Search results for: OPVD operative vaginal delivery

Authors: Jiji Jose, R. Narayanacharyulu, Molly Mathew, Jisha Prems

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Introduction: Lercanidipine hydrochloride (LD), an effective calcium channel blocker, widely used for the treatment of chronic stable angina and hypertension seems to be potential transdermal therapeutic system candidate, mainly due to its low oral bio availability, short half life and high first-pass metabolism. Objective: To develop transdermal therapeutic systems for LD and to evaluate its in vivo performance in rabbits. Methodology: Transdermal patches of LD were formulated using the polymer blend of eudragit RL100 (ERL) and polyvinyl pyrolidone (PVP) by casting method Propylene glycol (PG) and tween 80 were used as plasticizer and permeation enhancer respectively. The pharmaco kinetic parameters of LD after the administration of transdermal patches was compared with that of oral administration. The study was carried out in a two way crossover design in male New Zealand albino rabbits. Results: The formulation with ERL: PVP ratio 1:4 with 15% w/w PG as plasticizer and 4% w/w tween 80 as permeation enhancer showed the best drug release results. The pharmacokinetic parameters such as Cmax, tmax, mean residence time (MRT) and area under the curve (AUC 0-∞) were significantly different following transdermal administration compared to oral administration. The terminal half life of transdermally administered LD was found to similar that of oral administration. A sustained drug release over a period of 24 hrs was observed after transdermal administration. Conclusion: The fabricated transdermal delivery system have the potential to provide controlled and extended drug release, better bio availability and thus, this may improve the patient compliance.

Keywords: transdermal therapeutic system, lercanidipine hydrochloride, eudragit, skinpermeation

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Authors: Jasmin Cowin

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Augmented reality digital technologies, big data, and the need for a teacher workforce able to meet the demands of a knowledge-based society are poised to lead to major changes in the field of education. This paper explores applications and educational use cases of augmented reality digital technologies for educational organizations during the Fourth Industrial Revolution. The Fourth Industrial Revolution requires vision, flexibility, and innovative educational conduits by governments and educational institutions to remain competitive in a global economy. Educational organizations will need to focus on teaching in and for a digital age to continue offering academic knowledge relevant to 21st-century markets and changing labor force needs. Implementation of contemporary disciplines will need to be embodied through learners’ active knowledge-making experiences while embracing ubiquitous accessibility. The power of distributed ledger technology promises major streamlining for educational record-keeping, degree conferrals, and authenticity guarantees. Augmented reality digital technologies hold the potential to restructure educational philosophies and their underpinning pedagogies thereby transforming modes of delivery. Structural changes in education and governmental planning are already increasing through intelligent systems and big data. Reimagining and redesigning education on a broad scale is required to plan and implement governmental and institutional changes to harness innovative technologies while moving away from the big schooling machine.

Keywords: fourth industrial revolution, artificial intelligence, big data, education, augmented reality digital technologies, distributed ledger technology

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Authors: Yousuf Nasser Al Khamisi

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Purpose: This paper presents a Knowledge Transfer (KT) Framework in healthcare sectors by applying a systematic literature review process to the healthcare organizations domain to identify enablers and barriers of KT in Healthcare. Methods: The paper conducted a systematic literature search of peer-reviewed papers that described key elements of KT using four databases (Medline, Cinahl, Scopus, and Proquest) for a 10-year period (1/1/2008–16/10/2017). The results of the literature review were used to build a conceptual framework of KT in healthcare organizations. The author used a systematic review of the literature, as described by Barbara Kitchenham in Procedures for Performing Systematic Reviews. Findings: The paper highlighted the impacts of using Knowledge Management (KM) concept at a healthcare organization in controlling infectious diseases in hospitals, improving family medicine performance and enhancing quality improvement practices. Moreover, it found that good-coding performance is analytically linked with a knowledge sharing network structure rich in brokerage and hierarchy rather than in density. The unavailability or ignored of the latest evidence on more cost-effective or more efficient delivery approaches leads to increase the healthcare costs and may lead to unintended results. Originality: Search procedure produced 12,093 results, of which 3523 were general articles about KM and KT. The titles and abstracts of these articles had been screened to segregate what is related and what is not. 94 articles identified by the researchers for full-text assessment. The total number of eligible articles after removing un-related articles was 22 articles.

Keywords: healthcare organisation, knowledge management, knowledge transfer, KT framework

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Authors: Jin Fan, M. Ala Saadeghvaziri

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Unmanned aerial vehicles (UAVs), also referred to as drones, equipped with various kinds of advanced detecting or surveying systems, are effective and low-cost in data acquisition, data delivery and sharing, which can benefit the building of infrastructures. This paper will give an overview of applications of drones in planning, designing, construction and maintenance of infrastructures. The drone platform, detecting and surveying systems, and post-data processing systems will be introduced, followed by cases with details of the applications. Challenges from different aspects will be addressed. Opportunities of drones in infrastructure include but not limited to the following. Firstly, UAVs equipped with high definition cameras or other detecting equipment are capable of inspecting the hard to reach infrastructure assets. Secondly, UAVs can be used as effective tools to survey and map the landscape to collect necessary information before infrastructure construction. Furthermore, an UAV or multi-UVAs are useful in construction management. UVAs can also be used in collecting roads and building information by taking high-resolution photos for future infrastructure planning. UAVs can be used to provide reliable and dynamic traffic information, which is potentially helpful in building smart cities. The main challenges are: limited flight time, the robustness of signal, post data analyze, multi-drone collaboration, weather condition, distractions to the traffic caused by drones. This paper aims to help owners, designers, engineers and architects to improve the building process of infrastructures for higher efficiency and better performance.

Keywords: bridge, construction, drones, infrastructure, information

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Authors: Andreas Helwig, John Bell, Wangmo

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Hybrid energy storage systems (HESS) are gaining popularity for grid energy storage (ESS) driven by the increasingly dynamic nature of energy demands, requiring both high energy and high power density. Particularly the ability of energy storage systems via inverters to respond to increasing fluctuation in energy demands, the combination of lithium Iron Phosphate (LFP) battery and supercapacitor (SC) is a particular example of complex electro-chemical devices that may provide benefit to each other for pulse width modulated DC to AC inverter application. This is due to SC’s ability to respond to instantaneous, high-current demands and batteries' long-term energy delivery. However, there is a knowledge gap on the current sharing mechanism within a HESS supplying a load powered by high-frequency pulse-width modulation (PWM) switching to understand the mechanism of aging in such HESS. This paper investigates the prediction of current utilizing various equivalent circuits for SC to investigate sharing between battery and SC in MATLAB/Simulink simulation environment. The findings predict a significant reduction of battery current when the battery is used in a hybrid combination with a supercapacitor as compared to a battery-only model. The impact of PWM inverter carrier switching frequency on current requirements was analyzed between 500Hz and 31kHz. While no clear trend emerged, models predicted optimal frequencies for minimized current needs.

Keywords: hybrid energy storage, carrier frequency, PWM switching, equivalent circuit models

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Authors: Omil Nady Mahrous Maximous

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The construction industry is currently experiencing a shift towards digitisation. This transformation is driven by adopting technologies like Building Information Modelling (BIM), drones, and augmented reality (AR). These advancements are revolutionizing the process of designing, constructing, and operating projects. BIM, for instance, is a new way of communicating and exploiting technology such as software and machinery. It enables the creation of a replica or virtual model of buildings or infrastructure projects. It facilitates simulating construction procedures, identifying issues beforehand, and optimizing designs accordingly. Drones are another tool in this revolution, as they can be utilized for site surveys, inspections, and even deliveries. Moreover, AR technology provides real-time information to workers involved in the project. Implementing these technologies in the construction industry has brought about improvements in efficiency, safety measures, and sustainable practices. BIM helps minimize rework and waste materials, while drones contribute to safety by reducing workers' exposure to areas. Additionally, AR plays a role in worker safety by delivering instructions and guidance during operations. Although the digital transformation within the construction industry is still in its early stages, it holds the potential to reshape project delivery methods entirely. By embracing these technologies, construction companies can boost their profitability while simultaneously reducing their environmental impact and ensuring safer practices.

Keywords: architectural education, construction industry, digital learning environments, immersive learning BIM, digital construction, construction technologies, digital transformation artificial intelligence, collaboration, digital architecture, digital design theory, material selection, space construction

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Authors: Siti Nor Amira Bt. Mohamad, Mohamad Yazis B. Ali Basah, Muhammad Ridhwan B. Ab. Aziz, Khairil Faizal B. Khairi, Mazlynda Bt. Md. Yusuf, Hisham B. Sabri

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The understanding of risk and the concept of it occurs associated in Islamic financing was well-known in the financial industry by the using of Profit-and-Loss Sharing (PLS). It was presently in any Islamic financial transactions in order to comply with shariah rules. However, the existence of risk in Murabahah contract of financing is an ability that the counterparty is unable to complete its obligations within the agreed terms. Therefore, it is called as credit or default risk. Credit risk occurs when the client fails to make timely payment after the bank makes complete delivery of assets. Thus, it affects the growth of the bank as the banking business is in no position to have appropriate measures to cover the risk. Therefore, the bank may impose penalty on the outstanding balance. This paper aims to highlight the credit risk determinant and issues surrounding in Islamic bank in Malaysia in terms of Murabahah financing and how to manage it by using the proper techniques. Finally, it explores the credit risk management concept that might solve the problems arise. The study found that the credit risk can be managed properly by improving the use of comprehensive reference checklist of business partners on their character and past performance as well as their comprehensive database. Besides that, prevention of credit risk can be done by using collateral as security against the risk and we also argue on the Shariah guidelines and procedures should be implement coherently by the banking business because so that the risk would be control by having an effective instrument for Islamic modes of financing.

Keywords: Islamic banking, credit risk, Murabahah financing, risk mitigation

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Authors: Polina Prokopovich

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Disease-modifying osteoarthritis drugs (DMOADs) are a new therapeutic class for OA, preventing or inhibiting OA development. Unfortunately, none of the DMOADs have been clinically approved due to their poor therapeutic effects in clinical trials. The joint environment has played a role in the poor clinical performance of these drugs by limiting the amount of drug effectively delivered as well as the time that the drug spends within the joint space. The current study aims to enhance the cartilage uptake and retention time of the DMOADs-model (licofelone), which showed a significant therapeutic effect against OA progression and is currently in phase III. Licofelone will be covalently conjugated to the hydrolysable, cytocompatible, and cationic poly beta-amino ester polymers (PBAE). The cationic polymers (A16 and A87) can be electrostatically attached to the negatively charged cartilage component (glycosaminoglycan), which will increase the drug penetration through the cartilage and extend the drug time within the cartilage. In the cartilage uptake and retention time studies, an increase of 18 to 37 times of the total conjugated licofelone to A87 and A16 was observed when compared to the free licofelone. Furthermore, the conjugated licofelone to A87 was detectable within the cartilage at 120 minutes, while the free licofelone was not detectable after 60 minutes. Additionally, the A87-licofelone conjugate showed no effect on the chondrocyte viability. In conclusion, the cationic A87 and A16 polymers increased the percentage of licofelone within the cartilage, which could potentially enhance the therapeutic effect and pharmacokinetic performance of licofelone or other DMOADs clinically.

Keywords: PBAE, cartilage., osteoarthritis, injectable biomaterials, drug delivery

Procedia PDF Downloads 74

Authors: Md. Shadab, Mariyam N. Nashid, Venkata Srikanth Meka, Thiagarajan Madheswaran

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Naringenin (NAR), is a naturally occurring plant flavonoid, found predominantly in citrus fruits, that possesses a wide range of pharmacological properties including anti-oxidant, anti-inflammatory behaviour, cholesterol-lowering and anticarcinogenic activities. However, despite the therapeutic potential of naringenin shown in a number of animal models, its clinical development has been hindered due to its low aqueous solubility, slow dissolution rate and inefficient transport across biological membranes resulting in low bioavailability. Naringenin nanosuspension were produced using stabilizers Tween® 80 by high pressure homogenization techniques. The nanosuspensions were characterized with regard to size (photon correlation spectroscopy (PCS), size distribution, charge (zeta potential measurements), morphology, short term physical stability, dissolution profile and antioxidant potential. A nanocrystal PCS size of about 500 nm was obtained after 20 homogenization cycles at 1500 bar. The short-term stability was assessed by storage of the nanosuspensions at 4 ◦C, room temperature and 40 ◦C. Result showed that naringenin nanosuspension was physically unstable due to large fluctuations in the particle size and zeta potential after 30 days. Naringenin nanosuspension demonstrated higher drug dissolution (97.90%) compared to naringenin powder (62.76%) after 120 minutes of testing. Naringenin nanosuspension showed increased antioxidant activity compared to naringenin powder with a percentage DPPH radical scavenging activity of 49.17% and 31.45% respectively at the lowest DPPH concentration.

Keywords: bioavailability, naringenin, nanosuspension, oral delivery

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Authors: Volker Koch, Sigrid Swobodnik, Bernd M. Zunk

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The success of companies on globalized markets is significantly influenced by the performance of purchasing departments and, of course, the individuals employed as professional purchasers. Nonetheless, this is generally accepted in practice, in literature as well as in empirical research, only insufficient attention was given to the assessment of this relationship between the personality of professional purchasers and their individual performance. This paper aims to describe the relationship against the background of the 'Big Five Inventory'. Based on the five dimensions of a personality (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) a research model was designed. The research model divides the individual performance of professional purchasers into two major dimensions: operational and strategic. The operational dimension consists of the items 'cost', 'quality delivery' and 'flexibility'; the strategic dimension comprises the positions 'innovation', 'supplier satisfaction' as wells as 'purchasing and supply management integration in the organization'. To test the research model, a survey study was performed, and an online questionnaire was sent out to purchasing professionals in Austrian companies. The data collected from 78 responses was used to test the research model applying a group comparison. The comparison points out that there is (i) an influence of the purchasers’ personality on the individual performance of professional purchasers and (ii) a link between purchasers’ personality to a high or a low individual performance of professional purchasers. The findings of this study may help human resource managers during staff recruitment processes to identify the 'right performing personality' for an operational and/or a strategic position in purchasing departments.

Keywords: big five inventory, individual performance, personality, purchasing professionals

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Authors: Seon Yeong Byeon, Hwa Sung Shin

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Nanofibrous sheets are of interest in the beauty industries due to the properties of moisturizing, adhesion to skin and delivery of nutrient materials. The benefit and function of the cosmetic products should not be considered without safety thus a non-toxic manufacturing process is ideal when fabricating the products. In this study, we have developed cosmetic patches consisting of alginate and Spirulina extract, a marine resource which has antibacterial and antioxidant effects, without addition of harmful cross-linkers. The patches obtained their structural stabilities by layer-upon-layer electrospinning of an alginate layer on a formerly spread polycaprolactone (PCL) layer instead of crosslinking method. The morphological characteristics, release of Spirulina extract, water absorption, skin adhesiveness and cytotoxicity of the double-layered patches were assessed. The image of scanning electron microscopy (SEM) showed that the addition of Spirulina extract has made the fiber diameter of alginate layers thinner. Impregnation of Spirulina extract increased their hydrophilicity, moisture absorption ability and skin adhesive ability. In addition, wetting the pre-dried patches resulted in releasing the Spirulina extract within 30 min. The patches were detected to have no cytotoxicity in the human keratinocyte cell-based MTT assay, but rather showed increased cell viability. All the results indicate the bioactive and hydro-adhesive double-layered patches have an excellent applicability to bioproducts for personal skin care in the trend of ‘A mask pack a day’.

Keywords: alginate, cosmetic patch, electrospun nanofiber, polycaprolactone, Spirulina extract

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Authors: Nabaweesi Josephine, Namwanje Regina Germina

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Antenatal care is referred to as the totality of care given to pregnant women from conception to delivery from a certified health care setting. A number of 8 contacts is recommended throughout pregnancy, according to WHO, 2016. Antenatal services are free in Uganda courtesy of the government of Uganda, though attendance is still very low, which has continued to cause maternal and infant mortality and morbidity from preventable causes. Early booking has an advantage for proper pregnancy information sharing and pregnancy monitoring. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practices towards attendance of antenatal care at Mukono General Hospital. A sample of 60 pregnant women was used, and a descriptive quantitative design was employed. Data was collected using a structured questionnaire consisting of questions about socio-demographic factors, knowledge, attitude, and practice, and this was affected using the structured interview method. Pregnant women had good practice at 90.2%, a positive attitude of 94.6%, and slightly less knowledge of 66.7%. Only 12% were knowledgeable about the number of antenatal care visits recommended, 45% had knowledge about when to initiate first antenatal care visit, and 79% had a positive attitude towards the early booking. We recommend that pregnant women are given all the necessary information regarding antenatal care with special emphasis on the recommended number of visits and when to initiate their first visit and encourage early booking in order to achieve the 8 contacts WHO policy for antenatal care since when we increase knowledge, we increase antenatal care utilization according to Anderson's behavioral model.

Keywords: ANC- antenatal care, contacts, mortality, morbidity

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Authors: Rafat Alwazna

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Translation teaching is a particular activity that includes translators and interpreters training either inside or outside institutionalised settings, such as universities. It can also serve as a means of teaching other fields, such as foreign languages. Translation teaching began in the twentieth century. Teachers of translation hold the responsibilities of educating students, developing their translation competence and training them to be professional translators. The activity of translation teaching involves various tasks, including curriculum design, course delivery, material writing as well as application and implementation. The present paper addresses translation teaching during COVID-19 outbreak, seeking to find out the challenges encountered by translation teachers in online translation teaching and the discoveries/solutions arrived at to resolve them. The paper makes use of a comprehensive questionnaire, containing closed-ended and open-ended questions to elicit both quantitative as well as qualitative data from about sixty translation teachers who have been teaching translation at BA and MA levels during COVID-19 outbreak. The data shows that about 40% of the participants evaluate their online translation teaching experience during COVID-19 outbreak as enjoyable and exhilarating. On the contrary, no participant has evaluated his/her online translation teaching experience as being not good, nor has any participant evaluated his/her online translation teaching experience as being terrible. The data also presents that about 23.33% of the participants evaluate their online translation teaching experience as very good, and the same percentage applies to those who evaluate their online translation teaching experience as good to some extent. Moreover, the data indicates that around 13.33% of the participants evaluate their online translation teaching experience as good. The data also demonstrates that the majority of the participants have encountered obstacles in online translation teaching and have concurrently proposed solutions to resolve them.

Keywords: online translation teaching, electronic learning platform, COVID-19 outbreak, challenges, solutions

Procedia PDF Downloads 223

Authors: Mathias Schlenk, Susanne Seibt, Sabine Rosenfeldt, Josef Breu, Stephan Foerster

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Thin liquid jets on micrometer scale play an important role in processing such as in fiber fabrication, inkjet printing, but also for sample delivery in modern synchrotron X-ray devices. In all these cases the liquid jets contain solvents and dissolved materials such as polymers, nanoparticles, fibers pigments or proteins. As liquid flow in liquid jets differs significantly from flow in capillaries and microchannels, particle localization and orientation will also be different. This is of critical importance for applications, which depend on well-defined homogeneous particle and fiber distribution and orientation in liquid jets. Investigations of particle orientation in liquid microjets of diluted solutions have been rare, despite their importance. With the arise of micro-focused X-ray beams it has become possible to scan across samples with micrometer resolution to locally analyse structure and orientation of the samples. In the present work, we used this method to scan across liquid microjets to determine the local distribution and orientation of anisotropic particles. The compromise wormlike block copolymer micelles as an example of long flexible fibrous structures, hectorite materials as a model of extended nanosheet structures, and gold nanorods as an illustration of short stiff cylinders to comprise all relevant anisotropic geometries. We find that due to the different velocity profile in the liquid jet, which resembles plug flow, the orientation of the particles which was generated in the capillary is lost or changed into non-oriented or bi-axially orientations depending on the geometrical shape of the particle.

Keywords: anisotropic particles, liquid microjets, reorientation, SAXS

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Authors: Torsten Mielitz, Dietmar Schulz, York C. Roth

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Market forecasts show a significant increase in the demand for aircraft within the next two decades and production rates will be adapted accordingly. Improvements and optimizations in the industrial system are becoming more important to cope with future challenges in manufacturing and assembly. Highest quality standards have to be met for aerospace parts, whereas cost effective production in industrial systems and methodologies are also a key driver. A look at other industries like e.g., automotive shows well established processes to streamline existing manufacturing systems. In this paper, the implementation of 'PULL' principles in an existing manufacturing process chain for a large scale composite part is presented. A nonlinear extrapolation based on 'Little's Law' showed a risk of a significant increase of parts needed in the process chain to meet future demand. A project has been set up to mitigate the risk whereas the methodology has been changed from a traditional milestone approach in the beginning towards an agile way of working in the end in order to facilitate immediate benefits in the shop-floor. Finally, delivery rates could be increased avoiding more semi-finished parts in the process chain (work in progress & inventory) by the successful implementation of the 'PULL' philosophy in the shop-floor between the work stations. Lessons learned during the running project as well as implementation and operations phases are discussed in order to share best practices.

Keywords: aerospace composite part manufacturing, PULL principles, shop-floor implementation, lessons learned

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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Authors: Jaana Sepp, Ulvi Kõrgemaa, Kristi Puusepp, Õie Tähtla

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COVID-19 was officially recognized as a pandemic in late 2019 by the WHO, and it has led to changes in the education sector. Educational institutions were closed, and most schools adopted distance learning. Estonia is known as a digitally well-developed country. Based on that, in the pandemic time, nursing education continued, and new technological solutions were implemented. To provide nursing education, special focus was paid on quality and flexibility. The aim of this paper is to present administrative, digital, and technological solutions which support Estonian nursing educators to continue the study process in the pandemic time and to develop a sustainable solution for nursing education for the future. This paper includes the authors’ analysis of the documents and decisions implemented in the institutions through the pandemic time. It is a case study of Estonian nursing educators. Results of the analysis show that the implementation of distance learning principles challenges the development of innovative strategies and technics for the assessment of student performance and educational outcomes and implement new strategies to encourage student engagement in the virtual classroom. Additionally, hospital internships were canceled, and the simulation approach was deeply implemented as a new opportunity to develop and assess students’ practical skills. There are many other technical and administrative changes that have also been carried out, such as students’ support and assessment systems, the designing and conducting of hybrid and blended studies, etc. All services were redesigned and made more available, individual, and flexible. Hence, the feedback system was changed, the information was collected in parallel with educational activities. Experiences of nursing education during the pandemic time are widely presented in scientific literature. However, to conclude our study, authors have found evidence that solutions implemented in Estonian nursing education allowed the students to graduate within the nominal study period without any decline in education quality. Operative information system and flexibility provided the minimum distance between the students, support, and academic staff, and likewise, the changes were implemented quickly and efficiently. Institution memberships were updated with the appropriate information, and it positively affected their satisfaction, motivation, and commitment. We recommend that the feedback process and the system should be permanently changed in the future to place all members in the same information area, redefine the hospital internship process, implement hybrid learning, as well as to improve the communication system between stakeholders inside and outside the organization. The main limitation of this study relates to the size of Estonia. Nursing education is provided by two institutions only, and similarly, the number of students is low. The result could be generated to the institutions with a similar size and administrative system. In the future, the relationship between nurses’ performance and organizational outcomes should be deeply investigated and influences of the pandemic time education analyzed at workplaces.

Keywords: hybrid learning, nursing education, nursing, COVID-19

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Authors: Desmond Wade, Alfredo Ormazabal

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Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.

Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education

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Authors: Nicola Milani, Carla Bellissimo, Davide Pogliana, Davide Panzin, Luca Garlaschelli, Giulia Facchinetti, Claudia Casson, Luca Marazzina, Andrea Sartori, Simone Rivaroli, Jeff Konin

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The patient is a 26 year-old male amateur football player from Milan, Italy; (81kg; 185cm; BMI 23.6 kg/m²). He sustained a non-contact anterior cruciate ligament tear to his right knee in June 2021. In September 2021, his right knee ligament was reconstructed using a semitendinosus graft. The injury occurred during a football match on natural grass with typical shoes on a warm day (32 degrees celsius). Playing as a defender he sustained the injury during a change of direction, where the foot was fixated on the grass. He felt pain and was unable to continue playing the match. The surgeon approved his rehabilitation to begin two weeks post-operative. The initial physiotherapist assessment determined performing two training sessions per day within the first three months. In the first three weeks, the pain was 4/10 on Numerical Rating Scale (NRS), no swelling, a range of motion was 0-110°, with difficulty fully extending his knee and minimal quadriceps activation. Crutches were discontinued at four weeks with improved walking. Active exercise, electrostimulator, physical therapy, massages, osteopathy, and passive motion were initiated. At week 6, he completed his first functional movement screen; the score was 16/21 with no pain and no swelling. At week 8, the isokinetic test showed a 23% differential deficit between the two legs in maximum strength (at 90°/s). At week 10, he improved to 15% of injury-induced deficit which suggested he was ready to start running. At week 12, the athlete sustained his first threshold test. At week 16, he performed his first return to sports movement assessment, which revealed a 10% stronger difference between the legs. At week 16, he had his second threshold test. At week 17, his first on-field test revealed a 5% differential deficit between the two legs in the hop test. At week 18, isokinetic test demonstrates that the uninjured leg was 7% stronger than the recovering leg in maximum strength (at 90°/s). At week 20, his second on-field test revealed a 2% difference in hop test; at week 21, his third isokinetic test demonstrated a difference of 5% in maximum strength (at 90°/s). At week 21, he performed his second return to sports movement assessment which revealed a 2% difference between the limbs. Since it was the end of the championship, the team asked him to partake in the playoffs; moreover the player was very motivated to participate in the playoffs also because he was the captain of the team. Together with the player and the team, we decided to let him play even though we were aware of a heightened risk of injury than what is reported in the literature because of two factors: biological recovery times and the results of the tests we performed. In the decision making process about the athlete’s recovery time, it is important to balance the information available from the literature with the desires of the patient to avoid frustration.

Keywords: ACL, football, rehabilitation, return to play

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Authors: Shenaz Ahmed, Hussain Jafri, Muhammed Faran, Wajeeha Naseer Ahmed, Yasmin Rashid, Yasmin Ehsan, Shabnam Bashir, Mushtaq Ahmed

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Low uptake of cascade screening for βeta-Thalassaemia Major (β-TM) in the ‘Punjab Thalassaemia Prevention Project’ (PTPP) in Pakistan led to the development of a ‘decision support intervention for relatives’ (DeSIRe). This paper presents the experiences of relatives of children with β-TM of the DeSIRe following its use by PTPP field officers in routine clinical practice. Fifty-four semi-structured qualitative interviews were conducted (April to June 2021) with relatives in seven cities in the Punjab province (Lahore, Sheikhupura, Nankana Sahab, Kasur, Gujranwala, Multan, and Faisalabad). Thematic analysis shows that participants were satisfied with the content of the DeSIRe and its delivery by the field officers in a family meeting. They understood the main purpose of the DeSIRe was to improve their knowledge of β-TM and its inheritance, to enable them to make decisions about thalassemia carrier testing, particularly before marriage. While participants raised concerns about the stigma of testing positive, they believed the DeSIRe was an appropriate intervention, which supported relatives to make informed decisions. Our findings show the DeSIRe is appropriate for use by healthcare professionals in routine practice in a low-middle income country and has the potential to facilitate shared decision-making about cascade screening for thalassemia. Further research is needed to prove the efficacy of the DeSIRe.

Keywords: thalassemia, Pakistan, cascade screening, decision support

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Authors: Zeev Wiesman, Paula Berman, Nitzan Meiri, Charles Linder

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Supramolecular chemistry refers to the domain of chemistry beyond that of molecules and focuses on the chemical systems made up of a discrete number of assembled molecular sub units or components. Biodiesel components self arrangements is closely related/affect their physical properties in combustion systems and emission. Due to technological difficulties, knowledge regarding the molecular packing of FAMEs (biodiesel) in the liquid phase is limited. Spectral tools such as X-ray and NMR are known to provide evidences related to molecular structure organization. Recently, it was reported by our research group that using 1H Time Domain NMR methodology based on relaxation time and self diffusion coefficients, FAMEs clusters with different motilities can be accurately studied in the liquid phase. Head to head dimarization with quasi-smectic clusters organization, based on molecular motion analysis, was clearly demonstrated. These findings about the assembly/packing of the FAME components are directly associated with fluidity/viscosity of the biodiesel. Furthermore, these findings may provide information of micro/nano-particles that are formed in the delivery and injection system of various combustion systems (affected by thermodynamic conditions). Various relevant parameters to combustion such as: distillation/Liquid Gas phase transition, cetane number/ignition delay, shoot, oxidation/NOX emission maybe predicted. These data may open the window for further optimization of FAME/diesel mixture in terms of combustion and emission.

Keywords: supermolecular chemistry, FAMEs, liquid phase, fluidity, LF-NMR

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Authors: Tuba Kizilirmak

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Distinct properties of porous metamaterials have been largely processed for biomedicine requiring a three-dimensional (3D) porous structure engaged with fine mechanical features, biodegradation ability, and biocompatibility. Applications of metamaterials are (i) porous orthopedic and dental implants; (ii) in vitro cell culture of metamaterials and bone regeneration of metamaterials in vivo; (iii) macro-, micro, and nano-level porous metamaterials for sensors, diagnosis, and drug delivery. There are some specific properties to design metamaterials for tissue engineering. These are surface to volume ratio, pore size, and interconnection degrees are selected to control cell behavior and bone ingrowth. In this study, additive manufacturing technique selective laser melting will be used to print the scaffolds. Selective Laser Melting prints the 3D components according to designed 3D CAD models and manufactured materials, adding layers progressively by layer. This study aims to design metamaterials with Ti6Al4V material, which gives benefit in respect of mechanical and biological properties. Ti6Al4V scaffolds will support cell attachment by conferring a suitable area for cell adhesion. This study will control the osteoblast cell attachment on Ti6Al4V scaffolds after the determination of optimum stiffness and other mechanical properties which are close to mechanical properties of bone. Before we produce the samples, we will use a modeling technique to simulate the mechanical behavior of samples. These samples include different lattice models with varying amounts of porosity and density.

Keywords: additive manufacturing, titanium lattices, metamaterials, porous metals

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Authors: Mallikarjunachari Gangapuram

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The design of stimuli-responsive hydrogel nanocomposite thin films is gaining significant attention in these days due to its wide variety of applications. Soft microrobots, drug delivery, biosensors, regenerative medicine, bacterial adhesion, energy storage and wound dressing are few advanced applications in different fields. In this research work, the nanomechanical properties of composite thin films of 20 microns were tuned by applying homogeneous external DC, and AC magnetic fields of magnitudes 0.05 T and 0.1 T. Polyvinyl alcohol (PVA) used as a matrix material and elliptical hematite nanoparticles (ratio of the length of the major axis to the length of the minor axis is 140.59 ± 1.072 nm/52.84 ± 1.072 nm) used as filler materials to prepare the nanocomposite thin films. Both quasi-static nanoindentation, Nano Dynamic Mechanical Analysis (Nano-DMA) tests were performed to characterize the viscoelastic properties of PVA, PVA+Hematite (0.1% wt, 2% wt and 4% wt) nanocomposites. Different properties such as storage modulus, loss modulus, hardness, and Er/H were carefully analyzed. The increase in storage modulus, hardness, Er/H and a decrease in loss modulus were observed with increasing concentration and DC magnetic field followed by AC magnetic field. Contact angle and ATR-FTIR experiments were conducted to understand the molecular mechanisms such as hydrogen bond formation, crosslinking density, and particle-particle interactions. This systematic study is helpful in design and modeling of magnetic responsive hydrogel nanocomposite thin films for biomedical applications.

Keywords: hematite, hydrogel, nanoindentation, nano-DMA

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Authors: Mohammed Usman Sani

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Worldwide it is observed that sport plays an important role in our communities and is capable of bringing about the need for peaceful coexistence within and among nations which include tolerating one another, building team spirit, showing loyalty and fair play. In addition, sport builds character and the development of skills, which are necessary in fulfilling a desirable and happy life among nations. Sport builds discipline, endurance, courage and self-motivation among nations. Sports for Peace was set up to answer the question of whether sport can foster common ideals. In sports as a powerful tool in building peace, athletes all over the world come together to promote the core values of sport, such as fair play, tolerance, the Olympic ideal of freedom and intercultural understanding. Sport as a powerful tool is used to address varieties of social issues that is widely accepted in countries mostly affected by poverty, violence and conflict. In building peace through sports among nations, a wide range of individuals and nonprofit organizations which includes the United Nations (UN) and international development agencies have accepted sport as an important social catalyst. This paper therefore seeks to define sports, sports and its fundamental rights, sports as a powerful tool, and ways in which sport may bring about peace building among countries and finally the status of Sport Development and Peace initiatives in Nigeria. It concluded that the international community has acknowledged the importance of sport in peace building efforts among nations. It further recommended that countries should engage in the design and delivery of sports, adhering to generally accepted principles of openness and sustainability through sports collaboration, sports partnerships and coordinated effort.

Keywords: building, peace, powerful tool, sports

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Authors: Yazan S. Khaled, Shazana Shamsuddin, Jim Tiernan, Mike McPherson, Thomas Hughes, Paul Millner, David G. Jayne

Abstract:

Introduction: There is a need for real-time imaging of colorectal cancer (CRC) to allow tailored surgery to the disease stage. Fluorescence guided laparoscopic imaging of primary colorectal cancer and the draining lymphatics would potentially bring stratified surgery into clinical practice and realign future CRC management to the needs of patients. Fluorescent nanoparticles can offer many advantages in terms of intra-operative imaging and therapy (theranostic) in comparison with traditional soluble reagents. Nanoparticles can be functionalised with diverse reagents and then targeted to the correct tissue using an antibody or Affimer (artificial binding protein). We aimed to develop and test fluorescent silica nanoparticles and targeted against CRC using an anti-carcinoembryonic antigen (CEA) Affimer (Aff). Methods: Anti-CEA and control Myoglobin Affimer binders were subcloned into the expressing vector pET11 followed by transformation into BL21 Star™ (DE3) E.coli. The expression of Affimer binders was induced using 0.1 mM isopropyl β-D-1-thiogalactopyranoside (IPTG). Cells were harvested, lysed and purified using nickle chelating affinity chromatography. The photosensitiser Foslip (soluble analogue of 5,10,15,20-Tetra(m-hydroxyphenyl) chlorin) was incorporated into the core of silica nanoparticles using water-in-oil microemulsion technique. Anti-CEA or control Affs were conjugated to silica nanoparticles surface using sulfosuccinimidyl-4-(N-maleimidomethyl) cyclohexane-1-carboxylate (sulfo SMCC) chemical linker. Binding of CEA-Aff or control nanoparticles to colorectal cancer cells (LoVo, LS174T and HC116) was quantified in vitro using confocal microscopy. Results: The molecular weights of the obtained band of Affimers were ~12.5KDa while the diameter of functionalised silica nanoparticles was ~80nm. CEA-Affimer targeted nanoparticles demonstrated 9.4, 5.8 and 2.5 fold greater fluorescence than control in, LoVo, LS174T and HCT116 cells respectively (p < 0.002) for the single slice analysis. A similar pattern of successful CEA-targeted fluorescence was observed in the maximum image projection analysis, with CEA-targeted nanoparticles demonstrating 4.1, 2.9 and 2.4 fold greater fluorescence than control particles in LoVo, LS174T, and HCT116 cells respectively (p < 0.0002). There was no significant difference in fluorescence for CEA-Affimer vs. CEA-Antibody targeted nanoparticles. Conclusion: We are the first to demonstrate that Foslip-doped silica nanoparticles conjugated to anti-CEA Affimers via SMCC allowed tumour cell-specific fluorescent targeting in vitro, and had shown sufficient promise to justify testing in an animal model of colorectal cancer. CEA-Affimer appears to be a suitable targeting molecule to replace CEA-Antibody. Targeted silica nanoparticles loaded with Foslip photosensitiser is now being optimised to drive photodynamic killing, via reactive oxygen generation.

Keywords: colorectal cancer, silica nanoparticles, Affimers, antibodies, imaging

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Authors: Olufemi Samuel Shola, Oladapo Adenike Adesola

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Inadequate dietary intake has increased the susceptibility of under five children to malnutrition and infections. This study, therefore, assessed the feeding practices of children of 0-23 months of age among mothers in urban areas of Akure, Ondo State, Nigeria. Simple random sampling technique was used to select four hundred (400) mothers out of 710 mothers from 7 primary health care centres in Akure metropolis for the study. Data were collected using modified WHO 2003 Questionnaire on child feeding practices. Data were analyzed using descriptive statistics, while chi-square was used to determine the association between variables. Results showed that 52.0% of the children were males, with 47.5% in the 6-8 months age group. More than half (57.0%) of the mothers were between the ages of 20-29 years, and 45.0% had secondary education. Majority (94.3%) of the mothers breastfed their children in the last 24 hours preceding the survey. The feeding practices history of mothers showed that 28.0% and 53.7% of the mothers initiated breastfeeding less than 30 minutes and between 30 minutes to 1 hour after delivery, respectively. Also, 52.0% of mothers practiced exclusive breastfeeding for six months, while 26.2% breastfed from 6 months up to 2 years of age. Dietary diversity of the children age 6-23 months revealed that 68.7% of the children attained the minimum dietary diversity by consuming 4 or more food groups in the last 24 hours. There was a significant association (P < 0.05) between mothers’ education (n=180), occupation(n=41) and dietary diversity (n= 150) and meal frequency (n=209). Therefore, the study concluded that the duration of breastfeeding and time of introduction of complementary food did not meet WHO recommended guidelines. There is urgent need to launching more programmes.

Keywords: breastfeeding, mothers, child feeding, urban areas, ondo state, nigeria

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Authors: Vildan Cırık, Emine Efe

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Complementary health approaches are growing in popularity worldwide and play a substantial role in health care. It is very important for paediatric nurses to have knowledge of practices affecting the medical conditions of patients and to communicate with them through integrative nursing care. The purpose of this study was to determine paediatric nurses’ knowledge and experiences of complementary health approaches (CHA) and their personal and professional attitudes to the use of complementary health approaches. This multicentre study was conducted with 1450 paediatric nurses in 18 hospitals in Turkey. Paediatric nurses included in the study were working in the following clinics: Paediatric Service, Paediatric Intensive Care, Paediatric Haematology/Oncology. Data collection focused on the paediatric nurses’ knowledge and experiences of CHA. A high proportion of our sample of paediatric nurses reported that they had used some form of CHA themselves; the most popular choices of CHA were prayer, massage, and vitamins techniques. Paediatric nurses reported positive experiences (drawing/music/art/dance therapies, prayer, herbs, thermal springs, massage, and reflexology) and negative experiences (herbs, thermal springs, prayer, and massage). This study may contribute to increased awareness of the potentially important role of paediatric nurses in the delivery of CHA. Paediatric nurses play important roles in helping patients to use complementary health approaches safely and accurately. Trainings on CHA should be organised, data collection forms including CHA should be created, and evidence-based studies should be focused towards improving the clinical practice of paediatric nurses.

Keywords: complementary health approaches, paediatric nurses, knowledge, experience, attitude, Turkey

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Authors: Sajia Islam, T. Tahsina, S. Raihana, M. M. Rahman, Q. S. Rahman, T. M. Huda, S. E. Arifeen, M. J. Dibley

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Early neonatal sepsis accounts for more than two-thirds of all deaths in the first year of life. This study assessed the counseling during antenatal, perinatal, post natal periods and its association with possible sepsis in rural Bangladesh. Method: Data were collected from a large community-based trial in Bangladesh where pregnant women were enrolled from 2013-2015 covering 29,497 newborns. Sepsis was defined using neonatal danger signs reported by 'The Young-Infants Clinical Science Study Group. 'Result: Signs of sepsis was found among 15% of the neonates. Neonatal sepsis was higher among those who did not receive advice on TT vaccinations (15.4% vs. 11%, p < 0.05) and danger signs (14.8% vs. 12.8%, p < 0.05) during pregnancy. Advice on delivering in well-lit place was significantly associated with lower incidence of sepsis (12.7% vs. 14.8% p < 0.05). Sepsis was lower among neonates whose mothers were counseled on immediate newborn care for bathing after 3 days of delivery (13.4% vs. 15.2% p=0), breastfeeding within 1hr of birth (13.82 % vs. 15.28% p=0), apply nothing on the cord (11.54 vs. 15.06 p=0), immediate drying of child (12.62% vs. 14.89%, p=0). Neonatal sepsis was lower among children whose mothers received 2-4 advice [OR=0.91(95% CI: 0.85-0.97)] compared to neonates whose mothers received only 1 or none. Overall, children to mothers who received ≥ 5 advice had lowest incidence of sepsis [OR=0.83 (95% CI: 0.71-0.97)] Conclusion: Advice on antenatal, prenatal and post natal is significantly reduced with early newborn sepsis. Further research is required to identify specific type of counseling messages that translate into practices and reduce pathways towards early-newborn morbidities.

Keywords: ante natal care, counseling, neonatal sepsis, post natal care

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Authors: Iram Siddique

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Synthetic seed technology is an alternative to traditional micropropagation for production and delivery of cloned plantlets. Synthetic seeds were produced by encapsulating nodal segments of C. angustifolia in calcium alginate gel. 3% (w/v) sodium alginate and 100 mM CaCl2. 2H2O were found most suitable for encapsulation of nodal segments. Synthetic seeds cultured on half strength Murashige and Skoog (MS) medium supplemented with thidiazuron (5.0 µM) + indole -3- acetic acid (1.0 µM) produced maximum number of shoots (10.9 ± 0.78) after 8 weeks of culture exhibiting (78%) in vitro conversion response. Encapsulated nodal segments demonstrated successful regeneration after different period (1-6 weeks) of cold storage at 4 °C. The synthetic seeds stored at 4 °C for a period of 4 weeks resulted in maximum conversion frequency (93%) after 8 weeks when placed back to regeneration medium. The isolated shoots when cultured on half strength MS medium supplemented with 1.0 µM indole -3- butyric acid (IBA), produced healthy roots and plantlets with well developed shoot and roots were successfully hardened off in plastic pots containing sterile soilrite inside the growth chamber and gradually transferred to greenhouse where they grew well with 85% survival rate. Changes in the content of photosynthetic pigments, net photosynthetic rate (PN), superoxide dismutase (SOD) and catalase (CAT) activity in C. angustifolia indicated the adaptation of micropropagated plants to ex vitro conditions.

Keywords: biochemical studies, nodal segments, rooting, synthetic seeds, thidiazuron

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Authors: Mustapha Abdulsalam, R. N. Ahmed

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Nauclea latifolia is one of the medicinal plants used in traditional Nigerian medicine in the treatment of various diseases such as fever, toothaches, malaria, diarrhea among several other conditions. Nauclea latifolia leaf extract acts as a capping and reducing agent in the formation of silver nanoparticles. Silver nanoparticles (AgNPs) were synthesized using a combination of aqueous extract of Nauclea latifolia and 1mM of silver nitrate (AgNO₃) solution to obtain concentrations of 100mg/ml-400mg/ml. Characterization of the particles was done by UV-Vis spectroscopy and Fourier transform infrared (FTIR). In this study, aqueous as well as ethanolic extract of leaf of Nauclea latifolia were investigated for antibacterial activity using the standard agar well diffusion technique against three clinical isolates (Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa). The Minimum Inhibitory Concentration (MIC) was achieved by microbroth dilution method and Minimum Bactericidal Concentration (MBC) was also determined by plate assay. Characterization by UV-visible spectrometry revealed peak absorbance of 0.463 at 450.0nm, while FTIR showed the presence of two functional groups. At 400mg/ml, the highest inhibitory activities were observed with S.aureus and E.coli with zones of inhibition measuring 20mm and 18mm respectively. The MIC was obtained at 400mg/ml while MBC was at a higher concentration. The data from this study indicate the potential of silver nanoparticle of Nauclea latifolia as a suitable alternative antibacterial agent for incorporation into orthodox medicine in health care delivery in Nigeria.

Keywords: agar well diffusion, antimicrobial activity, Nauclea latifolia, silver nanoparticles

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