hot liquids, and fall of improperly stowed overhead baggage. Injuries occur not only to passengers but also to the flight attendants who are handling the passengers throughout the flight. A retrospective study of all records of crew safety report by the captain of the aircraft for all the flights from 01 Mar 2015 to 31 Mar 2019 in a National Carrier of Middle Eastern country, were analyzed. There was one injury to Flight attendant every 1200 flights. Commonest aircraft involved was Boeing. Inflight phase had 82% of all injuries. 63% of accidents involved female Attendants. Commonest age group involved was from 25-30 years. Cart and container injuries were the commonest and accounted for nearly 62% of the total injuries followed by turbulence. Back injuries were the commonest injuries followed by ankle, shoulder, and burns. Mean days of absence from work seen in shoulder injuries 40 days followed by injuries to back, which accounted for 38 Days. Reduction in injuries to flight attendants can be brought about by proper selection of crew, reduction in cart load. Proper maintenance of cart and container plays a major role in prevention of occupational accidents.

Keywords: flight attendants, in-flight injuries, types of injuries, work related injury prevention

Procedia PDF Downloads 103

Authors: Anka Gorgiev, Chris Martin, Nikolaos Dimitriadis, Dimitrios V. Nikolaidis

Abstract:

This paper is part of a doctoral research study aimed to identify behavioral indicators for the existence of the new marketing paradigm. Neuromarketing is becoming a growing trend in the marketing industry worldwide and it is capturing a lot of interest among the members of academia and the practitioner community. However, it is still not very clear how big of an impact neuromarketing might have in the following years. In an effort to get closer to an answer, this study investigates behavioral intentions and willingness to adopt neuromarketing and its practices by the marketing professionals, including academics, practitioners, students, researchers, experts and journal editors. The participants in the study include marketing professionals at different levels of neuromarketing fluency with residency in the United States of America and the South East Europe. The total of 19 participants participated in the interviews, all of whom belong to more than one group of marketing professionals. The authors use qualitative research approach and open-ended interview questions specifically developed to assess ideas, beliefs and opinions that marketing professionals hold towards neuromarketing. In constructing the interview questions, the authors have used the theory of planned behavior, the prototype willingness model and the technology acceptance model as a theoretical framework. Previous studies have not explicitly investigated the behavioral intentions of marketing professionals to engage in neuromarketing behavior, which is described here as a tendency to apply neuromarketing assumptions and tools in usual marketing practices. This study suggests that the marketing professionals believe that neuromarketing can contribute to the business in a positive way and outlines the main advantages and disadvantages of adopting neuromarketing as identified by the participants. In addition, the study reveals an emerging image of an exemplar company that is perceived to be using neuromarketing, including the most common characteristics and attributes. These findings are believed to be crucial in facilitating a way for neuromarketing field to have a broader impact than it currently does by recognizing and understanding the limitations that such exemplars imply and how that has an effect on the decision-making of marketing professionals.

Keywords: behavioral intentions, marketing paradigm, neuromarketing adoption, theory of planned behavior

Procedia PDF Downloads 162

Authors: R. Dimitri Halley

Abstract:

The research within Jungian Psychology presented here is on the wave state of Self. What has been discovered via shared dreaming, independently correlating dreams across dreamers, is beyond the Self stage into the deepest layer or the wave state Self: the very quantum ocean, the Self archetype is embedded in. A quantum wave or rhyming of meaning constituting synergy across several dreamers was discovered in dreams and in extensively shared dream work with small groups at a post therapy stage. Within the format of shared dreaming, we find synergy patterns beyond what Jung called the Self archetype. Jung led us up to the phase of Individuation and delivered the baton to Von Franz to work out the next synchronistic stage, here proposed as the finding of the quantum patterns making up the wave state of Self. These enfolded synchronistic patterns have been found in group format of shared dreaming of individuals approximating individuation, and the unfolding of it is carried by belief and faith. The reason for this format and operating system is because beyond therapy and of living reality, we find no science – no thinking or even awareness in the therapeutic sense – but rather a state of mental processing resembling more like that of spiritual attitude. Thinking as such is linear and cannot contain the deepest layer of Self, the quantum core of the human being. It is self reflection which is the container for the process at the wave state of Self. Observation locks us in an outside-in reactive flow from a first-person perspective and hence toward the surface we see to believe, whereas here, the direction of focus shifts to inside out/intrinsic. The operating system or language at the wave level of Self is thus belief and synchronicity. Belief has up to now been almost the sole province of organized religions but was viewed by Jung as an inherent property in the process of Individuation. The shared dreaming stage of the synchronistic patterns forms a larger story constituting a deep connectivity unfolding around individual Selves. Dreams of independent dreamers form larger patterns that come together as puzzles forming a larger story, and in this sense, this group work level builds on Jung as a post individuation collective stage. Shared dream correlations will be presented, illustrating a larger story in terms of trails of shared synchronicity.

Keywords: belief, shared dreaming, synchronistic patterns, wave state of self

Procedia PDF Downloads 176

Authors: Mohaammad Ahmadpanah, Amineh Akhondi, Mohammad Haghighi, Ali Ghaleiha, Leila Jahangard, Elham Salari

Abstract:

Background: Working memory includes the capability to keep and manipulate information in a short period of time. This capability is the basis of complicated judgments and has been attended to as the specific and constant character of individuals. Children with attention deficit and hyperactivity are among the people suffering from deficiency in the active memory, and this deficiency has been attributed to the problem of frontal lobe. This study utilizes a new approach with suitable tasks and methods for training active memory and assessment of the effects of the trainings. Participants: The children participating in this study were of 7-15 year age, who were diagnosed by the psychiatrist and psychologist as hyperactive and attention deficit based on DSM-IV criteria. The intervention group was consisted of 8 boys and 6 girls with the average age of 11 years and standard deviation of 2, and the control group was consisted of 2 girls and 5 boys with an average age of 11.4 and standard deviation of 3. Three children in the test group and two in the control group were under medicinal therapy. Results: Working memory training meaningfully improved the performance in not-trained areas as visual-spatial working memory as well as the performance in Raven progressive tests which are a perfect example of non-verbal, complicated reasoning tasks. In addition, motional activities – measured based on the number of head movements during computerized measuring program – was meaningfully reduced in the medication group. The results of the second test showed that training similar exercise to teenagers and adults results in the improvement of cognition functions, as in hyperactive people. Discussion: The results of this study showed that the performance of working memory is improved through training, and these trainings are extended and generalized in other areas of cognition functions not receiving any training. Trainings resulted in the improvement of performance in the tasks related to prefrontal. They had also a positive and meaningful impact on the moving activities of hyperactive children.

Keywords: attention deficit hyperactivity disorder, working memory, non-medical treatment, children

Procedia PDF Downloads 344

Authors: Bidya Dhar Sahu, Meghana Koneru, R. Shyam Sunder, Ramakrishna Sistla

Abstract:

Environmental and occupational exposure to hexavalent chromium [Cr(VI)] via textile manufacture, metallurgy, spray paints, stainless steel industries, drinking water containing chromium are often known to cause acute renal injury in humans and animals. Nephrotoxicity is the major effect of chromium poisoning. In the present study, we investigated the potential renoprotective effect and underlying mechanisms of carvedilol using rat model of potassium dichromate (K2Cr2O7)-induced nephrotoxicity. Exploration of the underlying mechanisms of carvedilol revealed that carvedilol attenuated nuclear translocation and DNA binding activity of NF-κB (p65), restored antioxidant and mitochondrial respiratory enzyme activities and attenuated apoptosis related protein expressions in kidney tissues. The serum levels of TNF-α, the renal iNOS and myeloperoxidase activity were significantly decreased in carvedilol pre-treated K2Cr2O7-induced nephrotoxic rats. These results were further supported and confirmed by histological findings. In conclusion, the findings of the present study demonstrated that carvedilol is an effective chemoprotectant against K2Cr2O7-induced nephrotoxicity in rats.

Keywords: apoptosis, carvedilol, inflammation, potassium dichromate-induced nephrotoxicity, applied pharmacology

Procedia PDF Downloads 263

Authors: S. Asplund, J. Åhlin, S. Åström, B. M. Lindgren

Abstract:

The aim of this qualitative study was to describe experiences of work-related stress among highly stressed municipal employees in rural northern Sweden. We interviewed 15 employees in the municipal sector in rural northern Sweden using a semi-structured guide and subjected the interviews to qualitative content analysis. Under the main theme of Suffering Though Endless Chaos, we summarized four themes: facing incompatible interests and high demands due to lack of time and resources; feeling powerless, trapped, and ignored due to lack of control; feeling insufficient, insecure, and guilty due to challenging relations and high expectations; and struggling with consequences such as health problems, spillover effects on family life, and difficulty coping. Findings from this study suggest the importance of acknowledging suffering among municipal employees in a stressful work environment. An imbalance between job demands and resources is affecting both the health and family lives of employees and also their ability to work. It seems important to improve the work environment through supportive leadership, job control, and reasonable job demands to prevent stress, reduce suffering, and create a healthy organization.

Keywords: manager, municipal sector, occupational health, qualitative content analysis

Procedia PDF Downloads 69

Authors: Sheikha Turki Alketbi

Abstract:

Objectives: 1. Documenting the spontaneous resolution of AML following the initiation of anti-TB therapy. 2. Presenting an uncommon type of relapse in Acute Myeloid Leukemia. 3. Highlighting the role of immune markers in the diagnosis of Leukemia cutis. 4. Exploring and highlighting the possibility of skin relapse as the exclusive manifestation, even when skin involvement is known secondary manifestation in AML. Background: Spontaneous remission of Acute Myeloid Leukemia (AML) is a rare phenomenon that has only been reported in some case reports, usually following severe infections. Some studies have described the occurrence of tuberculosis (TB) infection with AML, usually after starting chemotherapy. Spontaneous resolution of AML after starting anti TB therapy (ATT), without starting chemotherapy has never been described in the literature. Moreover, Leukemia cutis is another rare skin manifestation of Acute Myeloid Leukemia as a result of infiltration of the skin or subcutaneous tissue by leukemic cells, in which can present during, precedes, after or independently of systemic leukemia. Methods: Here, we present a case of a 13-year-old male who presented with fever, weight loss, lethargy, epistaxis, bruising and dry cough and was later diagnosed with AML. Before initiating leukemia treatment, the patient was tested for TB and was found to have active TB infection. His leukemia treatment was postponed to clear the TB infection and he was commenced on ATT. Two months later, repeat blood film and bone marrow biopsy showed resolution of his AML. The patient remained in remission for 1 month, after which he presented with symmetrical blue purple well-defined round indurated plaques on the chest and thighs. Our differentials were leukemia cutis and Kaposi sarcoma. Results: Skin Biopsy with immune markers done, showed a picture of Acute Myeloid Leukemia. Immunohistochemistry (IHC) showed neoplastic cells diffusely and strongly positive for LCA, CD2, CD31, MPO, CD117, Lysozymes and TDT, and moderately positive for CD34, CD99, CD43 and CD6 And patchy for CD68. Ki67 showed 60% proliferation index. They were negative for the remaining markers. This suggested acute myeloid leukemia (AML). Conclusion: In summary, we present a rare case of TB with AML that resolved after treatment of TB with ATT but relapsed later as leukemia cutis. While skin involvement might occur as a secondary manifestation of AML, Skin relapse could be the only one.

Keywords: Leukemia cutis, Leukemia relapse, Acute Myeloid Leukemia, spontaneous resolution of AML

Procedia PDF Downloads 43

Authors: Joseph Udofia, Isaac Olufadewa

Abstract:

Everyday, the size of Electronic Health Records data keeps increasing as new patients visit health practitioner and returning patients fulfil their appointments. As these data grow, so is their susceptibility to cyber-attacks from criminals waiting to exploit this data. In the US, the damages for cyberattacks were estimated at $8 billion (2018), $11.5 billion (2019) and $20 billion (2021). These attacks usually involve the exposure of PII. Health data is considered PII, and its exposure carry significant impact. To this end, an enhancement of Health Policy and Standards in relation to data security, especially among patients and their clinical providers, is critical to ensure ethical practices, confidentiality, and trust in the healthcare system. As Clinical accelerators and applications that contain user data are used, it is expedient to have a review and revamp of policies like the Payment Card Industry Data Security Standard (PCI DSS), the Health Insurance Portability and Accountability Act (HIPAA), the Fast Healthcare Interoperability Resources (FHIR), all aimed to ensure data protection and security in healthcare. FHIR caters for healthcare data interoperability, FHIR caters to healthcare data interoperability, as data is being shared across different systems from customers to health insurance and care providers. The astronomical cost of implementation has deterred players in the space from ensuring compliance, leading to susceptibility to data exfiltration and data loss on the security accuracy of protected health information (PHI). Though HIPAA hones in on the security accuracy of protected health information (PHI) and PCI DSS on the security of payment card data, they intersect with the shared goal of protecting sensitive information in line with industry standards. With advancements in tech and the emergence of new technology, it is necessary to revamp these policies to address the complexity and ambiguity, cost barrier, and ever-increasing threats in cyberspace. Healthcare data in the wrong hands is a recipe for disaster, and we must enhance its protection and security to protect the mental health of the current and future generations.

Keywords: cloud security, healthcare, cybersecurity, policy and standard

Procedia PDF Downloads 63

Authors: Sarah Rietze, Hannes Zacher

Abstract:

Daily stand-up meetings are the most commonly used method in agile teams. In daily stand-ups, team members gather to coordinate and align their efforts, typically for a predefined period of no more than 15 minutes. The primary purpose is to ask and answer the following three questions: What was accomplished yesterday? What will be done today? What obstacles are impeding my progress? Daily stand-ups aim to enhance communication, mutual understanding, and support within the team, as well as promote collective learning from mistakes through daily synchronization and transparency. The use of daily stand-ups is intended to positively influence psychological safety within teams, which is the belief that it is safe to show oneself and take personal risks. Two studies will be presented, which explore the relationships between daily stand-ups, psychological safety, and psychological well-being. In a first study, based on survey results (n = 318), we demonstrated that daily stand-ups have a positive indirect effect on job satisfaction and a negative indirect effect on turnover intention through their impact on psychological safety. In a second study, we investigate, using an experimental design, how the use of daily stand-ups in teams enhances psychological safety and well-being compared to a control group that does not use daily stand-ups. Psychological safety is considered one of the most crucial cultural factors for a sustainable, agile organization. Agile approaches, such as daily stand-ups, are a critical part of the evolving work environment and offer a proactive means to shape and foster psychological safety within teams.

Keywords: occupational wellbeing, agile work practices, psychological safety, daily stand-ups

Procedia PDF Downloads 46

Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

Abstract:

Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

Procedia PDF Downloads 87

Authors: Thirumila Muthukamaru

Abstract:

The objective of a Health Risk Assessment (HRA) is to achieve a quality evaluation of risk assessments in a timely manner where adequate controls can be in place to protect workers health, especially during turnarounds where the exposure to health hazards is expected to rise during the performance of the many activities that take place, exposing workers to health risk. HRA development requires a competent team comprising experienced subject matter experts in the field, such as Industrial hygienists, Occupational Health Doctors, Turnaround Coordinators, Operation / Maintenance personnel, etc. The conventional way of conducting HRA is not only tedious and time-consuming but also less appreciated when it is not interpreted correctly, which may contribute to inadequate operationalization of it. Simplification can be the essence of timely intervention in managing health risks. This paper is intended as a sharing of the approach taken to simplify the methodology of developing the HRA report and operationalizing it. The approach includes developing a Generic HRA for turnaround activities to be used as a reference document and the empowerment of identified personnel through upskilling sessions to take up the role of facilitating HRA sessions. This empowerment is one of the key approaches towards the successful translation of the HRA into specific turnaround Job Hazard Analysis (JHA) that embed it in the Permit to Work (PTW) process. The approach used here increases awareness and compliance on HRA for turnaround activities through better interpretation and operationalization of the HRA report, adding value to the risk assessment for turnaround activities.

Keywords: industrial hygiene, health risk assessment, HRA, risk assessment

Procedia PDF Downloads 27

Authors: Marie Bajnarová

Abstract:

The core part of the research project is represented by taking a perspective on the role of an educator in Juvenile Institutional Centres. In accordance with the research questions, the research explores impact of the environment, situations, practices, attitudes, values and also experience of the respondents. Art activities minimize risky behaviours and contribute to a healthy lifestyle. They also help children and adolescents with conduct disorders develop positive social behaviour, psychosocial skills and cope with difficult life situations.

Keywords: Juvenile Detention Centres, drawing, conduct disorders, art therapy

Procedia PDF Downloads 266

Authors: Mahla Azimi

Abstract:

Introduction: Post-bladder catheter infection is a common and significant healthcare-associated infection that affects individuals with indwelling urinary catheters. These infections can lead to various complications, including urinary tract infections (UTIs), bacteremia, sepsis, and increased morbidity and mortality rates. This article aims to provide a comprehensive review of post-bladder catheter infections, including their causes, risk factors, clinical presentation, diagnosis, treatment options, and preventive measures. Causes and Risk Factors: Post-bladder catheter infections primarily occur due to the colonization of microorganisms on the surface of the urinary catheter. The most common pathogens involved are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species. Several risk factors contribute to the development of these infections, such as prolonged catheterization duration, improper insertion technique, poor hygiene practices during catheter care, compromised immune system function in patients with underlying conditions or immunosuppressive therapy. Clinical Presentation: Patients with post-bladder catheter infections may present with symptoms such as fever, chills, malaise, suprapubic pain or tenderness, and cloudy or foul-smelling urine. In severe cases or when left untreated for an extended period of time, patients may develop more severe symptoms like hematuria or signs of systemic infection. Diagnosis: The diagnosis of post-bladder catheter infection involves a combination of clinical evaluation and laboratory investigations. Urinalysis is crucial in identifying pyuria (presence of white blood cells) and bacteriuria (presence of bacteria). A urine culture is performed to identify the causative organism(s) and determine its antibiotic susceptibility profile. Treatment Options: Prompt initiation of appropriate antibiotic therapy is essential in managing post-bladder catheter infections. Empirical treatment should cover common pathogens until culture results are available. The choice of antibiotics should be guided by local antibiogram data to ensure optimal therapy. In some cases, catheter removal may be necessary, especially if the infection is recurrent or associated with severe complications. Preventive Measures: Prevention plays a vital role in reducing the incidence of post-bladder catheter infections. Strategies include proper hand hygiene, aseptic technique during catheter insertion and care, regular catheter maintenance, and timely removal of unnecessary catheters. Healthcare professionals should also promote patient education regarding self-care practices and signs of infection. Conclusion: Post-bladder catheter infections are a significant healthcare concern that can lead to severe complications and increased healthcare costs. Early recognition, appropriate diagnosis, and prompt treatment are crucial in managing these infections effectively. Implementing preventive measures can significantly reduce the incidence of post-bladder catheter infections and improve patient outcomes. Further research is needed to explore novel strategies for prevention and management in this field.

Keywords: post-bladder catheter infection, urinary tract infection, bacteriuria, indwelling urinary catheters, prevention

Procedia PDF Downloads 64

Authors: Duygu Alptekin

Abstract:

Patriarchal social structure is based on a gender-based discrimination. Due to confrontational nature of discrimination; in a patriarchal society men and women exists in a based on contrasts and inequalities interaction patterns and this situation continues as socio-cultural with dominant gender perception in society. In this context gender perception of youth is a required vision tool for multidimensional understanding and resolving of gender discrimination problem and making projections about future. The aim of the study is explaining the gender discrimination by helping of Ambivalent Sexism Inventory and hostile benevolent sexism which are subdimensions of (ASI). Additionally the sexism perception of youth will be try to analyse ın the context of conflict of conventionalism and modernism. For that purpose survey have carried aout with the participation of students at the Selcuk University and the conclusions revealed that reached ampirically Young people's perceptions about the hierarchy of power revealed between men and women; sexual, economic and occupational segregation by pointing to statements about male-female relationships commitment, guardianship, gratitude, expressions containing highlights the superiority of socio-psychological (ASI) where results are determined by the application. The results of the factor analysis performed in this direction with the detection of the previous studies were evaluated by blending.

Keywords: ambivalent sexism inventory, gender discrimination, youth, conventionalism

Procedia PDF Downloads 317

Authors: S. Abed, S. O’Neill

Abstract:

This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: health care, nurse education, nursing in Iraq, nurse leadership

Procedia PDF Downloads 255

Authors: Neslihan Demirci, Serdar Durdağı

Abstract:

Mycobacterium tuberculosis is still a worldwide disease-causing agent that, according to WHO, led to the death of 1.5 million people from tuberculosis (TB) in 2020. The bacteria reside in macrophages located specifically in the lung. There is a known quadruple drug therapy regimen for TB consisting of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB). Over the past 60 years, there have been great contributions to treatment options, such as recently approved delamanid (OPC67683) and bedaquiline (TMC207/R207910), targeting mycolic acid and ATP synthesis, respectively. Also, there are natural compounds that can block the tryptophanyl-tRNA synthetase (TrpRS) enzyme, chuangxinmycin, and indolmycin. Yet, already the drug resistance is reported for those agents. In this study, the newly released TrpRS enzyme structure is investigated for potential inhibitor drugs from already synthesized molecules to help the treatment of resistant cases and to propose an alternative drug for the quadruple drug therapy of tuberculosis. Maestro, Schrodinger is used for docking and molecular dynamic simulations. In-house library containing ~8000 compounds among FDA-approved indole-containing compounds, a total of 57 obtained from the ChemBL were used for both ATP and tryptophan binding pocket docking. Best of indole-containing 57 compounds were subjected to hit expansion and compared later with virtual screening workflow (VSW) results. After docking, VSW was done. Glide-XP docking algorithm was chosen. When compared, VSW alone performed better than the hit expansion module. Best scored compounds were kept for ten ns molecular dynamic simulations by Desmond. Further, 100 ns molecular dynamic simulation was performed for elected molecules according to Z-score. The top three MMGBSA-scored compounds were subjected to steered molecular dynamic (SMD) simulations by Gromacs. While SMD simulations are still being conducted, ponesimod (for multiple sclerosis), vilanterol (β₂ adrenoreceptor agonist), and silodosin (for benign prostatic hyperplasia) were found to have a significant affinity for tuberculosis TrpRS, which is the propulsive force for the urge to expand the research with in vitro studies. Interestingly, top-scored ponesimod has been reported to have a side effect that makes the patient prone to upper respiratory tract infections.

Keywords: drug repurposing, molecular dynamics, tryptophanyl-tRNA synthetase, tuberculosis

Procedia PDF Downloads 102

Authors: M. R. Aher, R. B. Laware, G. S. Asane, B. S. Kuchekar

Abstract:

Objective: Studies have shown that a new combination therapy with Artemisinin derivatives and curcumin is unique, with potential advantages over known ACTs. In present study an attempt was made to prepare microparticulate drug delivery system of Curcumin-Zn complex and evaluate it in combination with artemether for antimalarial activity. Material and method: Curcumin Zn complex was prepared and encapsulated using sodium alginate. Microparticles thus obtained are further coated with various enteric polymers at different coating thickness to control the release. Microparticles are evaluated for encapsulation efficiency, drug loading and in vitro drug release. Roentgenographic Studies was conducted in rabbits with BaSO 4 tagged formulation. Optimized formulation was screened for antimalarial activity using P. berghei-infected mice survival test and % paracetemia inhibition, alone (three oral dose of 5mg/day) and in combination with arthemether (i.p. 500, 1000 and 1500µg). Curcumin-Zn(II) was estimated in serum after oral administration to rats by using spectroflurometry. Result: Microparticles coated with Cellulose acetate phthalate showed most satisfactory and controlled release with 479 min time for 60% drug release. X-ray images taken at different time intervals confirmed the retention of formulation in GI tract. Estimation of curcumin in serum by spectroflurometry showed that drug concentration is maintained in the blood for longer time with tmax of 6 hours. The survival time (40 days post treatment) of mice infected with P. berghei was compared to survival after treatment with either Curcumin-Zn(II) microparticles artemether combination, curcumin-Zn complex and artemether. Oral administration of Curcumin-Zn(II)-artemether prolonged the survival of P.berghei-infected mice. All the mice treated with Curcumin-Zn(II) microparticles (5mg/day) artemether (1000µg) survived for more than 40 days and recovered with no detectable parasitemia. Administration of Curcumin-Zn(II) artemether combination reduced the parasitemia in mice by more than 90% compared to that in control mice for the first 3 days after treatment. Conclusion: Antimalarial activity of the curcumin Zn-artemether combination was more pronounced than mono therapy. A single dose of 1000µg of artemether in curcumin-Zn combination gives complete protection in P. berghei-infected mice. This may reduce the chances of drug resistance in malaria management.

Keywords: formulation, microparticulate drug delivery, antimalarial, pharmaceutics

Procedia PDF Downloads 377

Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

Abstract:

Klebsiella pneumoniae causes a wide range of infections, including urinary tract infections, sepsis, bacteremia, pneumonia, and liver abscesses. The emergence of multi-drug resistance in this bacterium led to a major setback for clinical management. WHO also endorsed a need for finding alternative therapy to antibiotics for the treatment of these infections. Development of vaccines and passive antibody therapy has been proven as a potent alternative to antibiotics in the case of MDR, XDR, and PDR Klebsiella infections. Siderophore receptors have been demonstrated to be overexpressed for the internalization of iron siderophore complexes during infections in most Gram-negative bacteria. For the present study, immune response to siderophore receptors to establish this protein as a potential immunogen for the development of therapeutic leads was explored. Clinical strains of Klebsiella pneumoniae were grown in iron-deficient conditions, and the iron-regulated outer membrane proteins were extracted and characterized through mass spectrometry for specific identification. The gene for identified protein was cloned in pET- 28a vector and expressed in E. coli. The native protein and the recombinant protein were isolated and purified and used as antigens for the generation of immune response in BALB/c mice. The native protein of Klebsiella pneumoniae grown in iron-deficient conditions was identified as FepA (Ferrienterobactin receptor) and other siderophore receptors. This 80 kDa protein generated an immune response in BALB/c mice. The antiserum from mice after subsequent booster doses was collected and showed binding with FepA protein in western blot and phagocytic uptake of the K. pneumoniae in the presence antiserum from immunized mice also observed from the animal studies after bacterial challenge post immunisation in mice have shown bacterial clearance. The antiserum from mice showed binding and clearance of the Klebsiella pneumoniae bacteria in vitro and in vivo. These antigens used for generating an active immune response in mice can further be used for therapeutic monoclonal antibody development against Klebsiella pneumoniae infections.

Keywords: antiserum, FepA, Klebsiella pneumoniae, multi drug resistance, siderophore receptor

Procedia PDF Downloads 83

Authors: Matthew Scott Lau

Abstract:

This study addresses the research question: How effective has the Community Health Assist Scheme (CHAS) been in reducing market failure in Singapore’s healthcare sector? The CHAS policy, introduced in 2012 in Singapore, aims to improve accessibility and affordability of healthcare by offering subsidies to low and middle-income groups and elderly individuals for general practice consultations and healthcare. The investigation was undertaken by acquiring and analysing primary and secondary research data from 3 main sources, including handwritten survey responses of 334 individuals who were valid CHAS subsidy recipients (CHAS cardholders) from 5 different locations in Singapore, interview responses from two established general practitioner doctors with working knowledge of the scheme, and information from literature available online. Survey responses were analysed to determine how CHAS has affected the affordability and consumption of healthcare, and other benefits or drawbacks for CHAS users. The interview responses were used to explain the benefits of healthcare consumption and provide different perspectives on the impacts of CHAS on the various parties involved. Online sources provided useful information on changes in healthcare consumerism and Singapore’s government policies. The study revealed that CHAS has been largely effective in reducing market failure as the subsidies granted to consumers have improved the consumption of healthcare. This has allowed for the external benefits of healthcare consumption to be realized, thus reducing market failure. However, the study also revealed that CHAS cannot be fully effective in reducing market failure as the scope of CHAS prevents healthcare consumption from fully reaching the socially optimal level. Hence, the study concluded that CHAS has been effective to a large extent in reducing market failure in Singapore’s healthcare sector, albeit with some benefits to third parties yet to be realised. There are certain elements of the investigation, which may limit the validity of the conclusion, such as the means used to determine the socially optimal level of healthcare consumption, and the survey sample size.

Keywords: healthcare consumption, health economics, market failure, subsidies

Procedia PDF Downloads 142

Authors: R. H. Begaydarova, B. Zh. Kultanov, B. T. Esilbaeva, G. E. Nasakaeva, Y. Yukhnevich, G. K. Alshynbekova, A. E. Dyusembaeva

Abstract:

Background: The level of middle molecules of peptides (MMP) allows to evaluate the severity and prognosis of the disease and is a criterion for the effectiveness of the treatment. The detection the products of lipidperoxidation cascade, such as conjugated dienes, malondialdehyde in biological material, has an important role in the development of pathogenesis, the diagnosis and prognosis in different parasitic diseases. Purpose of the study was to evaluate the state of endogenous intoxication and indicators of lipid peroxidation in patients with giardiasis before and after treatment. Materials and methods: Endogenous intoxication was evaluated in patients with giardiasis in the level of middle molecules of peptides (MMP) in the blood. The amount of MMP and products of lipid peroxidation were determined in the blood of 198 patients with giardiasis, 129 of them were women (65%), 69 were men (35%). The MMP level was detected for comparison in the blood of 84 healthy volunteers. The lipid peroxidation were determined in 40 healthy men and women without giardiasis and history of chronic diseases. Data were processed by conventional methods of variation statistics, we calculated the arithmetic mean (M) and standard dispersion (m). t-test (t) was used to assess differences. Results: The level of MMP in the blood was significantly higher in patients with giardiasis in comparison with group of healthy men and women. MMP concentration in the blood of women with Giardia was 2.5 times greater than that of the comparison groups of women. The level of MMP exceeds more than 6 times in men with giardiasis. The decrease in the intensity of endogenous intoxication was two weeks after antigiardia therapy, both men and women. According to the study, a statistically significant increase in the level of all the studied parameters lipid peroxidation cascade was observed in the blood of men with giardiasis, with the exception of the total primary production (NGN). The treatment of giardiasis helped to stabilize the level of almost all metabolites of lipid peroxidation cascade. The exception was level of malondialdehyde, it was significantly elevated to compare with the control group and after treatment. Conclusion: Thus, the MMP level was significantly higher in blood of patients with giardiasis than in comparison group. This is evidence of severe endogenous intoxication caused by giardia infection. The accumulation of primary and secondary products of lipid peroxidation was observed in the blood of men and women. These processes tend to be more active in men than in women. Antigiardiasis therapy contributed to the normalization of almost all the studied indicators of lipid peroxidation in the blood of participants, except the level malondialdehyde in the blood of men.

Keywords: enzymes of antioxidant protection, giardiasis, blood, treatment

Procedia PDF Downloads 220

Authors: Hosam Abdelhady

Abstract:

Filming the behaviors of individual DNA molecules in their environment when they interact with individual medicinal nano-polymers in a molecular scale has opened the door to understand the effect of the molecular shape, size, and incubation time with nanocarriers on optimizing the design of robust genetic Nano molecules able to resist the enzymatic degradation, enter the cell, reach to the nucleus and kill individual cancer cells in their environment. To this end, we will show how we applied the 4D AFM as a guide to finetune the design of genetic nanoparticles and to film the effects of these nanoparticles on the nanomechanical and morphological profiles of individual cancer cells.

Keywords: AFM, dendrimers, nanoparticles, DNA, gene therapy, imaging

Procedia PDF Downloads 61

Authors: Zuzanna Miodonska, Michal Krecichwost, Pawel Badura

Abstract:

Sigmatism (lisping) is a speech disorder in which sibilant consonants are mispronounced. The diagnosis of this phenomenon is usually based on the auditory assessment. However, the progress in speech analysis techniques creates a possibility of developing computer-aided sigmatism diagnosis tools. The aim of the study is to statistically verify whether specific acoustic features of sibilant sounds may be related to pronunciation correctness. Such knowledge can be of great importance while implementing classifiers and designing novel tools for automatic sibilants pronunciation evaluation. The study covers analysis of various speech signal measures, including features proposed in the literature for the description of normative sibilants realization. Amplitudes and frequencies of three fricative formants (FF) are extracted based on local spectral maxima of the friction noise. Skewness, kurtosis, four normalized spectral moments (SM) and 13 mel-frequency cepstral coefficients (MFCC) with their 1st and 2nd derivatives (13 Delta and 13 Delta-Delta MFCC) are included in the analysis as well. The resulting feature vector contains 51 measures. The experiments are performed on the speech corpus containing words with selected sibilant sounds (/ʃ, ʒ/) pronounced by 60 preschool children with proper pronunciation or with natural pathologies. In total, 224 /ʃ/ segments and 191 /ʒ/ segments are employed in the study. The Mann-Whitney U test is employed for the analysis of stigmatism and normative pronunciation. Statistically, significant differences are obtained in most of the proposed features in children divided into these two groups at p < 0.05. All spectral moments and fricative formants appear to be distinctive between pathology and proper pronunciation. These metrics describe the friction noise characteristic for sibilants, which makes them particularly promising for the use in sibilants evaluation tools. Correspondences found between phoneme feature values and an expert evaluation of the pronunciation correctness encourage to involve speech analysis tools in diagnosis and therapy of sigmatism. Proposed feature extraction methods could be used in a computer-assisted stigmatism diagnosis or therapy systems.

Keywords: computer-aided pronunciation evaluation, sigmatism diagnosis, speech signal analysis, statistical verification

Procedia PDF Downloads 283

Authors: Iman Farasat, Howard M. Salis

Abstract:

The CRISPR/Cas9 system has revolutionized genome engineering by enabling site-directed and high-throughput genome editing, genome insertion, and gene knockdowns in several species, including bacteria, yeast, flies, worms, and human cell lines. This technology has the potential to enable human gene therapy to treat genetic diseases and cancer at the molecular level; however, the current CRISPR/Cas9 system suffers from seemingly sporadic off-target genome mutagenesis that prevents its use in gene therapy. A comprehensive mechanistic model that explains how the CRISPR/Cas9 functions would enable the rational design of the guide-RNAs responsible for target site selection while minimizing unexpected genome mutagenesis. Here, we present the first quantitative model of the CRISPR/Cas9 genome mutagenesis system that predicts how guide-RNA sequences (crRNAs) control target site selection and cleavage activity. We used statistical thermodynamics and law of mass action to develop a five-step biophysical model of cas9 cleavage, and examined it in vivo and in vitro. To predict a crRNA's binding specificities and cleavage rates, we then compiled a nearest neighbor (NN) energy model that accounts for all possible base pairings and mismatches between the crRNA and the possible genomic DNA sites. These calculations correctly predicted crRNA specificity across 5518 sites. Our analysis reveals that cas9 activity and specificity are anti-correlated, and, the trade-off between them is the determining factor in performing an RNA-mediated cleavage with minimal off-targets. To find an optimal solution, we first created a scheme of safe-design criteria for Cas9 target selection by systematic analysis of available high throughput measurements. We then used our biophysical model to determine the optimal Cas9 expression levels and timing that maximizes on-target cleavage and minimizes off-target activity. We successfully applied this approach in bacterial and mammalian cell lines to reduce off-target activity to near background mutagenesis level while maintaining high on-target cleavage rate.

Keywords: biophysical model, CRISPR, Cas9, genome editing

Procedia PDF Downloads 387

Authors: Ji-Chan Jang

Abstract:

Tuberculosis is still major health problem because there is an increase of multidrug-resistant and extensively drug-resistant forms of the disease. Therefore, the most urgent clinical need is to discover potent agents and develop novel drug combination capable of reducing the duration of MDR and XDR tuberculosis therapy. Three reference strains H37Rv, CDC1551, W-Beijing GC1237 and six clinical isolates of MDRTB were tested to daptomycin in the range of 0.013 to 256 mg/L. Daptomycin is resistant to all tested M. tuberculosis strains not only laboratory strains but also clinical MDR strains that were isolated at different source. Daptomycin will not be an antibiotic of choice for treating infection of Gram positive atypical slowly growing M. tuberculosis.

Keywords: tuberculosis, daptomycin, resistance, Mycobacterium tuberculosis

Procedia PDF Downloads 355

Authors: Mohammed Gamil Montasser, Angelo Battaglia

Abstract:

Entrepreneurship is mostly related to the beginning of organization. In growing business organizations, entrepreneurship expands its conceptualization. It reveals itself through new business creation in the active organization, through renewal, change, innovation, creation and development of current organization, through breaking and changing of established rules inside or outside the organization and becomes more flexible, adaptive and competitive, also improving effectiveness of organization activity. Therefore, the topic of entrepreneurship, relates the creation of firms to personal / individual characteristics of the entrepreneurs and their social context. This paper is an empirical study, which aims to address these two gaps in the literature. For this endeavor, we use the latest available data from the Global Entrepreneurship Monitor (GEM) project. This data set is widely regarded as a unique source of information about entrepreneurial activity, as well as the aspirations and attitudes of individuals across a wide number of countries and territories worldwide. This paper tries to contribute to fill this gap, by exploring the key drivers of innovative entrepreneurship in the tourism sector. Our findings are consistent with the existing literature in terms of the individual characteristics of entrepreneurs, but quite surprisingly we find an inverted U-shape relation between human development and innovative entrepreneurship in tourism sector. It has been revealed that tourism entrepreneurs are less likely to have innovative products, compared with entrepreneurs in medium developed countries.

Keywords: GEM, human development, innovative entrepreneurship, occupational choice, tourism

Procedia PDF Downloads 241