Search results for: oral delivery

Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

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Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

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Authors: Marinel Dayawon

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Student participation in classroom activities is vital in the teaching- learning the process as it develops self-confidence, social relationships and good academic performance of students. It is the teacher’s empathetic manner and creativity to create solutions that encourage teamwork and mutual support while dropping the academic competition within the class that hinder every shy student to walk with courage and talk with conviction because they consider their ideas, weak, as compared to the bright students. This study aimed to explore the different design thinking strategies that will change the mindset of shy students in classroom activities, maximizing their participation in all given tasks while sharing their views through ideation and providing them a wider world through compromise agreement within the members of the group, sensitivity to one’s idea, thus, arriving at a collective decision in the development of a prototype that indicates improvement in their classroom involvement. The study used the qualitative type of research. Triangulation is done through participant observation, focus group discussion and interview, documented through photos and videos. The respondents were the second- year Bachelor of Secondary Education students of the Institute of Teacher Education at Isabela State University- Cauayan City Campus. The result of the study revealed that reticent students when involved in game activities through a slap and tap method, writing their clustered ideas, using sticky notes is excited in sharing ideas as it doesn’t use oral communication. It is also observed after three weeks of using the design thinking strategies; shy students volunteer as secretary, rapporteur or group leader in the team- building activities as it represents the ideas of the heterogeneous group, removing the individual identity of the ideas. Superior students learned to listen to the ideas of the reticent students and involved them in the prototyping process of designing a remediation program for high school students showing reticence in the classroom, making their experience as a benchmark. The strategies made a 360- degrees transformation of the shy students, producing their journal log, in their journey to being open. Thus, faculty members are now adopting the design thinking approach.

Keywords: design thinking activities, qualitative, reticent students, Isabela, Philippines

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Authors: Rihab Gamaoun, Cynthia El Hage, Laura Ruiz, Erin Prosk, Antonio Vigano

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Introduction: Santé Cannabis (SC), a Canadian medical cannabis-specialized group of clinics based in Montreal and in the province of Québec, has served more than 5000 patients seeking cannabis-based treatment prescription for medical indications over the past five years. Within a research frame, data on the use of medical cannabis products from all the above patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to gather information on the profiles of both patients and prescribed medical cannabis products at SC clinics and to assess the safety of medical cannabis among Canadian patients. Methods: Using a retrospective analysis of the database, records of 2585 patients who were prescribed medical cannabis products for therapeutic purposes between 01-November 2017 and 04-September 2019 were included. Patients’ demographics, primary diagnosis, route of administration, and chemovars recorded at the initial visits were investigated. Results: At baseline: 9% of SC patients were female, with a mean age of 57 (SD= 15.8, range= [18-96]); Cannabis products were prescribed mainly for patients with a diagnosis of chronic pain (65.9% of patients), cancer (9.4%), neurological disorders (6.5%), mood disorders (5.8 %) and inflammatory diseases (4.1%). Route of administration and chemovars of prescribed cannabis products were the following: 96% of patients received cannabis oil (51% CBD rich, 42.5% CBD:THC); 32.1% dried cannabis (21.3% CBD:THC, 7.4% THC rich, 3.4 CBD rich), and 2.1% oral spray cannabis (1.1% CBD:THC, 0.8% CBD rich, 0.2% THC rich). Most patients were prescribed simultaneously, a combination of products with different administration routes and chemovars. Safety analysis is undergoing. Conclusion: Our results provided initial information on the profile of medical cannabis products prescribed in a Canadian population and the experienced adverse events over the past three years. The Santé Cannabis database represents a unique opportunity for comparing clinical practices in prescribing and titrating cannabis-based medications across different centers. Ultimately real-world data, including information about safety and effectiveness, will help to create standardized and validated guidelines for choosing dose, route of administration, and chemovars types for the cannabis-based medication in different diseases and indications.

Keywords: medical cannabis, real-world data, safety, pharmacovigilance

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Authors: Wenru Wang

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Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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Authors: Anca Dinischiotu, Sorina Nicoleta Voicu

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Silica nanoparticles (SiO2-NPs) are widely used in consumer products such as paints, plastics, insulation materials, tires, concrete production, as well as in gene delivery systems and imaging procedures. Environmental human exposure to them occurs during utilization of these products, in a time-dependent manner, the uptake being by topic and inhalation route especially. SiO2-NPs enter cells and induce membrane damage, oxidative stress and inflammatory reactions in a concentration-dependent manner. In this study, MRC-5 cells (human fetal lung fibroblasts) were exposed to amorphous SiO2-NPs at a dose of 62.5 μg/ml for 24, 48 and 72 hours. The size distribution of NPs was a lognormal function, in the range 3-14 nm. A time-dependent decrease of total reduced glutathione concentration by 36%, 50%, and 78% and an increase of NO level by 62%, 32%, respectively 24% compared to control were noticed. An up-regulation of NF-kB expression by 20%, 50% respectively 10% and of Nrf-2 by 139%, 58%, and 16% compared to control after 24, 48 and 72 hours was noticed also. The expression of IL-1β, IL-6, IL-8, and COX-2 was up-regulated in a time-dependent manner. Also, the expression of MMP-2 and MMP-9 were down-regulated after 48 and 72 hours, whereas their activities raised in a time-dependent manner. Exposure of cells to NPs up-regulated the expression of inducible NO synthase, as previously was shown, and probably this is the reason for the increased level of NO, that can react with the thiol groups of reduced glutathione molecules, diminishing its concentration Nrf2 is a transcription factor translocated in nucleus, under oxidative stress, where downstream gene expression activates in order to modulate the adaptive intracellular response against oxidative stress. The cross-talk between Nrf2 and NF-kB activities regulates the inflammatory processes. The activation of NF-kB could activate up-regulation of IL-1β, IL-6, and IL-8. The increase of COX-2 expression could be correlated with IL-1β one. Also, probably in response to the pro-inflammatory cytokines, MMP-2 and MMP-9 were induced and activated. In conclusion, the exposure of MRC-5 cells to SiO2-NPs generated inflammation in a time-dependent manner.

Keywords: inflammation, MRC-5 cells, oxidative stress, silica nanoparticles

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Authors: Yusuf Ismaila

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The developing countries are characterized by inefficient production systems and unequal distribution of wealth. Developing countries are largely populated, yet under developed. This can be attributed partly to the unplanned efforts towards the development of human capital through education and training. In the developed nations a huge attention is accorded to indices such as life expectancy, literacy, infant mortality, education, and the efficient delivery of social services. This is the reason why many developing countries have been scored low by the United Nations in terms of its human development indicators. The population growth continued to expand far beyond the rate of economic growth, a situation that gave rise to increasing poverty. This paper examines the effect of selected human development indicators on the economic development. Thus human capital development is one of the fundamental solutions to enter the international arena. Both quantitative and qualitative analyses were used to demonstrate the effect of selected human capital indices and related literatures were also reviewed for exposition of the human capital concept. It was found that there are no conscious efforts in human capital planning. This has therefore resulted to continuing dwindling of production system and poverty. Recommendations made to redress the situation include that human capital development should be planned and adequately funded in line with the needs of the economy and by applying international standards. Specifically, developing countries must invest necessary resources in developing human capital which tend to have a great impact on sustainable development. Information about the labour market should improve while government policy should favour labour mobility. HCD strategy must focus on improving the skills of the workforce, reducing the cost of doing business and making available the resources business needs to compete and thrive in a fast globalizing economy. There should be regular interaction of planners, employers and builders of human capital to facilitate the process of meaningful national development.

Keywords: economic development, human capital, economic growth, developing countries

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Authors: Akanksha Gupta, Vishal Dubey

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In the Neoliberal era, there has been a much-talked discourse about urban issues that arise from a narrow approach of the single rationality of market-driven planning in Indian cities. More to this, India's urban planning is already jeopardized by the captious shortage of infrastructure, a cluster of incoherent governing bodies and implementation mechanism, leading cities to lie in the plethora of urban challenges. In this context, Allahabad (now known as Prayagraj) a city in North India is not an exception. Once known as the most planned splendid Colonial city of the British regime in India collapsed phenomenally because of the incompetent approach of planning machinery, straightforward market-driven accession and lack of attention on urban equity and sustainability. Particularly Civil Lines a Colonial neighbourhood, reached to the zenith of the glorified legacy of the Colonial era, transformed into filthy and congested urban form. Contextually this study contemplates and assesses the chronological episodes of major changes in land management reforms and policies under the ad hoc approach of political economy and land use planning which radically degraded the living environment in the present context. This study would empirically showcase the selected sample area detailing some of the major consequences in terms of gradual change in urban morphology, land use, and function. Here the method of study is primarily a qualitative study implying oral history and other historical methods to exhibit the idiom of planning conundrum. This subsequently reflects the repercussions translated into major issues like unclear land titles, encroachment, and unauthorized development and mushrooming of informal and squatter settlements. In nutshell, the study seeks to distinct out the limitations of the land reform and land management policies, which impacted the general degradation to the beautiful setting of Colonial neighbourhood. The Colonial legacy of Civil Lines now exists in the traces of history- memories of people, who once took pride in its serenity have now witnessed the transformation bit by bit till neo-liberal market forces completely swallow it.

Keywords: civil lines, land reforms, policies, urban challenges

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Authors: Abdela Zeinu Yasin

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The current research aimed to assess the status of IMC in providing treatment for malnourished children and programs in water, sanitation, and hygiene (WASH), food and livelihood security, and comprehensive healthcare through Mobile health and nutrition programs during the last 5 years period. We have conducted 60 in-depth interviews with women during the period from conception to a child’s birthday, health facility staff, and female community health volunteers (FCHVs), as well as 12 focus group discussions with health facility staff and other household decision-makers. We employed thematic analysis using framework matrices and analytical memorandums. The study revealed that 78% of the respondents, of whom 97% were women, have benefited from the selected vulnerable areas. The use of the clear water and sanitization program has reached the 81% of selected households. The use of a modern baby delivery system among the respondent has been 68% of the women and health facilities among the decision-makers/focal person. More than 8 in 10 participants (84%) could read and understand the health facility instructions, and the majority (82%) of women, health facility staff, and male decision-makers can also read and write bulletins and instructions. We found that decision-maker women preferred participative education, whereas health facilities and the IMC desired educational and motivational bulletins. A Mobile Health and Nutrition program intervention by the IMC is acceptable in the conditions of the Ethiopian community and has the potential to improve community health and nutrition service utilization, particularly by providing clean water and sanitization; women’s birth control, and health improvement in the vulnerable regions of the country. The current research findings shall contribute to text IMC Mobile Health and Nutritional intervention design in under-resourced settings.

Keywords: clean water, health and nutrition services, hygiene, IMC, mobile health, sanitation

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Authors: Frazer G. Thompson

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The 1990s in America ended with a mass-school-shooting (at least four killed by gunfire excluding the perpetrator(s)) at Columbine High School in Littleton, Colorado. Post-event, many demanded that government and civilian experts develop a ‘profile’ of the potential school shooter in order to identify and preempt likely future acts of violence. This grounded theory research study seeks to explore the validity of the original hypotheses proposed by the Federal Bureau of Investigation (FBI) in 2000, as it relates to the commonality of disclosure by perpetrators of mass-school-shootings, by evaluating fourteen mass-school-shooting events between 2000 and 2019 at locations around the United States. Methods: The strategy of inquiry seeks to investigate case files, public records, witness accounts, and available psychological profiles of the shooter. The research methodology is inclusive of one-on-one interviews with members of the FBI’s Critical Incident Response Group seeking perspective on commonalities between individuals; specifically, disclosure of intent pre-event. Results: The research determined that school shooters do not ‘unfailingly’ notify others of their plans. However, in nine of the fourteen mass-school-shooting events analyzed, the perpetrator did inform the third party of their intent pre-event in some form of written, oral, or electronic communication. In the remaining five instances, the so-called ‘red-flag’ indicators of the potential for an event to occur were profound, and unto themselves, might be interpreted as notification to others of an imminent deadly threat. Conclusion: Data indicates that conclusions drawn in the FBI’s threat assessment perspective published in 2000 are relevant and current. There is evidence that despite potential ‘red-flag’ indicators which may or may not include a variety of other characteristics, perpetrators of mass-school-shooting events are likely to share their intentions with others through some form of direct or indirect communication. More significantly, implications of this research might suggest that society is often informed of potential danger pre-event but lacks any equitable means by which to disseminate, prevent, intervene, or otherwise act in a meaningful way considering said revelation.

Keywords: columbine, FBI profiling, guns, mass shooting, mental health, school violence

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Authors: V. Konjik, J. Schwartz, R. Sandhoff, M. Mack

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The rising number of multi-resistant pathogens demands the development of new antibiotics in order to reduce the lethal risk of infections. Here, we investigate roseoflavin, a vitamin B2 analogue which is produced by Streptomyces davawensis and Streptomyces cinnabarinus. We consider roseoflavin to be a 'Trojan horse' compound. Its chemical structure is very similar to riboflavin but in fact it is a toxin. Furthermore, it is a clever strategy with regard to the delivery of an antibiotic to its site of action but also with regard to the production of this chemical: The producer cell has only to convert a vitamin (which is already present in the cytoplasm) into a vitamin analog. Roseoflavin inhibits the activity of Flavin depending proteins, which makes up to 3.5 % of predicted proteins in organisms sequenced so far. We sequentially knocked out gene clusters and later on single genes in order to find the ones which are involved in the roseoflavin biosynthesis. Consequently, we identified the gene rosB, coding for the protein carrying out the first step of roseoflavin biosynthesis, starting form Flavin mononucleotide. Here we show, that the protein RosB has so far unknown features. It is per se an oxidoreductase, a decarboxylase and an aminotransferase, all rolled into one enzyme. A screen of cofactors revealed needs of oxygen, NAD+, thiamine and glutamic acid to carry out its function. Surprisingly, thiamine is not only needed for the decaboxylation step, but also for the oxidation of 8-demethyl-8-formyl Flavin mononucleotide. We had managed to isolate three different Flavin intermediates with different oxidation states, which gave us a mechanistic insight of RosB functionality. Our work points to a so far new function of thiamine in Streptomyces davawensis. Additionally, RosB could be extremely useful for chemical synthesis. Careful engineering of RosB may allow the site-specific replacement of methyl groups by amino groups in polyaromatic compounds of commercial interest. Finally, the complete clarification of the roseoflavin biosynthesis opens the possibility of engineering cost-effective roseoflavin producing strains.

Keywords: antibiotic, flavin analogue, roseoflavin biosynthesis, vitamin B2

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Authors: Shoukat Ali, Abdul Qadir Jandga, Amjad Hussain

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Objective: The main purpose of this study is to compare the Percent Depth dose (PDD) and In-plane and cross-plane profiles of Varian Golden beam data to the measured data of 6 and 18 MV photons for the commissioning of Eclipse treatment planning system. Introduction: Commissioning of treatment planning system requires an extensive acquisition of beam data for the clinical use of linear accelerators. Accurate dose delivery require to enter the PDDs, Profiles and dose rate tables for open and wedges fields into treatment planning system, enabling to calculate the MUs and dose distribution. Varian offers a generic set of beam data as a reference data, however not recommend for clinical use. In this study, we compared the generic beam data with the measured beam data to evaluate the reliability of generic beam data to be used for the clinical purpose. Methods and Material: PDDs and Profiles of Open and Wedge fields for different field sizes and at different depths measured as per Varian’s algorithm commissioning guideline. The measurement performed with PTW 3D-scanning water phantom with semi-flex ion chamber and MEPHYSTO software. The online available Varian Golden Beam Data compared with the measured data to evaluate the accuracy of the golden beam data to be used for the commissioning of Eclipse treatment planning system. Results: The deviation between measured vs. golden beam data was in the range of 2% max. In PDDs, the deviation increases more in the deeper depths than the shallower depths. Similarly, profiles have the same trend of increasing deviation at large field sizes and increasing depths. Conclusion: Study shows that the percentage deviation between measured and golden beam data is within the acceptable tolerance and therefore can be used for the commissioning process; however, verification of small subset of acquired data with the golden beam data should be mandatory before clinical use.

Keywords: percent depth dose, flatness, symmetry, golden beam data

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Obstructive sleep apnea syndrome (OSAS) is a popular problem in the modern society. It usually leads to sleep disorder, excessive daytime sleepiness and associated with cardiovascular diseases, cognitive dysfunction and even death. The nonsurgical therapies include continuous positive airway pressure (CPAP), diet and oral appliances. The surgical approaches have nasal surgery, tonsillectomy, adenoidectomy, uvulopalatopharyngoplasty (UPPP) and transoral robotic surgery (TORS).We compare the impact of surgical treatments on these kinds of patients. Methods: Between January 2018 to September 2022, We have enrolled 125 OSAS patients including 82 male and 43 female in Chi Mei Medical Center, Liouying, Taiwan. The age distribution from 6 to 71 years old (y/o) with mean age 36.1 y/o. The averaged body mass index (BMI) is 25 kg/m2 in male and 25.5 kg/m2 in female. In this cohort, we evaluated their upper airway obstruction sites with nasopharyngoscopy and scheduled a planned surgery. Some of cases received polysomnography (PSG) preoperatively, the averaged apnea-hypopnea index (AHI) is 37.7 events/hour. We have 68 patients received tonsillectomy, 9 received UPPP, 42 received UPPP and septomeatoplasty (SMP) and 6 received adenoidectomy and tonsillectomy (A and T). The subjective daytime sleepiness was evaluated with the Epworth sleepiness scale (ESS). Results: In the 68 tonsillectomy group, the averaged BMI is 24.9 kg/m2. In the UPPP group, the averaged BMI is 28.9 kg/m2. In UPPP and SMP group, the averaged BMI is 27.9 kg/m2. In the A and T group, the averaged BMI is 17.2 kg/m2. The reduction of AHI less than 20 is 58% postoperatively. The ESS reduced from 10.9 to 4.9 after surgery. Conclusion: Obstructive sleep apnea syndrome is a common upper airway disturbance in the general population. The prevalence rate is ranging high depending on different regions, age, sex and race. It leads to severe morbidity and mortality including car accident, stroke, nocturnal desaand sudden death and should be considered to be a major public health problem. The CPAP is effective to improve daytime sleepiness but the long-term compliance is low. The surgical treatment with different modalities can produce 50% decrease in AHI and ESS after surgery in the 6 to 12 months short-term period.

Keywords: apnea-hypopnea index, obstructive sleep apnea syndrome, polysomnography, uvulopalatopharyngoplasty

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Authors: Sara Cumming, Julianne DiSanto, Leah Burton

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Homelessness in Canada is a persistent problem. It has been widely argued that the best tactic for eradicating homelessness is to approach social issues from a Housing First perspective—an approach that centers on quickly moving people into permanent and independent housing and then providing them additional support and services as needed. It is recognized that life skills training is both necessary and an effective way to reduce cyclical homelessness; however, there is a scarcity of research on effective ways to teach life skills; this problem was exacerbated in a pandemic context, where in-person delivery was severely restricted or no longer possible. Very little attention has been paid to the diverse cultural needs of clients in a multicultural context and the need to foster cultural knowledge/awareness in individuals to successfully contribute to the cultural safety of communities. This research attempts to fill these gaps in the literature and in practice by employing a community-engaged research (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, equity, diversity, and inclusion (EDI) informed life skill learning management system. We employed a triangulation methodology for this research. An environmental scan was conducted for best practices. Two separate Creative Problem Solving Sessions were held with over 100 front-line workers, managers, and executive directors who work with homeless populations. Quantitative and open-ended surveys were completed by over 200 individuals with experience with homelessness. All sections of this research aimed to discover the areas of skills that individuals need to maintain housing and to ascertain what a more client-driven EDI approach to life skills training should include. This research will showcase which life skills are deemed essential for homeless and precariously housed individuals.

Keywords: homelessness, Housing First, life skills, community engaged research

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Authors: Smruti Mahapatra, Dipankar Biswas, Richard Um, Michael Meggyesy, Riccardo Serra, Noah Gorelick, Steven Marra, Amir Manbachi, Mark G. Luciano

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Intracranial pressure (ICP) is profoundly regulated by the effects of cardiac pulsation and the volume of the incoming blood. Furthermore, these effects on ICP are incremented by the presence of a rigid skull that does not allow for changes in total volume during the cardiac cycle. These factors play a pivotal role in cerebrospinal fluid (CSF) dynamics and distribution, with consequences that are not well understood to this date and that may have a deep effect on the Central Nervous System (CNS) functioning. We designed this study with two specific aims: (a) To study how pulsatility influences local CSF flow, and (b) To study how modulating intracranial pressure affects drug distribution throughout the SAS globally. In order to achieve these aims, we built an elaborate in-vitro model of the SAS closely mimicking the dimensions and flow rates of physiological systems. To modulate intracranial pressure, we used an intracranially implanted, cardiac-gated, volume-oscillating balloon (CADENCE device). Commercially available dye was used to visualize changes in CSF flow. We first implemented two control cases, seeing how the tracer behaves in the presence of pulsations from the brain phantom and the balloon individually. After establishing the controls, we tested 2 cases, having the brain and the balloon pulsate together in sync and out of sync. We then analyzed the distribution area using image processing software. The in-sync case produced a significant increase, 5x times, in the tracer distribution area relative to the out-of-sync case. Assuming that the tracer fluid would mimic blood flow movement, a drug introduced in the SAS with such a system in place would enhance drug distribution and increase the bioavailability of therapeutic drugs to a wider spectrum of brain tissue.

Keywords: blood-brain barrier, cardiac-gated, cerebrospinal fluid, drug delivery, neurosurgery

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Authors: Ebenezer O. Ige, Funmilayo H. Oyelami, Joshua Olutayo-Irheren, Joseph T. Okunlola

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Hyperthermia therapy is an adjuvant procedure during which perfused body tissues is subjected to elevated range of temperature in bid to achieve improved drug potency and efficacy of cancer treatment. While a selected class of hyperthermia techniques is shouldered on the thermal radiations derived from single-sourced electro-radiation measures, there are deliberations on conjugating dual radiation field sources in an attempt to improve the delivery of therapy procedure. This paper numerically explores the thermal effectiveness of combined infrared hyperemia having nanoparticle recirculation in the vicinity of imposed magnetic field on subcutaneous strata of a model lesion as ablation scheme. An elaborate Spectral relaxation method (SRM) was formulated to handle equation of coupled momentum and thermal equilibrium in the blood-perfused tissue domain of a spongy fibrous tissue. Thermal diffusion regimes in the presence of external magnetic field imposition were described leveraging on the renowned Roseland diffusion approximation to delineate the impact of radiative flux within the computational domain. The contribution of tissue sponginess was examined using mechanics of pore-scale porosity over a selected of clinical informed scenarios. Our observations showed for a substantial depth of spongy lesion, magnetic field architecture constitute the control regimes of hemodynamics in the blood-tissue interface while facilitating thermal transport across the depth of the model lesion. This parameter-indicator could be utilized to control the dispensing of hyperthermia treatment in intravenous perfused tissue.

Keywords: spectra relaxation scheme, thermal equilibrium, Roseland diffusion approximation, hyperthermia therapy

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Authors: Gabriela Macera DiFilippo

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The world watched in disbelief as George Floyd was killed by a policeman. The images from the scene were made more memorable by Mr. Floyd’s pleas and cries for his mother. In the aftermath of this tragedy, the Black Lives Matter movement gained momentum. Weeks and months after the protests, global interest in learning about tackling systemic racism erupted. One must wonder how school children of color viewed and processed this trauma. This study will examine the kinds of trauma experienced by children of color and the opportunity for school mental health providers to support these children. This study used literature searches that were previously conducted for proven and practical assessment methods that can help deal with racial trauma for children. As part of the assessment, trauma symptoms experienced by children of color were summarized and characterized in a non-imperial manner. The research was also will be done in practical ways to make adequate and effective mental health services available in schools and lessen the stigma. This research study found that there is a need to provide an analysis of the ongoing racial trauma of children of color after the death of George Floyd. Impactful and appropriate assessment methods, such as surveys, were presented to all school professionals. Lastly, this paper attempted to provide mental health professionals with the tools to screen and provide guidance based on unequivocal, unbiased methods for helping these children. There is a need for both schools and community leaders to ensure that every child has access to mental health care and is being assessed for their overall well-being. There is a need to educate the communities about racial trauma and its impact on individuals, especially children. School mental health professionals are encouraged to offer and educate schools and communities about racial trauma awareness, its importance, and ways to cope with it in different settings. The delivery of these informed services should focus on behavioral health and must be sensitive to children of color and different ways of self-care.

Keywords: trauma, children, black psychology, students

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Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Olupemi E. Oludare

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This paper investigates the creative practice engaged in Juju music, a Nigerian Neo-traditional genre of the Yoruba, and its influence on the consciousness of societal praxis. It takes a musical and cultural perspective, as representational indices of how the people’s religious, social, educational, and political consciousness is expressed in their music. The study adopts the historical cum descriptive design in its methodology, tracing the historical development of Juju music, the appropriation of musical and cultural materials in its creative process, and a descriptive analysis of its musical practice, in order to substantiate the role and function of Juju music and its musicians in the political, philosophical, and social consciousness of Nigeria’s pre- and post-independence epoch. Data were collected through oral interviews of selected Juju practitioners, stakeholders, and enthusiasts. It also employed the use of discography of Juju musicians. This paper discusses musical factors such as form, melodic and rhythmic patterns, and thematic materials, while highlighting cultural factors such as linguistic elements, with textual analysis, as a conscious avenue of expression. The study revealed that Juju musicians composed their music by engaging both indigenous and foreign musical materials, as a means of creative practice for musical entertainment, while expressing the people’s consciousness of their beliefs, values, and socio-political issues, hence the music functioning as a vehicle for social commentaries. The popularization and commercialization of Juju music brought the musicians national and international accolades, subsequently attracting contributions from contemporary musicians, which led to innovations of new brands, such as ‘Afro-Juju’, ‘Gospel-Juju’, ‘Hip-Hop-Juju’, etc., albeit retaining the basic musical elements of its progenitor, as a conscious music for socio-cultural functions. This study concludes that Juju music and its musicians remain germane in the musical scene of the nation’s social, educational, and political terrain, especially in the current Nigerian democratic climate. This paper recommends the promotion and patronage of the Juju music in its original form, to prevent its decline in current times, since it serves as an enrichment of national identity both in Nigeria, and Internationally.

Keywords: appropriation, consciousness, creative practice, national identity, neo-traditional

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Authors: Masyitah Abd Aziz, Mohd Sabere Sulaiman, Norsiah Hassan, Jamilah Halina Abdul Halim, Mohd Saipul Asrafi Haron

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A well-defined terminology of ‘Marseilles’ clay roof tiles in conservation works will easily characterize the communication delivery between expert and layperson, which will help people effectively understand to such specific knowledge areas. While it reduces ambiguity and increases clarity, the communication will translate very fast as it encourage an important factor in quality of the preservation of cultural heritage for future generations. The experts in conservation works faces many important terms, and indeed the very basic terminology in conservation areas were misunderstood. Thus, there were such terminology that being taken for granted and just follow seriously the tradition of the common practitioner without having any precise knowledge of what it entails. This study aims to investigate on the misconception of the terminology of ‘Marseilles’ clay roof tiles that being used in Malaysia’s conservation work. To avoid confusion of the terminology of ‘Marseilles’ clay roof tiles that will be followed through by the next generation, observation, interviews, and readings from the literature reviews on the terminology of the roof tiles has been done. It shows some evidence that ‘Marseilles’ were referring specific to French type roof tiles that developed by the Gilardoni Brothers in 1851. It was also found in Mangalore as the pioneered manufacturer in the 1860s by The Common Wealth Trust Ltd (Basel Mission tile factory). The interlocking clay roof types that has been used in Malaysia have the similarity and are influenced by both Europe and India. However, ‘Marseilles’ terminology was commonly used in Malaysia’s conservation works which led to the misconception of the real interpretation of all interlocking clay roof tiles type. The future generations will found that the well-defined terminology will gives a specific impact on conservation method and techniques. These range of applications to which roof tiles terminology will direct the future experts to make realistic suggestion for a future sustainable conservation approaches. Furthermore, it should contributes value added to conservation knowledge as well as holistic references for next generation.

Keywords: interlocking roof tiles, marseilles, misconception, terminology

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Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

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Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

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Authors: Indu ray

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In today’s digital world the internet is already flooded with information on how to master grammar in a foreign language. It is well known that one cannot master a language without grammar. Grammar is the backbone of any language. Without grammar there would be no structure to help you speak/write or listen/read. Successful communication is only possible if the form and function of linguistic utterances are firmly related to one another. Grammar has its own rules of use to formulate an easier-to-understand language. Like a tool, grammar formulates our thoughts and knowledge in a meaningful way. Every language has its own grammar. With grammar, we can quickly analyze whether there is any action in this text: (Present, past, future). Knowledge of grammar is an important prerequisite for mastering a foreign language. What’s most important is how teachers can make grammar lessons more interesting for students and thus promote grammar skills more successfully. Through this paper, we discuss a few important methods like (Interactive Grammar Exercises between students, Interactive Grammar Exercise between student to teacher, Grammar translation method, Audio -Visual Method, Deductive Method, Inductive Method). This paper is divided into two sections. In the first part, brief definitions and principles of these approaches will be provided. Then the possibility and the case of combination of this approach will be analyzed. In the last section of the paper, I would like to present a survey result conducted at my university on a few methods to quickly learn grammar in Foreign Language. We divided the Grammatical Skills in six Parts. 1.Grammatical Competence 2. Speaking Skills 3. Phonology 4. The syntax and the Semantics 5. Rule 6. Cognitive Function and conducted a survey among students. From our survey results, we can observe that phonology, speaking ability, syntax and semantics can be improved by inductive method, Audio-visual Method, and grammatical translation method, for grammar rules and cognitive functions we should choose IGE (teacher-student) method. and the IGE method (pupil-pupil). The study’s findings revealed, that the teacher delivery Methods should be blend or fusion based on the content of the Grammar.

Keywords: innovative method, grammatical skills, audio-visual, translation

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Authors: Kathryn Nderitu, Atunga Nyachieo, Ezekiel Mecha

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Introduction: Solanum nigrum , also known as black nightshade, biosynthesizes various phytochemical compounds with various pharmacological activities, including treating cardiovascular diseases and type 2 diabetes, among others. Materials and Methods: To assess the anti-obesity effects of Solanum nigrum using high-fat-fed diet rats, Sprague Dawley male rats (n = 35) of weights 160–180 g were assigned randomly into seven groups comprising n = 5 rats each. Each group was fed for 11 weeks as follows: normal group (normal chow rat feed); high-fat diet control (HFD); HFD and standard drug (Orlistat 30 mg/kg bw); HFD and methanolic extract 150 mg/kgbw; HFD and methanolic extract 300 mg/kgbw; HFD and dichloromethane extract 150 mg/kgbw; HFD and dichloromethane extract 300 mg/kgbw. Body mass index and food intake were monitored per week, and an oral glucose tolerance test was measured in weeks 5 and 10. Lipid profiles, liver function tests, adipose tissue, liver weights, and phytochemical analysis of Solanum nigrum were later carried out. Results: High-fat diet control group rats exhibited a significant increase in body mass index (BMI), while rats administered with leaf extracts of Solanum nigrum showed a reduction in BMI. Both low doses of dichloromethane (150 mg/kgbw) and high doses of methanol extracts (300 mg/kgbw) showed a better reduction in BMI than the other treatment groups. A significant decrease (p <0.05) in low-density lipoprotein-cholesterol, triglycerides, and cholesterol was observed among the rats administered with Solanum nigrum extracts compared to those of HFD control. Moreover, the HFD control group significantly increased liver and adipose tissue weights compared to other treatment groups (p<0.05). Solanum nigrum also decreased glycemic levels and normalized the hepatic enzymes of HFD control. However, food intake among the groups showed no significant difference (p>0.05). Qualitative analysis of Solanum nigrum leaf extracts indicated the presence of various bioactive compounds associated with anti-obesity. Conclusion: These results validate the use of Solanum nigrum in controlling obesity.

Keywords: solanum nigrum, High fat diet, phytocompounds, obesity

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Authors: Maad Kamal Al-Anni

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This study is about an algorithmic dependence of Artificial Neural Network on Multilayer Perceptron (MPL) pertaining to the classification and clustering presentations for Mobile Adhoc Network vulnerabilities. Moreover, mobile ad hoc network (MANET) is ubiquitous intelligent internetworking devices in which it has the ability to detect their environment using an autonomous system of mobile nodes that are connected via wireless links. Security affairs are the most important subject in MANET due to the easy penetrative scenarios occurred in such an auto configuration network. One of the powerful techniques used for inspecting the network packets is Intrusion Detection System (IDS); in this article, we are going to show the effectiveness of artificial neural networks used as a machine learning along with stochastic approach (information gain) to classify the malicious behaviors in simulated network with respect to different IDS techniques. The monitoring agent is responsible for detection inference engine, the audit data is collected from collecting agent by simulating the node attack and contrasted outputs with normal behaviors of the framework, whenever. In the event that there is any deviation from the ordinary behaviors then the monitoring agent is considered this event as an attack , in this article we are going to demonstrate the  signature-based IDS approach in a MANET by implementing the back propagation algorithm over ensemble-based Traffic Table (TT), thus the signature of malicious behaviors or undesirable activities are often significantly prognosticated and efficiently figured out, by increasing the parametric set-up of Back propagation algorithm during the experimental results which empirically shown its effectiveness  for the ratio of detection index up to 98.6 percentage. Consequently it is proved in empirical results in this article, the performance matrices are also being included in this article with Xgraph screen show by different through puts like Packet Delivery Ratio (PDR), Through Put(TP), and Average Delay(AD).

Keywords: Intrusion Detection System (IDS), Mobile Adhoc Networks (MANET), Back Propagation Algorithm (BPA), Neural Networks (NN)

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Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

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Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

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Authors: Hossam E. Emam

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Metal–organic frameworks (MOFs) are new hybrid materials investigated from 15 years ago; they synthesized from metals as inorganic center joined with multidentate organic linkers to form a 1D, 2D or 3D network structure. MOFs have unique properties such as pore crystalline structure, large surface area, chemical tenability and luminescent characters. These significant properties enable MOFs to be applied in many fields such like gas storage, adsorption/separation, drug delivery/biomedicine, catalysis, polymerization, magnetism and luminescence applications. Recently, many of published reports interested in superiority of MOFs for functionalization of textiles to exploit the unique properties of MOFs. Incorporation of MOFs is found to acquire the textiles some additional formidable functions to be used in considerable fields such like water treatment and fuel purification. Modification of textiles with MOFs could be easily performed by two main techniques; Ex-situ (preparation of MOFs then applied onto textiles) and in-situ (ingrowth of MOFs within textiles networks). Uniqueness of MOFs could be assimilated in acquirement of decorative color, antimicrobial character, anti-mosquitos character, ultraviolet radiation protective, self-clean, photo-luminescent and sensor character. Additionally, textiles treatment with MOFs make it applicable as filter in the adsorption of toxic gases, hazardous materials (such as pesticides, dyes and aromatics molecules) and fuel purification (such as removal of oxygenated, nitrogenated and sulfur compounds). Also, the porous structure of MOFs make it mostly utilized in control release of insecticides from the surface of the textile. Moreover, MOF@textiles as recyclable materials lead it applicable as photo-catalyst composites for photo-degradation of different dyes in the day light. Therefore, MOFs is extensively considered for imparting textiles with formidable properties as ingeniousness way for textile functionalization.

Keywords: MOF, functional textiles, water treatment, fuel purification, environmental applications

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Authors: Saeed M. Alshahrani

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This research integrated blockchain technology to reform medical records management in healthcare informatics. It was aimed at resolving the limitations of centralized systems by establishing a secure, decentralized, and user-centric platform. The system was architected with a sophisticated three-tiered structure, integrating advanced cryptographic methodologies, consensus algorithms, and the Fast Healthcare Interoperability Resources (HL7 FHIR) standard to ensure data security, transaction validity, and semantic interoperability. The research has profound implications for healthcare delivery, patient care, legal compliance, operational efficiency, and academic advancements in blockchain technology and healthcare IT sectors. The methodology adapted in this research comprises of Preliminary Feasibility Study, Literature Review, Design and Development, Cryptographic Algorithm Integration, Modeling the data and testing the system. The research employed a permissioned blockchain with a Practical Byzantine Fault Tolerance (PBFT) consensus algorithm and Ethereum-based smart contracts. It integrated advanced cryptographic algorithms, role-based access control, multi-factor authentication, and RESTful APIs to ensure security, regulate access, authenticate user identities, and facilitate seamless data exchange between the blockchain and legacy healthcare systems. The research contributed to the development of a secure, interoperable, and decentralized system for managing medical records, addressing the limitations of the centralized systems that were in place. Future work will delve into optimizing the system further, exploring additional blockchain use cases in healthcare, and expanding the adoption of the system globally, contributing to the evolution of global healthcare practices and policies.

Keywords: healthcare informatics, blockchain, medical records management, decentralized architecture, data security, cryptographic algorithms

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Authors: Sonal Gupta, Rakhi Bansal, Javed Ali, Reema Gabrani, Shweta Dang

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Nanoemulsions (NEs) and microemulsions (MEs) have been an attractive tool for encapsulation of both hydrophilic and lipophillic actives. Both these systems are composed of oil phase, surfactant, co-surfactant and aqueous phase. Depending upon the application and intended use, both oil-in-water and water-in-oil emulsions can be designed. NEs are fabricated using high energy methods employing less percentage of surfactant as compared to MEs which are self assembled drug delivery systems. Owing to the nanometric size of the droplets these systems have been widely used to enhance solubility and bioavailability of natural as well as synthetic molecules. The aim of the present study is to assess the effect of % age of surfactants on cell viability of Vero cells (African Green Monkeys’ Kidney epithelial cells) via MTT assay. Green tea catechin (Polyphenon 60) loaded ME employing low energy vortexing and NE employing high energy ultrasonication were prepared using same excipients (labrasol as oil, cremophor EL as surfactant and glycerol as co-surfactant) however, the % age of oil and surfactant needed to prepare the ME was higher as compared to NE. These formulations along with their excipients (oilME=13.3%, SmixME=26.67%; oilNE=10%, SmixNE=13.52%) were added to Vero cells for 24 hrs. The tetrazolium dye, 3-(4,5-dimethylthia/ol-2-yl)-2,5-diphi-iiyltclrazolium bromide (MTT), is reduced by live cells and this reaction is used as the end point to evaluate the cytoxicity level of a test formulation. Results of MTT assay indicated that oil at different percentages exhibited almost equal cell viability (oilME ≅ oilNE) while surfactant mixture had a significant difference in the cell viability values (SmixME < SmixNE). Polyphenon 60 loaded ME and its PlaceboME showed higher toxicity as compared to Polyphenon 60 loaded NE and its PlaceboNE that can be attributed to the higher concentration of surfactants present in MEs. Another probable reason for high % cell viability of Polyphenon 60 loaded NE might be due to the effective release of Polyphenon 60 from NE formulation that helps in the sustenance of Vero cells.

Keywords: cell viability, microemulsion, MTT, nanoemulsion, surfactants, ultrasonication

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Authors: Muhammad Faheem Khakhi, Jian Yu Wang, Salman Muhammad, Muhammad Faisal Shabir

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Population growth and Chinese two-child policy will boost pharmaceutical market, and it will continue to maintain the growth for a period of time in the future, the traditional pharmacy dispensary has been unable to meet the growing medical needs of the peoples. Under the strong support of the national policy, the automatic transformation of traditional pharmacies is the inclination of the Times, the new type of intelligent pharmacy system will continue to promote the development of the pharmaceutical industry. Under this background, based on PLC control, the paper proposed an intelligent storage and automatic drug delivery system; complete design of the lower computer's control system and the host computer's software system has been present. The system can be applied to dispensing work for Chinese herbal medicinal and Western medicines. Firstly, the essential of intelligent control system for pharmacy is discussed. After the analysis of the requirements, the overall scheme of the system design is presented. Secondly, introduces the software and hardware design of the lower computer's control system, including the selection of PLC and the selection of motion control system, the problem of the human-computer interaction module and the communication between PC and PLC solves, the program design and development of the PLC control system is completed. The design of the upper computer software management system is described in detail. By analyzing of E-R diagram, built the establish data, the communication protocol between systems is customize, C++ Builder is adopted to realize interface module, supply module, main control module, etc. The paper also gives the implementations of the multi-threaded system and communication method. Lastly, each module of the lower computer control system is tested. Then, after building a test environment, the function test of the upper computer software management system is completed. On this basis, the entire control system accepts the overall test.

Keywords: automatic pharmacy, PLC, control system, management system, communication

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Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

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Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

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