Search results for: Healthcare Service Delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6306

Search results for: Healthcare Service Delivery

4356 Immunoliposome-Mediated Drug Delivery to Plasmodium-Infected and Non-Infected Red Blood Cells as a Dual Therapeutic/Prophylactic Antimalarial Strategy

Authors: Ernest Moles, Patricia Urbán, María Belén Jiménez-Díaz, Sara Viera-Morilla, Iñigo Angulo-Barturen, Maria Antònia Busquets, Xavier Fernàndez-Busquets

Abstract:

Bearing in mind the absence of an effective vaccine against malaria and its severe clinical manifestations causing nearly half a million deaths every year, this disease represents nowadays a major threat to life. Besides, the basic rationale followed by currently marketed antimalarial approaches is based on the administration of drugs on their own, promoting the emergence of drug-resistant parasites owing to the limitation in delivering drug payloads into the parasitized erythrocyte high enough to kill the intracellular pathogen while minimizing the risk of causing toxic side effects to the patient. Such dichotomy has been successfully addressed through the specific delivery of immunoliposome (iLP)-encapsulated antimalarials to Plasmodium falciparum-infected red blood cells (pRBCs). Unfortunately, this strategy has not progressed towards clinical applications, whereas in vitro assays rarely reach drug efficacy improvements above 10-fold. Here, we show that encapsulation efficiencies reaching >96% can be achieved for the weakly basic drugs chloroquine (CQ) and primaquine using the pH gradient active loading method in liposomes composed of neutrally charged, saturated phospholipids. Targeting antibodies are best conjugated through their primary amino groups, adjusting chemical crosslinker concentration to retain significant antigen recognition. Antigens from non-parasitized RBCs have also been considered as targets for the intracellular delivery of drugs not affecting the erythrocytic metabolism. Using this strategy, we have obtained unprecedented nanocarrier targeting to early intraerythrocytic stages of the malaria parasite for which there is a lack of specific extracellular molecular tags. Polyethylene glycol-coated liposomes conjugated with monoclonal antibodies specific for the erythrocyte surface protein glycophorin A (anti-GPA iLP) were capable of targeting 100% RBCs and pRBCs at the low concentration of 0.5 μM total lipid in the culture, with >95% of added iLPs retained into the cells. When exposed for only 15 min to P. falciparum in vitro cultures synchronized at early stages, free CQ had no significant effect over parasite viability up to 200 nM drug, whereas iLP-encapsulated 50 nM CQ completely arrested its growth. Furthermore, when assayed in vivo in P. falciparum-infected humanized mice, anti-GPA iLPs cleared the pathogen below detectable levels at a CQ dose of 0.5 mg/kg. In comparison, free CQ administered at 1.75 mg/kg was, at most, 40-fold less efficient. Our data suggest that this significant improvement in drug antimalarial efficacy is in part due to a prophylactic effect of CQ found by the pathogen in its host cell right at the very moment of invasion.

Keywords: immunoliposomal nanoparticles, malaria, prophylactic-therapeutic polyvalent activity, targeted drug delivery

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4355 Development of Hierarchically Structured Tablets with 3D Printed Inclusions for Controlled Drug Release

Authors: Veronika Lesáková, Silvia Slezáková, František Štěpánek

Abstract:

Drug dosage forms consisting of multi-unit particle systems (MUPS) for modified drug release provide a promising route for overcoming the limitation of conventional tablets. Despite the conventional use of pellets as units for MUP systems, 3D printed polymers loaded with a drug seem like an interesting candidate due to the control over dosing that 3D printing mechanisms offer. Further, 3D printing offers high flexibility and control over the spatial structuring of a printed object. The final MUPS tablets include PVP and HPC as granulate with other excipients, enabling the compaction process of this mixture with 3D printed inclusions, also termed minitablets. In this study, we have developed the multi-step production process for MUPS tablets, including the 3D printing technology. The MUPS tablets with incorporated 3D printed minitablets are a complex system for drug delivery, providing modified drug release. Such structured tablets promise to reduce drug fluctuations in blood, risk of local toxicity, and increase bioavailability, resulting in an improved therapeutic effect due to the fast transfer into the small intestine, where particles are evenly distributed. Drug loaded 3D printed minitablets were compacted into the excipient mixture, influencing drug release through varying parameters, such as minitablets size, matrix composition, and compaction parameters. Further, the mechanical properties and morphology of the final MUPS tablets were analyzed as many properties, such as plasticity and elasticity, can significantly influence the dissolution profile of the drug.

Keywords: 3D printing, dissolution kinetics, drug delivery, hot-melt extrusion

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4354 Biophysical Consideration in the Interaction of Biological Cell Membranes with Virus Nanofilaments

Authors: Samaneh Farokhirad, Fatemeh Ahmadpoor

Abstract:

Biological membranes are constantly in contact with various filamentous soft nanostructures that either reside on their surface or are being transported between the cell and its environment. In particular, viral infections are determined by the interaction of viruses (such as filovirus) with cell membranes, membrane protein organization (such as cytoskeletal proteins and actin filament bundles) has been proposed to influence the mechanical properties of lipid membranes, and the adhesion of filamentous nanoparticles influence their delivery yield into target cells or tissues. The goal of this research is to integrate the rapidly increasing but still fragmented experimental observations on the adhesion and self-assembly of nanofilaments (including filoviruses, actin filaments, as well as natural and synthetic nanofilaments) on cell membranes into a general, rigorous, and unified knowledge framework. The global outbreak of the coronavirus disease in 2020, which has persisted for over three years, highlights the crucial role that nanofilamentbased delivery systems play in human health. This work will unravel the role of a unique property of all cell membranes, namely flexoelectricity, and the significance of nanofilaments’ flexibility in the adhesion and self-assembly of nanofilaments on cell membranes. This will be achieved utilizing a set of continuum mechanics, statistical mechanics, and molecular dynamics and Monte Carlo simulations. The findings will help address the societal needs to understand biophysical principles that govern the attachment of filoviruses and flexible nanofilaments onto the living cells and provide guidance on the development of nanofilament-based vaccines for a range of diseases, including infectious diseases and cancer.

Keywords: virus nanofilaments, cell mechanics, computational biophysics, statistical mechanics

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4353 Critical Success Factors Quality Requirement Change Management

Authors: Jamshed Ahmad, Abdul Wahid Khan, Javed Ali Khan

Abstract:

Managing software quality requirements change management is a difficult task in the field of software engineering. Avoiding incoming changes result in user dissatisfaction while accommodating to many requirement changes may delay product delivery. Poor requirements management is solely considered the primary cause of the software failure. It becomes more challenging in global software outsourcing. Addressing success factors in quality requirement change management is desired today due to the frequent change requests from the end-users. In this research study, success factors are recognized and scrutinized with the help of a systematic literature review (SLR). In total, 16 success factors were identified, which significantly impacted software quality requirement change management. The findings show that Proper Requirement Change Management, Rapid Delivery, Quality Software Product, Access to Market, Project Management, Skills and Methodologies, Low Cost/Effort Estimation, Clear Plan and Road Map, Agile Processes, Low Labor Cost, User Satisfaction, Communication/Close Coordination, Proper Scheduling and Time Constraints, Frequent Technological Changes, Robust Model, Geographical distribution/Cultural differences are the key factors that influence software quality requirement change. The recognized success factors and validated with the help of various research methods, i.e., case studies, interviews, surveys and experiments. These factors are then scrutinized in continents, database, company size and period of time. Based on these findings, requirement change will be implemented in a better way.

Keywords: global software development, requirement engineering, systematic literature review, success factors

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4352 pH-Responsive Carrier Based on Polymer Particle

Authors: Florin G. Borcan, Ramona C. Albulescu, Adela Chirita-Emandi

Abstract:

pH-responsive drug delivery systems are gaining more importance because these systems deliver the drug at a specific time in regards to pathophysiological necessity, resulting in improved patient therapeutic efficacy and compliance. Polyurethane materials are well-known for industrial applications (elastomers and foams used in different insulations and automotive), but they are versatile biocompatible materials with many applications in medicine, as artificial skin for the premature neonate, membrane in the hybrid artificial pancreas, prosthetic heart valves, etc. This study aimed to obtain the physico-chemical characterization of a drug delivery system based on polyurethane microparticles. The synthesis is based on a polyaddition reaction between an aqueous phase (mixture of polyethylene-glycol M=200, 1,4-butanediol and Tween® 20) and an organic phase (lysin-diisocyanate in acetone) combined with simultaneous emulsification. Different active agents (omeprazole, amoxicillin, metoclopramide) were used to verify the release profile of the macromolecular particles in different pH mediums. Zetasizer measurements were performed using an instrument based on two modules: a Vasco size analyzer and a Wallis Zeta potential analyzer (Cordouan Technol., France) in samples that were kept in various solutions with different pH and the maximum absorbance in UV-Vis spectra were collected on a UVi Line 9,400 Spectrophotometer (SI Analytics, Germany). The results of this investigation have revealed that these particles are proper for a prolonged release in gastric medium where they can assure an almost constant concentration of the active agents for 1-2 weeks, while they can be disassembled faster in a medium with neutral pHs, such as the intestinal fluid.

Keywords: lysin-diisocyanate, nanostructures, polyurethane, Zetasizer

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4351 An Experimental Quantitative Case Study of Competency-Based Learning in Online Mathematics Education

Authors: Pascal Roubides

Abstract:

The presentation proposed herein describes a research case study of a hybrid application of the competency-based education model best exemplified by Western Governor’s University, within the general temporal confines of an accelerated (8-week) term of a College Algebra course at the author’s institution. A competency-based model was applied to an accelerated online College Algebra course, built as an Open Educational Resources (OER) course, seeking quantifiable evidence of any differences in the academic achievement of students enrolled in the competency-based course and the academic achievement of the current delivery of the same course. Competency-based learning has been gaining in support in recent times and the author’s institution has also been involved in its own efforts to design and develop courses based on this approach. However, it is unknown whether there had been any research conducted to quantify evidence of the effect of this approach against traditional approaches prior to the author’s case study. The research question sought to answer in this experimental quantitative study was whether the online College Algebra curriculum at the author’s institution delivered via an OER-based competency-based model can produce statistically significant improvement in retention and success rates against the current delivery of the same course. Results obtained in this study showed that there is no statistical difference in the retention rate of the two groups. However, there was a statistically significant difference found between the rates of successful completion of students in the experimental group versus those in the control group.

Keywords: competency-based learning, online mathematics, online math education, online courses

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4350 The Relationship between Marketing Mix Strategy and Valuable of Muay Thai Training and Thai Massage in Foreign Tourists' Perception

Authors: Thammamonr Khunrattanaporn

Abstract:

The purpose of the research was to examine the relationship between the marketing mix factors and valuable of Muay Thai Training and Thai massage in foreign tourists’ perception. The research used the 8 P’s of marketing framework presented in the theory of compound marketing services strategy. Data was collect using survey for 400 questionnaires using the Quota sampling from foreign tourists travelling in Thailand. The data was analyzed to determine valuation statistics, the frequency, percent average, means and standard deviation and pearson's correlation coefficients. The result shows the foreign tourists’ perception with the marketing mix strategy in term of Muay Thai training and massage regarding curriculum areas: product, pricing, channel distribution, Promotion, Personnel services, Physical evidence and external partnerships the overall, it significant at a high level. The awareness level of service and value for travelers had two aspects of service quality and value for money it significant at the highest level.

Keywords: foreign tourists’ perception, marketing mix strategy, Muay Thai training, the massage

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4349 Authority and Function of Administrative Organs According to the Constitution: A Construction of Democracy in the Administrative Law of Indonesia

Authors: Andhika Danesjvara, Nur Widyastanti

Abstract:

The constitution regulates the forms, types, and powers of sState organs in a government. The powers of the organs are then regulated in more detail in the legislation. One of these organs is a government organ, headed by a president or by another name that serves as the main organizer of government. The laws and regulations will govern how the organs of government shall exercise their authority and functions. In a modern state, the function of enacting laws or called executive power does not exercise the functions of government alone, but there are other organs that help the government run the country. These organs are often called government agencies, government accelerating bodies, independent regulatory bodies, commissions, councils or other similar names. The legislation also limits the power of officials within the organs to keep from abusing its authority. The main question in this paper is whether organs are the implementation of a democratic country, or as a form of compromise with the power of stakeholders. It becomes important to see how the administrative organs perform their functions. The administrative organs that are bound by government procedures work in the public service; therefore the next question is how far the function of public service is appropriate and not contradictory to the constitution.

Keywords: administrative organs, constitution, democracy, government

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4348 Preparation of Polymer-Stabilized Magnetic Iron Oxide as Selective Drug Nanocarriers to Human Acute Myeloid Leukemia

Authors: Kheireddine El-Boubbou

Abstract:

Drug delivery to target human acute myeloid leukemia (AML) using a nanoparticulate chemotherapeutic formulation that can deliver drugs selectively to AML cancer is hugely needed. In this work, we report the development of a nanoformulation made of polymeric-stabilized multifunctional magnetic iron oxide nanoparticles (PMNP) loaded with the anticancer drug Doxorubicin (Dox) as a promising drug carrier to treat AML. Dox@PMNP conjugates simultaneously exhibited high drug content, maximized fluorescence, and excellent release properties. Nanoparticulate uptake and cell death following addition of Dox@PMNPs were then evaluated in different types of human AML target cells, as well as on normal human cells. While the unloaded MNPs were not toxic to any of the cells, Dox@PMNPs were found to be highly toxic to the different AML cell lines, albeit at different inhibitory concentrations (IC50 values), but showed very little toxicity towards the normal cells. In comparison, free Dox showed significant potency concurrently to all the cell lines, suggesting huge potentials for the use of Dox@PMNPs as selective AML anticancer cargos. Live confocal imaging, fluorescence and electron microscopy confirmed that Dox is indeed delivered to the nucleus in relatively short periods of time, causing apoptotic cell death. Importantly, this targeted payload may potentially enhance the effectiveness of the drug in AML patients and may further allow physicians to image leukemic cells exposed to Dox@PMNPs using MRI.

Keywords: magnetic nanoparticles, drug delivery, acute myeloid leukemia, iron oxide, cancer nanotherapy

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4347 Neural Network Based Approach of Software Maintenance Prediction for Laboratory Information System

Authors: Vuk M. Popovic, Dunja D. Popovic

Abstract:

Software maintenance phase is started once a software project has been developed and delivered. After that, any modification to it corresponds to maintenance. Software maintenance involves modifications to keep a software project usable in a changed or a changing environment, to correct discovered faults, and modifications, and to improve performance or maintainability. Software maintenance and management of software maintenance are recognized as two most important and most expensive processes in a life of a software product. This research is basing the prediction of maintenance, on risks and time evaluation, and using them as data sets for working with neural networks. The aim of this paper is to provide support to project maintenance managers. They will be able to pass the issues planned for the next software-service-patch to the experts, for risk and working time evaluation, and afterward to put all data to neural networks in order to get software maintenance prediction. This process will lead to the more accurate prediction of the working hours needed for the software-service-patch, which will eventually lead to better planning of budget for the software maintenance projects.

Keywords: laboratory information system, maintenance engineering, neural networks, software maintenance, software maintenance costs

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4346 The Nurse Practitioner’s Role Functions in Multi-Specialist Team When Caring for a Metastatic Colon Cancer Patient with Acute Intestinal Obstruction

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

Abstract:

Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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4345 Secure Cryptographic Operations on SIM Card for Mobile Financial Services

Authors: Kerem Ok, Serafettin Senturk, Serdar Aktas, Cem Cevikbas

Abstract:

Mobile technology is very popular nowadays and it provides a digital world where users can experience many value-added services. Service Providers are also eager to offer diverse value-added services to users such as digital identity, mobile financial services and so on. In this context, the security of data storage in smartphones and the security of communication between the smartphone and service provider are critical for the success of these services. In order to provide the required security functions, the SIM card is one acceptable alternative. Since SIM cards include a Secure Element, they are able to store sensitive data, create cryptographically secure keys, encrypt and decrypt data. In this paper, we design and implement a SIM and a smartphone framework that uses a SIM card for secure key generation, key storage, data encryption, data decryption and digital signing for mobile financial services. Our frameworks show that the SIM card can be used as a controlled Secure Element to provide required security functions for popular e-services such as mobile financial services.

Keywords: SIM card, mobile financial services, cryptography, secure data storage

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4344 Pregnancy Outcomes in Patients With Inflammatory Bowel Disease: Retrospective Data From a Greek National Registry

Authors: Evgenia Papathanasiou, Georgios Kokkotis, Georgios Axiaris, Theodoros Argyropoulos, Nikos Viazis, Olga Giouleme, Konstantinos Gkoumas, Αnthia Gatopoulou, Αggelos Theodoulou, Georgios Theocharis, Αngeliki Theodoropoulou, Μaria Κalogirou, Pantelis Karatzas, Κonstantinos Κatsanos, Theodora Kafetzi, Κonstantinos Κarmiris, Αnastasia Κourikou, Ιoannis E Κoutroubakis, Christos Liatsos, Gerassimos J. Mantzaris, Νicoletta Μathou, Georgia Bellou, George Michalopoulos Αikaterini Μantaka, Penelope Nikolaou, Μichael Oikonomou, Dimitrios Polymeros, George Papatheodoridis, Εvdoxia Stergiou, Κonstantinos Soufleris, Εpameinondas Skouloudis, Μaria Tzouvala, Georgia Tsiolakidou, Εftychia Tsironi, Styliani Tsafaraki, Kalliopi Foteinogiannopoulou, Konstantina Chalakatevaki, Αngeliki Christidou, Dimitrios K. Christodoulou, Giorgos Bamias, Spyridon Michopoulos, Εvanthia Zampeli

Abstract:

Background: Inflammatory bowel disease (IBD) commonly affects female patients of reproductive age, making the interaction between fertility, pregnancy and IBD an important issue in disease management. The effect of disease activity on the outcome of pregnancy and its impact on neonatal growth is a field of intense research. Close follow-up of pregnant IBD patients by a multidisciplinary team improves maternal and neonatal outcomes. Aim – Methods: Α national retrospective study of pregnancies in women with IBD between 2010-2020 was carried out in 22 IBD reference centers in Greece. Patient characteristics such as disease profile, type of treatment, and disease activity during gestation were analyzed in correlation to the method of delivery, pregnancy outcomes, as well as breastfeeding and offspring health. Results: Two-hundred and twenty-three pregnancies in 175 IBD patients were registered in the study. 122 with Crohn’s disease (CD). Median age during diagnosis was 25.6 years (12-44), with median disease duration of 7.4 years (0-23). One-hundred and twenty-nine patients (58%) were recorded during their first pregnancy. Early pregnancy termination was reported by 48 patients (22%). Pregnancy as a result of in vitro fertilization (IVF) occurred in 15 cases (6.7%). At the beginning of gestation, 165 patients (74%) were under treatment: 48 with anti-TNF agents (29%), 43 with azathioprine (26%), 101 with 5-aminosalicylic acid formulations (61%) and 12 with steroids (7%). We recorded 49 cases of IBD flares (22%) during pregnancy. Two-thirds of them (n=30) were in remission at the onset of the pregnancy. Almost half of them (n=22) required corticosteroid treatment. Patients with ulcerative colitis (UC) were in greater risk of disease flare during pregnancy (p<0.001). All but 3 pregnancies (99.1%) resulted in uncomplicated delivery. In 147 cases (67.1%), cesarean delivery was performed. Two late fetal deaths (0.9%) were reported, both in patients with continuously active disease since the beginning of pregnancy. After delivery, 75 patients (34%) presented with a disease flare, which was associated with active disease at the beginning of pregnancy (p <0.001). Conclusion: The majority of female, Greek IBD patients, had a favorable pregnancy outcome. Active inflammation during gestation and UC diagnosis were associated with a negative impact on pregnancy outcomes. The results of this study are in favor of the continuation of IBD treatment during pregnancy.

Keywords: pregnancy, ulcerative colitis, Crohn disease, flare

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4343 A Case Study on Expanding Access to Higher Education of Students with Hearing Impairment

Authors: Afaf Manzoor, Abdul Hameed

Abstract:

Children with hearing impairment face several challenges in accessing primary and secondary education in general and higher education in particular in Pakistan. A large number of these children are excluded from formal education system through segregated special institutions. The enrollment rate of these children at school level is very low and it continues decreasing as they move on the ladder of education. Negligible number of students with hearing impairment gets any chance to be enrolled at tertiary or higher education institutes. The segregated system of education at primary and secondary level makes it even more difficult to adjust in an inclusive classroom at a higher level not only for students with hearing impairment but for their teachers and peers as well. A false belief of teachers and parents about low academic profile of students with hearing impairment is one of the major challenges to overcome for their participation at higher education. This case study was conducted to document an innovative step taken by the Department of Special Education Needs, University of Management & Technology, Lahore Pakistan. The prime objective of this study was to assess the satisfaction level of students with hearing impairment in BS 4 Years and MA Special Education programs at Lahore campus. Structured interviews were of 40 students with hearing impairment to assess the satisfaction on service delivery (admission process, classroom pedagogy, content, assessment/results, access to other services centers i.e. library, cafeteria, hostel, co-curricular activities) and campus life. Their peers without disabilities were also interviewed to assess their acceptance level. The findings of the study revealed positive results about their educational as well as social inclusion in the university. The students also shared their fears at the time of admission and how fear eventually faded out with the passage of time due to the proper academic support system. The findings of the study will be shared in detail with the audience during the presentation.

Keywords: students with hearing impairment, higher education, inclusive education, marginalization

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4342 X-Ray Diffraction Technique as a Means for Degradation Assessment of Welded Joints

Authors: Jaroslav Fiala, Jaroslav Kaiser, Pavel Zlabek, Vaclav Mentl

Abstract:

The X-ray diffraction technique was recognized as a useful tool for the assessment of material degradation degree after a long-time service. In many industrial applications materials are subjected to degradation of mechanical properties as a result of real service conditions. The assessment of the remnant lifetime of components and structures is commonly based on correlated procedures including numerous destructive, non-destructive and mathematical techniques that should guarantee reasonable precise assessment of the current damage extent of materials in question and the remnant lifetime assessment. This paper summarizes results of an experimental programme concentrated on mechanical properties degradation of welded components. Steel an Al-alloy test specimens of base metal, containing welds and simple weldments were fatigue loaded at room temperature to obtain Woehler S-N curve. X-ray diffraction technique was applied to assess the degradation degree of material as a result of cyclic loading.

Keywords: fatigue loading, material degradation, steels, AL-alloys, X-ray diffraction

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4341 Implementation of an Induction Programme to Help the International Medical Graduates in the NHS

Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

Abstract:

Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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4340 Integrating Music on Construction Sites: Key Benefits and Cautions: A Literature Perspective

Authors: Oluwatayomi Daniel Fadumo, Chinyere Celestina Esimone

Abstract:

The construction industry, as a massive human capital-related sector, requires an always motivated workforce. The inability to maintain this state has been found to hamper productivity which ultimately leads to poor project delivery, infrastructural development decline, and low morale among citizens. The need to develop an approach to keep this set of people inspired before, during, and after work becomes a necessity; this paper aims to evaluate the key benefits and cautions in integrating music on construction sites in Nigeria to improve effective project delivery. In attaining this, the study identified the advantages of music on construction sites, evaluated the key considerations in introducing music on construction sites, and recommended measures for the effective integration of music on construction sites in Nigeria. The study is a descriptive research through the use of secondary data gleaned from relevant literature, journals, and research sites. The study concluded that different forms of music genres can be implemented ranging from Pop music, rock, metal, and classical music. Introducing music has the advantage of industrial branding, improving workers` morale, setting the pace for working, helping in information retention, and improving mental health and happiness. The key consideration, however, is to provide the right volume and music that doesn’t pose health and safety challenges. The study finally recommended that for effective integration of music on construction sites in Nigeria, policies should be drafted regulating its use, specific radio customized for the site be introduced and that research-based music, proven to have previously helped, should be given to a group of workers.

Keywords: music, construction sites, workers, construction industry, construction management practice

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4339 An Investigation of the Effectiveness and Quality Service of Thai Labor Fund

Authors: Chutikarn Sriviboon

Abstract:

The objectives of this research were to study the operation of the Labor Fund and to investigate the needs for money and assistance from Thai laborers both from within the system and out of the system and to compare between the assistance from domestic and international funds. The population of this study included three labor groups: group one was laborer in the system who were the members of saving cooperative, group two was laborer in the system who were not the members of saving cooperative, and group three was laborer who were not in the system. This was a mixed research of quantitative and qualitative methods. The findings can be categorized into four parts. First, the labor fund was beneficial to Thai laborers by giving access to government funds but the weakness was found to be poor public relations. Second, the labor funds should extend their assistance to laborer in the system who was not the members of saving cooperative. Third, the comparison between domestic labor funds and international labor funds revealed that there were no international funds which provided assistance the same way as Thai labor funds. Finally, there was a need to improve the management of labor funds and to provide long term assistance to Thai labors.

Keywords: effectiveness, quality, labor funds, service

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4338 A Comprehensive Framework to Ensure Data Security in Cloud Computing: Analysis, Solutions, and Approaches

Authors: Loh Fu Quan, Fong Zi Heng, Burra Venkata Durga Kumar

Abstract:

Cloud computing has completely transformed the way many businesses operate. Traditionally, confidential data of a business is stored in computers located within the premise of the business. Therefore, a lot of business capital is put towards maintaining computing resources and hiring IT teams to manage them. The advent of cloud computing changes everything. Instead of purchasing and managing their infrastructure, many businesses have started to shift towards working with the cloud with the help of a cloud service provider (CSP), leading to cost savings. However, it also introduces security risks. This research paper focuses on the security risks that arise during data migration and user authentication in cloud computing. To overcome this problem, this paper provides a comprehensive framework that includes Transport Layer Security (TLS), user authentication, security tokens and multi-level data encryption. This framework aims to prevent authorized access to cloud resources and data leakage, ensuring the confidentiality of sensitive information. This framework can be used by cloud service providers to strengthen the security of their cloud and instil confidence in their users.

Keywords: Cloud computing, Cloud security, Cloud security issues, Cloud security framework

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4337 Suggestions to the Legislation about Medical Ethics and Ethics Review in the Age of Medical Artificial Intelligence

Authors: Xiaoyu Sun

Abstract:

In recent years, the rapid development of Artificial Intelligence (AI) has extensively promoted medicine, pharmaceutical, and other related fields. The medical research and development of artificial intelligence by scientific and commercial organizations are on the fast track. The ethics review is one of the critical procedures of registration to get the products approved and launched. However, the SOPs for ethics review is not enough to guide the healthy and rapid development of artificial intelligence in healthcare in China. Ethical Review Measures for Biomedical Research Involving Human Beings was enacted by the National Health Commission of the People's Republic of China (NHC) on December 1st, 2016. However, from a legislative design perspective, it was neither updated timely nor in line with the trends of AI international development. Therefore, it was great that NHC published a consultation paper on the updated version on March 16th, 2021. Based on the most updated laws and regulations in the States and EU, and in-depth-interviewed 11 subject matter experts in China, including lawmakers, regulators, and key members of ethics review committees, heads of Regulatory Affairs in SaMD industry, and data scientists, several suggestions were proposed on top of the updated version. Although the new version indicated that the Ethics Review Committees need to be created by National, Provincial and individual institute levels, the review authorities of different levels were not clarified. The suggestion is that the precise scope of review authorities for each level should be identified based on Risk Analysis and Management Model, such as the complicated leading technology, gene editing, should be reviewed by National Ethics Review Committees, it will be the job of individual institute Ethics Review Committees to review and approve the clinical study with less risk such as an innovative cream to treat acne. Furthermore, to standardize the research and development of artificial intelligence in healthcare in the age of AI, more clear guidance should be given to data security in the layers of data, algorithm, and application in the process of ethics review. In addition, transparency and responsibility, as two of six principles in the Rome Call for AI Ethics, could be further strengthened in the updated version. It is the shared goal among all countries to manage well and develop AI to benefit human beings. Learned from the other countries who have more learning and experience, China could be one of the most advanced countries in artificial intelligence in healthcare.

Keywords: biomedical research involving human beings, data security, ethics committees, ethical review, medical artificial intelligence

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4336 Library on the Cloud: Universalizing Libraries Based on Virtual Space

Authors: S. Vanaja, P. Panneerselvam, S. Santhanakarthikeyan

Abstract:

Cloud Computing is a latest trend in Libraries. Entering in to cloud services, Librarians can suit the present information handling and they are able to satisfy needs of the knowledge society. Libraries are now in the platform of universalizing all its information to users and they focus towards clouds which gives easiest access to data and application. Cloud computing is a highly scalable platform promising quick access to hardware and software over the internet, in addition to easy management and access by non-expert users. In this paper, we discuss the cloud’s features and its potential applications in the library and information centers, how cloud computing actually works is illustrated in this communication and how it will be implemented. It discuss about what are the needs to move to cloud, process of migration to cloud. In addition to that this paper assessed the practical problems during migration in libraries, advantages of migration process and what are the measures that Libraries should follow during migration in to cloud. This paper highlights the benefits and some concerns regarding data ownership and data security on the cloud computing.

Keywords: cloud computing, cloud-service, cloud based-ILS, cloud-providers, discovery service, IaaS, PaaS, SaaS, virtualization, Web scale access

Procedia PDF Downloads 629
4335 Helping the Helper: Impact of Teaching Assistantship Program among Psychology Alumni

Authors: Clarissa Delariarte

Abstract:

With the aim of helping the poorest of the poor achieve quality education, Psychology students supported and served as teacher assistants to its Early Childhood Education Center in two barangays since the program began in 1999. Making use of qualitative approach, the impact of the program to 29 alumni who served as teacher assistants between 2000-2014 was assessed. Results show that the impact to the alumni is in cognitive as well as social-emotional in terms of feelings of deep satisfaction and sense of volunteerism which is being carried out in their respective workspaces. They also expressed positive feelings of inspiration, gratefulness and happiness. A wider perspective in life, being confident, creative and resourceful was also articulated as concrete impacts. It is concluded that the program had an impact on helping the helper and is a concrete manifestation of the academe being successful in its commitment of forming individuals into becoming integrated and compassionate in the service of the Church and Society. It implies that more opportunities of helping others be provided to students since, in the final analysis, is actually an opportunity of helping the helper be of better service to others.

Keywords: applied psychology, life skill, qualitative research, quality education

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4334 Developing a Complete Profile: Vocational Assessment, Rehabilitation, and Management for Adults with Intellectual Disability in India

Authors: Virakti Dhaval Shah

Abstract:

Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

Procedia PDF Downloads 91
4333 Privacy-Preserving Location Sharing System with Client/Server Architecture in Mobile Online Social Network

Authors: Xi Xiao, Chunhui Chen, Xinyu Liu, Guangwu Hu, Yong Jiang

Abstract:

Location sharing is a fundamental service in mobile Online Social Networks (mOSNs), which raises significant privacy concerns in recent years. Now, most location-based service applications adopt client/server architecture. In this paper, a location sharing system, named CSLocShare, is presented to provide flexible privacy-preserving location sharing with client/server architecture in mOSNs. CSLocShare enables location sharing between both trusted social friends and untrusted strangers without the third-party server. In CSLocShare, Location-Storing Social Network Server (LSSNS) provides location-based services but do not know the users’ real locations. The thorough analysis indicates that the users’ location privacy is protected. Meanwhile, the storage and the communication cost are saved. CSLocShare is more suitable and effective in reality.

Keywords: mobile online social networks, client/server architecture, location sharing, privacy-preserving

Procedia PDF Downloads 301
4332 Increasing Solubility and Bioavailability of Fluvastatin through Transdermal Nanoemulsion Gel Delivery System for the Treatment of Osteoporosis

Authors: Ramandeep Kaur, Makula Ajitha

Abstract:

Fluvastatin has been reported for increasing bone mineral density in osteoporosis since last decade. Systemically administered drug undergoes extensive hepatic first-pass metabolism, thus very small amount of drug reaches the bone tissue which is highly insignificant. The present study aims to deliver fluvastatin in the form of nanoemulsion (NE) gel directly to the bone tissue through transdermal route thereby bypassing hepatic first pass metabolism. The NE formulation consisted of isopropyl myristate as oil, tween 80 as surfactant, transcutol as co-surfactant and water as the aqueous phase. Pseudoternary phase diagrams were constructed using aqueous titration method and NE’s obtained were subjected to thermodynamic-kinetic stability studies. The stable NE formulations were evaluated for their droplet size, zeta potential, and transmission electron microscopy (TEM). The nano-sized formulations were incorporated into 0.5% carbopol 934 gel matrix. Ex-vivo permeation behaviour of selected formulations through rat skin was investigated and compared with the conventional formulations (suspension and emulsion). Further, in-vivo pharmacokinetic study was carried using male Wistar rats. The optimized NE formulations mean droplet size was 11.66±3.2 nm with polydispersity index of 0.117. Permeation flux of NE gel formulations was found significantly higher than the conventional formulations i.e. suspension and emulsion. In vivo pharmacokinetic study showed significant increase in bioavailability (1.25 fold) of fluvastatin than oral formulation. Thus, it can be concluded that NE gel was successfully developed for transdermal delivery of fluvastatin for the treatment of osteoporosis.

Keywords: fluvastatin, nanoemulsion gel, osteoporosis, transdermal

Procedia PDF Downloads 173
4331 The Lessons Learned from Managing Malignant Melanoma During COVID-19 in a Plastic Surgery Unit in Ireland

Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

Abstract:

Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

Procedia PDF Downloads 153
4330 Adaptive Certificate-Based Mutual Authentication Protocol for Mobile Grid Infrastructure

Authors: H. Parveen Begam, M. A. Maluk Mohamed

Abstract:

Mobile Grid Computing is an environment that allows sharing and coordinated use of diverse resources in dynamic, heterogeneous and distributed environment using different types of electronic portable devices. In a grid environment the security issues are like authentication, authorization, message protection and delegation handled by GSI (Grid Security Infrastructure). Proving better security between mobile devices and grid infrastructure is a major issue, because of the open nature of wireless networks, heterogeneous and distributed environments. In a mobile grid environment, the individual computing devices may be resource-limited in isolation, as an aggregated sum, they have the potential to play a vital role within the mobile grid environment. Some adaptive methodology or solution is needed to solve the issues like authentication of a base station, security of information flowing between a mobile user and a base station, prevention of attacks within a base station, hand-over of authentication information, communication cost of establishing a session key between mobile user and base station, computing complexity of achieving authenticity and security. The sharing of resources of the devices can be achieved only through the trusted relationships between the mobile hosts (MHs). Before accessing the grid service, the mobile devices should be proven authentic. This paper proposes the dynamic certificate based mutual authentication protocol between two mobile hosts in a mobile grid environment. The certificate generation process is done by CA (Certificate Authority) for all the authenticated MHs. Security (because of validity period of the certificate) and dynamicity (transmission time) can be achieved through the secure service certificates. Authentication protocol is built on communication services to provide cryptographically secured mechanisms for verifying the identity of users and resources.

Keywords: mobile grid computing, certificate authority (CA), SSL/TLS protocol, secured service certificates

Procedia PDF Downloads 287
4329 Budget Impact Analysis of a Stratified Treatment Cascade for Hepatitis C Direct Acting Antiviral Treatment in an Asian Middle-Income Country through the Use of Compulsory and Voluntary Licensing Options

Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

Abstract:

Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

Procedia PDF Downloads 148
4328 Reinventing Education Systems: Towards an Approach Based on Universal Values and Digital Technologies

Authors: Ilyes Athimni, Mouna Bouzazi, Mongi Boulehmi, Ahmed Ferchichi

Abstract:

The principles of good governance, universal values, and digitization are among the tools to fight corruption and improve the quality of service delivery. In recent years, these tools have become one of the most controversial topics in the field of education and a concern of many international organizations and institutions against the problem of corruption. Corruption in the education sector, particularly in higher education, has negative impacts on the quality of education systems and on the quality of administrative or educational services. Currently, the health crisis due to the spread of the COVID-19 pandemic reveals the difficulties encountered by education systems in most countries of the world. Due to the poor governance of these systems, many educational institutions were unable to continue working remotely. To respond to these problems encountered by most education systems in many countries of the world, our initiative is to propose a methodology to reinvent education systems based on global values and digital technologies. This methodology includes a work strategy for educational institutions, whether in the provision of administrative services or in the teaching method, based on information and communication technologies (ICTs), intelligence artificial, and intelligent agents. In addition, we will propose a supervisory law that will be implemented and monitored by intelligent agents to improve accountability, transparency, and accountability in educational institutions. On the other hand, we will implement and evaluate a field experience by applying the proposed methodology in the operation of an educational institution and comparing it to the traditional methodology through the results of teaching an educational program. With these specifications, we can reinvent quality education systems. We also expect the results of our proposal to play an important role at local, regional, and international levels in motivating governments of countries around the world to change their university governance policies.

Keywords: artificial intelligence, corruption in education, distance learning, education systems, ICTs, intelligent agents, good governance

Procedia PDF Downloads 191
4327 The Role of Brand Loyalty in Generating Positive Word of Mouth among Malaysian Hypermarket Customers

Authors: S. R. Nikhashemi, Laily Haj Paim, Ali Khatibi

Abstract:

Structural Equation Modeling (SEM) was used to test a hypothesized model explaining Malaysian hypermarket customers’ perceptions of brand trust (BT), customer perceived value (CPV) and perceived service quality (PSQ) on building their brand loyalty (CBL) and generating positive word-of-mouth communication (WOM). Self-administered questionnaires were used to collect data from 374 Malaysian hypermarket customers from Mydin, Tesco, Aeon Big and Giant in Kuala Lumpur, a metropolitan city of Malaysia. The data strongly supported the model exhibiting that BT, CPV and PSQ are prerequisite factors in building customer brand loyalty, while PSQ has the strongest effect on prediction of customer brand loyalty compared to other factors. Besides, the present study suggests the effect of the aforementioned factors via customer brand loyalty strongly contributes to generate positive word of mouth communication.

Keywords: brand trust, perceived value, Perceived Service Quality, Brand loyalty, positive word of mouth communication

Procedia PDF Downloads 463