Search results for: oral delivery

Authors: T. L. Granzyk, S. Scarborough, J. DeCosmo

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The use of health-related or medical narratives has gained increasing anecdotal and research-based support as a successful device for changing health behavior and outcomes. These narratives, in the form of oral storytelling, short films, and educational documentaries, for example, are most effective when including empathetic characters that transport viewers into the story and command both their attention and emotional response. This case study outlines how and why one large health system created a short narrative film for their internal Sepsis Awareness campaign, which told the dramatic story of a patient recovering from a missed sepsis diagnosis, leaving her a quad-amputee. Results include positive global anecdotal response to the film from healthcare professionals and patients, as well as use of the film to support legislation, ultimately passed in favor of the formation of Sepsis Awareness Workgroups in Maryland. Authors conclude that narrative films can be used successfully to initiate healthcare legislation and to increase internal and external awareness of health-related areas in need of greater improvement and support. As such, healthcare leaders and stakeholders would benefit from learning how to intentionally create, cultivate, and curate narratives from within their own health systems that elicit an empathetic response.

Keywords: healthcare policy, healthcare narratives, sepsis awareness, short films

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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: Tzu-I Chiang

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A central question for finite-nonfinite distinction in Mandarin Chinese is how does Mandarin encode temporal information without the grammatical contrast between past and present tense. Moreover, how do L2 learners of Mandarin whose native language is English and whose L1 system has tense morphology, acquire the temporal encoding system in L2 Mandarin? The current study reports preliminary findings on the relationship between topic prominence and the temporal encoding in L1 and L2 Chinese. Oral narratives data from 30 natives and learners of Mandarin Chinese were collected via a film-retell task. In terms of coding, predicates collected from the narratives were transcribed and then coded based on four major verb types: n-degree Statives (quality-STA), point-scale Statives (status-STA), n-atom EVENT (ACT), and point EVENT (resultative-ACT). How native speakers and non-native speakers started retelling the story was calculated. Results of the study show that native speakers of Chinese tend to express Topic Time (TT) syntactically at the topic position; whereas L2 learners of Chinese across levels rely mainly on the default time encoded in the event types. Moreover, as the proficiency level of the learner increases, learners’ appropriate use of the event predicates increased, which supports the argument that L2 development of temporal encoding is affected by lexical aspect.

Keywords: topic prominence, temporal encoding, lexical aspect, L2 acquisition

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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: S. Öcal, A. Erakgün, E. Yüksel, M. N. Deniz, E. Erhan, A. Çertuğ

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Background: Emergence agitation (EA) is defined as a dissociated state of consciousness during the early post-anesthesia period in which the child is inconsolable, irritable, uncompromising or uncooperative, typically thrashing, crying, moaning, or incoherent, and not recognizing or identifying familiar and known objects or people. Some studies found preoperative parental anxiety to be a predictor of EA. Methods: Seventy-four children, between the ages of 3-12 undergoing adenoidectomy/tonsillectomy at Ege University Hospital, were studied. Anesthesia was induced and maintained using 2% sevoflurane in 50% oxygen and 50% air following a premedicative dose of 0.5mg/kg oral midazolam. After the children were taken into the operating theater, the mothers were given the State-Trait Anxiety Inventory (STAI) questionnaire. To evaluate EA, Post Anesthetic Emergence Delirium (PAED) score of the children were noted every 10min during the first 30min of the postoperative period. EA was defined with a highest PAED score of ≥ 10, and non-EA with a highest PAED score of ≤ 9. Results: In this study, the incidence of postoperative EA was 31% (34% under the age of 6 and 19% over). Mothers of children with EA were found not to be significantly more anxious on STAI compared to mothers of non-EA children. Conclusions: Contrary to some earlier studies, we were unable to find an association between preoperative parental anxiety and postoperative EA.

Keywords: parental anxiety, emergence agittion, Post Anesthetic Emergence Delirium, anesthesia

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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: 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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Authors: Srikanth Nagarajan, P. Parthasarathy, Frits Lagers

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Lower crude oil prices increased the pressure on oil and gas projects. Being competitive becomes very important and critical for the success in any industry. Increase in size of the project multiplies the magnitude of the issue. Timely completion of projects within the budget and schedule is very important for any project to succeed. A simple idea makes a larger impact on the total cost of the plant. In this robust world, the phases of engineering right from licensing technology, feed, different phases of detail engineering, procurement and construction has been so much compressed that they overlap with each other. Hence constructability techniques have become very important. Here in this paper, the focus will be on how these techniques can be implemented and reduce cost with the help of a case study. Constructability is a process driven by the need to impact project’s construction phase resulting in improved project delivery, costs and schedule. In construction phase of one of our fast-track mega project, it was noticed that there was an opportunity to reduce significant amount of cost and schedule by implementing Constructability study processes. In this case study, the actual methodology adopted during engineering and construction and the way for doing it better by implementing Constructability techniques with collaborative engineering efforts will be explained.

Keywords: being competitive, collaborative engineering, constructability, cost reduction

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Authors: Abdul Musaweer Habib, Habibul Hasan Mazumder, Saiful Islam, Sohel Sikder, Omar Faruk Sikder

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The plethora of genome sequence information of bacteria in recent times has ushered in many novel strategies for antibacterial drug discovery and facilitated medical science to take up the challenge of the increasing resistance of pathogenic bacteria to current antibiotics. In this study, we adopted subtractive genomics approach to analyze the whole genome sequence of the Fusobacterium nucleatum, a human oral pathogen having association with colorectal cancer. Our study divulged 1499 proteins of Fusobacterium nucleatum, which has no homolog in human genome. These proteins were subjected to screening further by using the Database of Essential Genes (DEG) that resulted in the identification of 32 vitally important proteins for the bacterium. Subsequent analysis of the identified pivotal proteins, using the KEGG Automated Annotation Server (KAAS) resulted in sorting 3 key enzymes of F. nucleatum that may be good candidates as potential drug targets, since they are unique for the bacterium and absent in humans. In addition, we have demonstrated the 3-D structure of these three proteins. Finally, determination of ligand binding sites of the key proteins as well as screening for functional inhibitors that best fitted with the ligands sites were conducted to discover effective novel therapeutic compounds against Fusobacterium nucleatum.

Keywords: colorectal cancer, drug target, Fusobacterium nucleatum, homology modeling, ligands

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Authors: Y. S. Mohamed, L. A. Ahmed, H. A. Salem, A. M. Agha

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Liver Fibrosis is one of the most serious conditions that affect the Egyptian society. In the present study, the effect of nicorandil was investigated in experimentally-induced liver fibrosis by bile duct ligation in rats. Nicorandil (3mg/kg/day) was given orally 24 h after bile duct ligation for 14 days till the end of the experiment. Nicorandil group showed a significant improvement in liver function tests (ALT and ALP) as well as a significant decrease in oxidative stress biomarkers (TBARS and GSH), area of fibrosis and activity of hepatic stellate cells as indicated by decreased expression of alpha smooth muscle actin.Moreover, nicorandil treatment decreased HSCs proliferation due to its inhibitory effects on protein kinase C(PKC) and Platelet derived growth factor (PDGF) . Oral administration of either glibenclamide (10 mg/kg/day)(a KATP channel blocker) or L-NAME (30 mg/kg/day) (an inhibitor of nitric oxide synthase) blocked the protective effects of nicorandil. However, nicorandil and L-NAME treated group showed more or less results similar to that of untreated bile duct ligated group. In conclusion, nicorandil was effective against the development of bile duct ligated-induced liver fibrosis in rats where activation of the NO pathway plays an important role in the protective effect nicorandil.

Keywords: hepatic stellate cells, nicorandil, nitric oxide donor, liver fibrosis

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Authors: Dennis Infante

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This paper examined the reflections of teachers on curriculum reforms, the implementation of the K-12 Basic Education Program in the Philippines. The results revealed that problems and concerns raised by teachers could be classified into curriculum materials and design; competence, readiness and motivation of the teachers; the learning environment, and support systems; readiness, competence and motivation of students; and other relevant factors. The best features of the K-12 curriculum reforms included (1) the components, curriculum materials; (2) the design, structure and delivery of the lessons; (3) the framework and theoretical approach; (3) the qualities of the teaching-learning activities; (4) and other relevant features. With the demanding task of implementing the new curriculum, the teachers expressed their needs which included (1) making the curriculum materials available to achieve the goals of the curriculum reforms; (2) enrichment of the learning environments; (3) motivating and encouraging the teachers to embrace change; (4) providing appropriate support systems; (5) re-tooling, and empowering teachers to implement the curriculum reforms; and (6) other relevant factors. The research concluded with a synthesis that provided a paradigm for implementing curriculum reforms which recognizes the needs of the teachers and the features of the new curriculum.

Keywords: curriculum reforms, K-12, teachers' reflections, implementing curriculum change

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Authors: Dagim Ali Hussen, Adnan A. Bekhit, Ariaya Hymete

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In this study, several pyridine derivatives were synthesized and evaluated for their in vitro antimicrobial activity against gram-positive bacteria (S. aureus and B. Cereus), gram-negative bacteria (P. aeruginosa and E. coli) and fungus (C. albican and A niger). The intermediate chalcone derivative 2a,b was synthesized by condensation of pyrazole aldehydes 1a,b with acetophenone in alcoholic KOH. Cyclization of 2a,b with ethyl cyanoacetate ad ammonium acetate resulted in pyridine carbonitrile derivatives 3a,b. Furthermore, condensation of pyridine-4-carboxaldeyhe with different amino-derivatives gave rise to pyridine derivatives 5a,b, 6a,b. The oxadiazole derivative 7a was prepared by cyclization of 6a with acetic anhydride. Characterization of the synthesized compound was performed using IR, 1H NMR, 13C NMR spectra and elemental microanalyses. The antimicrobial results revealed that compounds 5a, 6b and 7a exhibited half fold antibacterial activity compared to ampicillin, against B. cereus. On the other hand, compound 3b showed an equivalent activity compared to miconazole against candida albican (CANDAL 03) and to clotrimazole against the clinical isolate candida albican 6647. Moreover, this compound 3b was further tested for its acute toxicity profile. The results showed that oral LD50 is more that 300 mg/kg and parentral LD50 is more than 100 mg/kg. Compound 3b is a good candidate for antifungal agent with good toxicity profile, and deserves more chemical derivatization and clinical study.

Keywords: antifungal, antimicrobial, Candida albican, pyridine

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Authors: K. A. Adeleke

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Often in epidemiological research, introducing stratified Cox model can account for the existence of interactions of some inherent factors with some major/noticeable factors. This research work aimed at modelling correlated variables in infant mortality with the existence of some inherent factors affecting the infant survival function. An alternative semiparametric Stratified Cox model is proposed with a view to take care of multilevel factors that have interactions with others. This, however, was used as a tool to model infant mortality data from Nigeria Demographic and Health Survey (NDHS) with some multilevel factors (Tetanus, Polio, and Breastfeeding) having correlation with main factors (Sex, Size, and Mode of Delivery). Asymptotic properties of the estimators are also studied via simulation. The tested model via data showed good fit and performed differently depending on the levels of the interaction of the strata variable Z*. An evidence that the baseline hazard functions and regression coefficients are not the same from stratum to stratum provides a gain in information as against the usage of Cox model. Simulation result showed that the present method produced better estimates in terms of bias, lower standard errors, and or mean square errors.

Keywords: stratified Cox, semiparametric model, infant mortality, multilevel factors, cofounding variables

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Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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Authors: Nitika Sharma, Yogesh Jain

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Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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Authors: Teng Minnie Y., Jarus Tal, Wong Anita

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Introduction: The COVID-19 pandemic has altered the lifestyle of all Canadians. While "stay-at-home" public health directives have been implemented to mitigate the spread of COVID-19, they may also lead to or worsen physical and social health challenges for older adults. In particular, older adults with disabilities are especially vulnerable. In response, we quickly adapted to virtual rehabilitation exercise intervention for older adults. Objectives: First, to identify the factors that influenced the acceptability and feasibility of virtual exercise implementation, and second, to evaluate whether the virtual delivery was effective for health promotion in older adults with disabilities. Methods: We carried out weekly virtual exercise programs from January 2021 to June 2021. We conducted semi-structured focus groups and interviews to explore the perspectives of participants who are older adults. The focus group and interview data are transcribed and coded thematically. Conclusions: The acceptability and feasibility of delivering exercises virtually were influenced by the provision of a safe and supportive environment for social connection, the availability of the necessary technology, and the role of the support system.

Keywords: physical activity, virtual exercises, older adults, people with disabilities

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Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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Authors: Melissa C. LaDuke

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The overarching purpose of this study was to determine the relationship between the current format of online delivery for Defense Acquisition University (DAU) courses and Air Force Acquisition (AFA) personnel participation. AFA personnel (hereafter named “student”) were particularly of interest, as they have been mandated to take anywhere from 3 to 30 online courses to earn various DAU specialization certifications. Participants in this qualitative case study were AFA personnel who pursued DAU certifications in science and technology management, program/contract management, and other related fields. Air Force personnel were interviewed about their experiences with online courses. The data gathered were analyzed and grouped into 12 major themes. The themes tied into the theoretical framework and spoke to either teacher-centered or student-centered educational practices within Defense Acquisitions University. Based on the results of the data analysis, various factors contributed to student perceptions of DAU courses, including the online course construct and relevance to their job. The analysis also found students want to learn the information presented but would like to be able to apply the information learned in meaningful ways.

Keywords: educational theory, computer-based training, interview, student perceptions, online course design, teacher positionality

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Authors: Dasha Karzunina, Laura Bridgestock

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Our oral presentation will be based on our qualitative and quantitative findings into motivations and challenges faced by international and UK students when choosing a university abroad. The insight was gathered through a series of over 60 focus groups held with prospective university students all over the world, including masters and PhD applicants. We spoke to students face-to-face in Latin America, North American, India, China, South East Asia and the major European cities. A survey was carried out alongside, to gather additional insight on their priorities and attitudes to universities’ reputation, collecting over 1,800 responses. The session’s aims are to break down some of the myths about the perspectives of international students and inform university leaders interested in recruiting more highly talented students from abroad and those currently working with international students. As a provider of one of the most demanded resources in higher education, QS World University Rankings, we specialize in understanding universities’ performance, their institutional brand and the impact of rankings on student recruitment. We therefore feel we are well placed to carry out and present this research. We hope for our findings to act as a bridge between bright students and their future universities abroad. We intend for our session to be interactive and so are happy to go into more depth on any of the destinations we visited, depending on what the audience is most interested in and which questions we receive.

Keywords: international student recruitment, market research, rankings, study abroad

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Authors: Ruwan Gunawardane

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This paper attempts to emphasize the benefits of conducting an intensive course in English for university entrants. In the Sri Lankan university context, an intensive course in English is usually conducted amidst various obstacles. In the 1970s and 1980s, undergraduates had intensive programmes in English for two to three months. Towards the end of the 1990s, a programme called General English Language Training (GELT) was conducted for the new students, and it was done outside universities before they entered their respective universities. Later it was not conducted, and that also resulted in students’ poor performance in English at university. However, having understood its importance, an eight week long intensive course in English was conducted for the new intake of the Faculty of Science, University of Ruhuna. As the findings show, the students heavily benefited from the programme. More importantly, they had the opportunity to refresh their knowledge of English gained at school and private institutions while gaining new knowledge. Another advantage was that they had plenty of time to enjoy learning English since the learners had adequate opportunities to carry out communicative tasks and the course was not exam-oriented, which reduced their fear of making mistakes in English considerably. The data was collected through an open-ended questionnaire given to 60 students, and their oral feedback was also taken into consideration. In addition, a focus group interview with 6 teachers was also conducted to get an idea about their experience and perception. The data were qualitatively analyzed. The findings suggest that an intensive programme in English undoubtedly lays a good foundation for the students’ academic career at university.

Keywords: intensive course, English, teachers, undergraduates, experience, perception

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Authors: Nader A. Al Theeb, Zaid Abu Manneh, Ibrahim Al-Qadi

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Traveling salesman problem (TSP) is a combinatorial integer optimization problem that asks "What is the optimal route for a vehicle to traverse in order to deliver requests to a given set of customers?”. It is widely used by the package carrier companies’ distribution centers. The main goal of applying the TSP in courier organizations is to minimize the time that it takes for the courier in each trip to deliver or pick up the shipments during a day. In this article, an optimization model is constructed to create a new TSP variant to optimize the routing in a courier organization with a consideration of congestion in Amman, the capital of Jordan. Real data were collected by different methods and analyzed. Then, concert technology - CPLEX was used to solve the proposed model for some random generated data instances and for the real collected data. At the end, results have shown a great improvement in time compared with the current trip times, and an economic study was conducted afterwards to figure out the impact of using such models.

Keywords: travel salesman problem, congestions, pick-up, integer programming, package carriers, service engineering

Procedia PDF Downloads 413