Search results for: orthopedic trauma during delivery

Authors: Diana Islam, Juan Fang, Vito Fanelli, Bing Han, Julie Khang, Jianfeng Wu, Arthur S. Slutsky, Haibo Zhang

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Introduction: MSC delivery in preclinical models of ARDS has demonstrated significant improvements in lung function and recovery from acute injury. However, the role of MSC delivery in ARDS associated pulmonary fibrosis is not well understood. Some animal studies using bleomycin, asbestos, and silica-induced pulmonary fibrosis show that MSC delivery can suppress fibrosis. While other animal studies using radiation induced pulmonary fibrosis, liver, and kidney fibrosis models show that MSC delivery can contribute to fibrosis. Hypothesis: The beneficial and deleterious effects of MSC in ARDS are modulated by the lung microenvironment at the time of MSC delivery. Methods: To induce ARDS a two-hit mouse model of Hydrochloric acid (HCl) aspiration (day 0) and mechanical ventilation (MV) (day 2) was used. HCl and injurious MV generated fibrosis within 14-28 days. 0.5x106 mouse MSCs were delivered (via both intratracheal and intravenous routes) either in the active inflammatory phase (day 2) or during the remodeling phase (day 14) of ARDS (mouse fibroblasts or PBS used as a control). Lung injury accessed using inflammation score and elastance measurement. Pulmonary fibrosis was accessed using histological score, tissue collagen level, and collagen expression. In addition alveolar epithelial (E) and mesenchymal (M) marker expression profile was also measured. All measurements were taken at day 2, 14, and 28. Results: MSC delivery 2 days after HCl exacerbated lung injury and fibrosis compared to HCl alone, while the day 14 delivery showed protective effects. However in the absence of HCl, MSC significantly reduced the injurious MV-induced fibrosis. HCl injury suppressed E markers and up-regulated M markers. MSC delivery 2 days after HCl further amplified M marker expression, indicating their role in myofibroblast proliferation/activation. While with 14-day delivery E marker up-regulation was observed indicating their role in epithelial restoration. Conclusions: Early MSC delivery can be protective of injurious MV. Late MSC delivery during repair phase may also aid in recovery. However, early MSC delivery during the exudative inflammatory phase of HCl-induced ARDS can result in pro-fibrotic profiles. It is critical to understand the interaction between MSC and the lung microenvironment before MSC-based therapies are utilized for ARDS.

Keywords: acute respiratory distress syndrome (ARDS), mesenchymal stem cells (MSC), hydrochloric acid (HCl), mechanical ventilation (MV)

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Authors: Jonas Mayer, Kai-Frederic Seitz, Thorben Kuprat

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In today’s competitive environment production’s logistic objectives such as ‘delivery reliability’ and ‘delivery time’ and distribution’s logistic objectives such as ‘service level’ and ‘delivery delay’ are attributed great importance. Especially for small and mid-sized enterprises (SME) attaining these objectives pose a key challenge. Within this context, one of the difficulties is that interactions between departments within the enterprise and their specific objectives are insufficiently taken into account and aligned. Interdepartmental independencies along with contradicting targets set within the different departments result in enterprises having sub-optimal logistic performance capability. This paper presents a research project which will systematically describe the interactions between departments and convert them into a quantifiable form.

Keywords: department-specific actuating and control variables, interdepartmental interactions, cybernetic model, logistic objectives

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Authors: Eisa A. Alsafran, Francis T. Edum-Fotwe, Wayne E. Lord

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The degree to which a public client actively participates in Public Private Partnership (PPP) schemes, is seen as a determinant of the success of the arrangement, and in particular, efficiency in the delivery of the assets of any infrastructure development. The asset delivery is often an early barometer for judging the overall performance of the PPP. Currently, there are no defined descriptors for the degree of such participation. The lack of defined descriptors makes the association between the degree of participation and efficiency of asset delivery, difficult to establish. This is particularly so if an optimum effect is desired. In addition, such an association is important for the strategic decision to embark on any PPP initiative. This paper presents a conceptual model of different levels of participation that characterise PPP schemes. The modelling was achieved by a systematic review of reported sources that address essential aspects and structures of PPP schemes, published from 2001 to 2015. As a precursor to the modelling, the common areas of Public Client Participation (PCP) were investigated. Equity and risk emerged as two dominant factors in the common areas of PCP, and were therefore adopted to form the foundation of the modelling. The resultant conceptual model defines the different states of combined PCP. The defined states provide a more rational basis for establishing how the degree of PCP affects the efficiency of asset delivery in PPP schemes.

Keywords: asset delivery, infrastructure development, public private partnership, public client participation

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Authors: Sean Hall

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Nanosystems for drug delivery are not new; as medicines evolve, so too does the desire to deliver a more targeted, patient-compliant medicine. Though, historically the widespread use of nanosystems for drug delivery has been fouled by non-replicability, scalability, toxicity issues, and economics. Examples include steps of manufacture and thus cost to manufacture, toxicity for nanoparticle scaffolding, autoimmune response, and considerable technical expertise for small non-commercial yields. This, unfortunately, demonstrates the not-so-obvious chasm between science and drug formulation for regulatory approval. Regardless there is a general and global desire to improve the delivery of medicines, reduce potential side effect profiles, promote increased patient compliance, and increase and/or speed public access to medicine availability. In this paper, the author will discuss NanoCelle®, a nano-delivery platform that specifically addresses degradation and solubility issues that expands from fundamental micellar preparations. NanoCelle® has been deployed in several Australian listed medicines and is in use of several drug candidates across small molecules, with research endeavors now extending into large molecules. The author will discuss several research initiatives as they relate to NanoCelle® to demonstrate similarities seen in various drug substances; these examples will include both in vitro and in vivo work.

Keywords: NanoCelle®, micellar, degradation, solubility, toxicity

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Authors: Ahsan Ahmed, Ming Lu, Syed Zaidi, Farhan Khan

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The Integrated Project Delivery (IPD) method has been proposed as the solution to tackle complexity and fragmentation in the real world while addressing the construction industry’s growing needs for productivity and sustainability. Although the private sector has taken the initiative in implementing IPD and taken advantage of new technology such as building information modeling (BIM) in delivering projects, IPD remains less known and rarely used in public sector construction. The focus of this paper is set on the use of IPD in projects in public sector, which is potentially complemented by the use of analytical functionalities for workface planning and construction oriented design enabled by recent research advances in BIM. Experiences and lessons learned from implementing IPD in the private sector and in BIM-based construction automation research would play a vital role in reducing barriers and eliminating issues in connection with project delivery in the public sector. The paper elaborates issues challenges, contractual relationships and the interactions throughout the planning, design and construction phases in the context of implementing IPD on construction projects in the public sector. A slab construction case is used as a ‘sandbox’ model to elaborate (1) the ideal way of communication, integration, and collaboration among all the parties involved in project delivery in planning and (2) the execution of projects by using IDP principles and optimization, simulation analyses.

Keywords: integrated project delivery, IPD, building information modeling, BIM

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Authors: Manisha Massey, Mariette Berndsen, Helen McLaren

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The existing body of literature concerning the incidence, prevalence, and experiences of childhood sexual abuse (CSA) lacked cultural inclusivity, primarily reflecting Euro-centric perspectives. This study investigated and reviewed the existing literature to understand the experiences of women of color from South Asia, addressing the gap in understanding how culture and diversity impact CSA. While individualist cultures emphasize autonomy, collectivist societies prioritize interdependence. South Asia's diverse intersections, including gender, caste, religion, and class, have intensified child sexual exploitation, challenging assumed homogeneity and safety. Additionally, the power exploitation in the space of abuse and grooming supplementing with the prevalence of honor violence makes disclosures of sexual abuse for children daunting and unsafe in these cultures. This scoping review examined the connection between CSA, psychological trauma, re-traumatization, and shame among adult South Asian women from India, Pakistan, and Bangladesh. Despite distinct borders, these countries share historical, linguistic, and traditional ties. Following PRISMA guidelines, the review employed thematic analysis. Findings underscored cultural factors' influence on CSA incidence, help-seeking barriers, and treatment challenges. The pivotal role of shame (sharam) and honor (izzat) in disclosure and healing processes was highlighted. The study emphasized the need for culturally sensitive interventions while noting limited literature on re-traumatisation. Incorporating a culturally informed perspective, this research aims to decolonize trauma therapy by contributing to the CSA discourse, shedding light on its intricate interaction with trauma, shame, and healing among South Asian women.

Keywords: Childhood sexual abuse, decolonizing psychology, trauma, re-trauma, shame

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Authors: Andrea Knezevic, Padmini Pai, Julaine Allan, Katarzyna Olcoń, Louisa Smith

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Healthcare staff are on the frontline during times of disaster and are required to support the health and wellbeing of communities despite any personal adversity and trauma they are experiencing as a result of the disaster. This study explored the experiences of healthcare staff trained as ‘Wellness Warriors’ following the 2019-2020 Australian bushfires. The findings indicated that healthcare staff developed interpersonal skills around deep listening and connecting with others which allowed them to feel differently about work and restored their faith in healthcare leadership.

Keywords: Australian bushfires, burnout, health care providers, mental health, occupational trauma, post-disaster, wellbeing, workplace wellness

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Authors: Daniel A. Walzer

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As the options for course delivery and development expand, plenty of misconceptions still exist concerning e-learning and online course delivery. Classroom instructors often discuss pedagogy, methodologies, and best practices regarding teaching from a singular, traditional in-class perspective. As more professors integrate online, blended, and hybrid courses into their dossier, a clearly defined rubric for gauging online course delivery is essential. The transition from a traditional learning structure towards an updated distance-based format requires careful planning, evaluation, and revision. This paper examines how new media stimulates reflective practice and guided inquiry to improve pedagogy, engage interdisciplinary collaboration, and supply rich qualitative data for future research projects in media arts disciplines.

Keywords: action research, inquiry, new media, reflection

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Authors: Felix Gbenoba, Opeyemi Dahunsi

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Customised, self-instructional materials are at the heart of instructional delivery in Open and Distance Learning (ODL). The success of any ODL institution depends on the availability of learning materials in quality and quantity. An ODL study material is expected to imitate what the teacher does in the face-to-face learning environment. This paper evaluates these expectation based on existing data and evidence. It concludes that the reality has not matched the expectation so far in terms of pedagogic aspect of instructional delivery especially in West Africa. This does not mean that instructional materials development has not produced any significant positive results in improving the overall learning (and teaching) experience in these institutions; it implies what will help further to identify the new challenges. Obstacles and problems of instructional materials development that could have affected the open educational resource initiatives are well established. The first section of this paper recalls some of the proposed values of instructional materials. The second section compares achievements so far and suggests that instructional materials development should be consider first at an early stage to realise the aspirations of instructional delivery. The third section highlights the challenges of instructional materials development in the future.

Keywords: face-to-face learning, instructional delivery, open and distance education, self-instructional materials

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Authors: Fernando G. Torres, Omar P. Troncoso

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Quercetin is a naturally occurring polyphenol found in many vegetables, such as onion, with antioxidant properties. It is a dietary component with a documented role in reducing different human cancers. However, its low bioavailability, poor water solubility, and chemical instability limit its applications. Different nano-delivery systems such as nanoparticles, micelles, and nanohydrogels have been studied in order to improve the bioavailability of quercetin. Nanoparticles based on natural polymers such as starch have the advantage of being biocompatible, biodegradable, and non-toxic. In this study, quercetin was loaded into starch nanoparticles using a nanoprecipitation method. Different routes, using sodium tripolyphosphate and Tween® 80 as tensioactive agents, were tested in order to obtain an optimized starch-based nano-delivery system. The characterization of the nanoparticles loaded with quercetin was assessed by Fourier Transform Infrared Spectroscopy, Dynamic Light Scattering, Zeta potential, and Differential scanning calorimetry. UV-vis spectrophotometry was used to evaluate the loading efficiency and capacity of the samples. The results showed that starch-based systems could be successfully used for the nano-delivery of quercetin.

Keywords: starch nanoparticles, nanoprecipitation, quercetin, biomedical applications

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Authors: Mohammad Abdullah Almalki

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Background: Despite the frequent usage of ankle arthroscopy, there is limited medical literature regarding its indications, patterns of admissions, surgical outcomes, and associated complicated at Saudi Arabia. Hence, this study would highlight the surgical outcomes of such surgical approach that will assist orthopedic surgeons to detect which surgical procedure needs to be done as well as to help them regarding their diagnostic workups. Methods: At the Orthopedic Division of King Abdul‑Aziz Medical City in Riyadh and through a cross‑sectional design and convenient sampling techniques, the present study had recruited 20 subjects who fulfill the inclusion and exclusion criteria between 2016 and 2018. Data collection was carried out by a questionnaire designed and revised by an expert panel of health professionals. Results: Twenty patients were reviewed (11M and 9F) with an average age of 40.1 ± 12.2. Only 30% of the patients (5M, 1F) have no comorbidity, but 70% of patients (7M, 8F) were having at least one comorbidity. The most common indications were osteochondritis dissecans (n = 7, 35%), ankle fracture without dislocation (n = 4, 20%), and tibiotalar impingement (n = 3, 15%). Patients recorded pain in all cases (100%). The top four symptoms after pain were instability (30%, n = 6), muscle weakness (15%, n = 3) swelling (15%, n = 3), and stiffness (5%, n = 1). Two‑third of cases reached to their full healthy status and toe‑touch weight‑bearing was seen in two patients (10%). Conclusion: Ankle arthroscopy improved the rehabilitation rates in our tertiary care center. In addition, the surgical outcomes are favorable in our hospital since it has a very short length of stay, unexpended surgery, and fewest physiotherapy sessions.

Keywords: ankle, arthroscopy, indications, patterns

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Authors: Glory Okereke

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Several research on the value of aid funding and delivery have emphasized the importance of partnership and accountability in implementing development projects between INGOs and NGOs. Despite challenges in accessing detailed information on their impact due to the extension of information they are willing to provide, this pathway has been seen as an alternative approach and more beneficial than aid funding and delivery through the state. This paper tends to analyze this relationship using liberal and international relations theories to understand the positive and negative aspects of INGO to NGO pathway as a better alternative to economic development. Looking through a broad spectrum of economic development, the paper focuses on Nigeria and analyzes existing empirical literature of INGOs with local NGOs with a comparative analysis of bilateral aid relations with the Nigerian government.

Keywords: NGOS, development, Nigeria, liberal theories, aid

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Authors: Hardeep

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The aim of this research work to improve the solubility and bioavailability of Simvastatin using a self nanoemulsifying drug delivery system (SNEDDS). Self emulsifying property of various oils including essential oils was evaluated with suitable surfactants and co-surfactants. Validation of a method for accuracy, repeatability, Interday and intraday precision, ruggedness, and robustness were within acceptable limits. The liquid SNEDDS was prepared and optimized using a ternary phase diagram, thermodynamic, centrifugation and cloud point studies. The globule size of optimized formulations was less than 200 nm which could be an acceptable nanoemulsion size range. The mean droplet size, drug loading, PDI and zeta potential were found to be 141.0 nm, 92.22%, 0.23 and -10.13 mV and 153.5nm, 93.89 % ,0.41 and -11.7 mV and 164.26 nm, 95.26% , 0.41 and -10.66mV respectively.

Keywords: simvastatin, self nanoemulsifying drug delivery system, solubility, bioavailability

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Authors: Nura Khattab, Fayad Al-Haimus, Teruko Kishibe, Netanel Krugliak, Melissa McGowan, Brodie Nolan

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Trauma-induced coagulopathy remains a significant contributor to mortality in severely injured patients. Fibrinogen is essential for early hemostasis and is recognized as the first coagulation factor to fall below critical levels, compromising the coagulation cascade. Early administration of fibrinogen concentrate may be feasible and effective to prevent coagulopathy. We conducted this scoping review to characterize the existing quantity of literature, and to explore the usage of prehospital fibrinogen concentrate products in improving clinical outcomes in trauma patients. Methods: A search strategy was developed in consultation with an information specialist. We searched MEDLINE, Embase, Cochrane, and Scopus from inception to May 6th 2024. English studies evaluating prehospital/military usage of fibrinogen concentrate in trauma patients were included. Studies were assessed by three independent reviewers for meeting inclusion and exclusion criteria. Reference lists of included articles were reviewed to identify additional studies meeting inclusion criteria. Clinical endpoints regarding fibrinogen concentrate were extracted and synthesized. Results: The literature search returned 1301 articles with seven studies meeting the inclusion criteria. Five studies (71%) were conducted in civilian settings and two studies (29%) were conducted in military settings. Of the included studies, three (43%) utilized a randomized control trial. We identified seven outcomes that compared varying concentrations of fibrinogen or fibrinogen concentrate to a placebo group. The outcomes included overall mortality, death from hemorrhage, thromboembolic events, clotting time, maximum clot firmness, clot stability at ER admission, and fibrinogen concentration at ER admission. Apart from thromboembolic events, all other reported outcomes showed statistically significant differences in group comparisons, determined using p values. The four (57%) non-clinical studies underscored the robustness, practicality, and degree of fibrinogen concentrate utilization in military environments and retrieval services. Conclusion: Preliminary research suggests that prehospital fibrinogen concentrate administration in traumatic bleeding patients is both feasible and effective, improving mortality and clotting parameters. While implementing a time-saving and proactive approach with fibrinogen holds potential for enhancing trauma care, the current evidence is limited. Further studies in this novel field are warranted.

Keywords: fibrinogen concentrate, prehospital, military, trauma, trauma-induced coagulopathy

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Authors: Osama Zayed

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Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

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Authors: Areej Al-Hamad, Cheryl Forchuk, Abe Oudshoorn, Gerald Patrick Mckinley

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Syrian refugee women face many obstacles when accessing health services in host countries that are influenced by various cultural, structural, and practical factors. This paper is based on critical ethnographic research undertaken in Canada to explore Syrian refugee women's migration experiences. Also, we aim to critically examine how the intersection of gender, trauma, violence and the political and economic conditions of Syrian refugee women shapes their everyday lives and health. The study also investigates the strategies and practices by which Syrian refugee women are currently addressing their healthcare needs and the models of care that are suggested for meeting their physical and mental health needs. Findings show that these women experienced constant worries, hardship, vulnerability, and intrusion of dignity. These experiences and challenges were aggravated by the structure of the Canadian social and health care system. This study offers a better understanding of the impact of migration and trauma on Syrian refugee women's roles, responsibilities, gender dynamics, and interaction with Ontario's healthcare system to improve interaction and outcomes. Health care models should address these challenges among Syrian refugee families in Canada.

Keywords: Syrian refugee women, intersectionality, critical ethnography, migration

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Authors: P. Donnelly, G. Mitchell

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Traumatic Brain Injury (TBI) is a major contributor to the global burden of disease; despite its ubiquity, there is significant variation in diagnosis, prognosis, and treatment between clinicians. This study aims to examine the spectrum of approaches that currently exist at a Level 1 Trauma Centre in Australasia by surveying Emergency Physicians and Neurosurgeons on those aspects of mTBI. A pilot survey of 17 clinicians (Neurosurgeons, Emergency Physicians, and others who manage patients with mTBI) at a Level 1 Trauma Centre in Brisbane, Australia, was conducted. The objective of this study was to examine the importance these clinicians place on various elements in their approach to the diagnosis, prognostication, and treatment of mTBI. The data were summarised, and the descriptive statistics reported. Loss of consciousness and post-traumatic amnesia were rated as the most important signs or symptoms in diagnosing mTBI (median importance of 8). MRI was the most important imaging modality in diagnosing mTBI (median importance of 7). ‘Number of the Previous TBIs’ and Intracranial Injury on Imaging’ were rated as the most important elements for prognostication (median importance of 9). Education and reassurance were rated as the most important modality for treating mTBI (median importance of 7). There was a statistically insignificant variation between the specialties as to the importance they place on each of these components. In this Australian tertiary trauma center, there appears to be variation in how clinicians approach mTBI. This study is underpowered to state whether this is between clinicians within a specialty or a trend between specialties. This variation is worthwhile in investigating as a step toward a unified approach to diagnosing, prognosticating, and treating this common pathology.

Keywords: mild traumatic brain injury, adult, clinician, survey

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Authors: Samar Mousa, Rebecca Shirley

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Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

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Authors: Abimbola Olaotan Akinsete

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Government all over the world has intensified efforts in making internet and resource centres readily available in public institutions and centres for the advancement of humanity and working processes. Information and communication resource centre will not only help in the reduction of task that are presumed to be herculean. This centres influenced the working rate and productivity of both staffs and students and its benefit. The utilization of the internet and information resource centre will not only speed up service delivery, working time and efficiency of the system. Information and Communication Technology plays significant roles in presenting equalization strategy for developing university community and improving educational service delivery. This equalization will not only advance, accelerate and ensure results are accessed electronically, ensuring the transfer and confirmation of students’ academic records and their results in the world without physically available to request for these services. This study seeks to make Critical Appraisal of Adekunle Ajasin University Policy on Internet Resource Centre in Service Delivery Adekunle Ajasin University, Akungba-Akoko, Ondo State. The study employ descriptive survey design method in identifying hindrances of the non-utilization of technology in the service delivery in the university. Findings revealed that the adoption of internet and resource centre in the Exams and Records unit of the University shall help in delivering more in students’ records/results processing.

Keywords: internet, resource, centre, policy and service delivery

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Authors: Jirayut Phetchuen, Jongkol Srithorn

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The study examines the unloading and repacking process of Read With Me Group Company Limited. The research aims to improve the old work process and build a new efficient process with the Lean Technique and new machines for faster delivery without increasing the number of employees. Currently, two employees work based on five days on and off. However, workplace injuries have delayed the delivery time, especially the delivery to the neighboring countries. After the process improvement, the working space increased by 25%, the Process Lead Time decreased by 40%, the work efficiency increased by 175.82%, and the work injuries rate was reduced to zero.

Keywords: lean technique, plant layout design, U-shaped disassembly line, value stream mapping

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Authors: S. S. Patil, B. U. Janugade, S. V. Patil

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Pulsatile systems are gaining a lot of interest as they deliver the drug at the right site of action at the right time and in the right amount, thus providing spatial and temporal delivery thus increasing patient compliance. These systems are designed according to the circadian rhythm of the body. Chronotherapeutics is the discipline concerned with the delivery of drugs according to inherent activities of a disease over a certain period of time. It is becoming increasingly more evident that the specific time that patients take their medication may be even more significant than was recognized in the past. The tradition of prescribing medication at evenly spaced time intervals throughout the day, in an attempt to maintain constant drug levels throughout a 24-hour period, may be changing as researcher’s report that some medications may work better if their administration is coordinated with day-night patterns and biological rhythms. The potential benefits of chronotherapeutics have been demonstrated in the management of a number of diseases. In particular, there is a great deal of interest in how chronotherapy can particularly benefit patients suffering from allergic rhinitis, rheumatoid arthritis and related disorders, asthma, cancer, cardiovascular diseases, and peptic ulcer disease.

Keywords: pulsatile drug delivery, chronotherapeutics, circadian rhythm, asthma, chronobiology

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Authors: Juvanie C. Lapesigue

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Worldwide school closures result from a significant public health crisis that has affected the nation and the entire world. It has affected students, educators, educational organizations globally, and many other aspects of society. Academic institutions worldwide teach students using diverse approaches of various learning delivery modes. This paper investigates the competence and performance of physical education teachers using various learning delivery modes, including Distance learning, Blended Learning, and Homeschooling during online distance education. To identify the Gap between their age generation using various learning delivery that affects teachers' preparation for distance learning and evaluates how these modalities impact teachers’ competence and performance in the case of a pandemic. The respondents were the Senior High School teachers of the Department of Education who taught in Davao City before and during the pandemic. Purposive sampling was utilized on 61 Senior High School Teachers in Davao City Philippines. The result indicated that teaching performance based on pedagogy and assessment has significantly affected teaching performance in teaching physical education, particularly those Non-PE teachers teaching physical education subjects. It should be supplied with enhancement training workshops to help them be more successful in preparation in terms of teaching pedagogy and assessment in the following norm. Hence, a proposed unique training design for non-P.E. Teachers has been created to improve the teachers’ performance in terms of pedagogy and assessment in teaching P.E subjects in various learning delivery modes in the next normal.

Keywords: distance learning, learning delivery modes, P.E teachers, senior high school, teaching competence, teaching performance

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Authors: Yinglisong, Jingge Chen, Jingxuan Chen, Yan Wang, Hui Huang, Jing Zhnag, Qianqian Zhang, Zhenzhen Zhang, Ji Zhang

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Purpose: The study aims to establish a nomogram prediction model for postpartum hemorrhage (PPH) in vaginal delivery. Patients and Methods: Clinical data were retrospectively collected from vaginal delivery patients admitted to a hospital in Zhengzhou, China, from June 1, 2022 - October 31, 2022. Univariate and multivariate logistic regression were used to filter out independent risk factors. A nomogram model was established for PPH in vaginal delivery based on the risk factors coefficient. Bootstrapping was used for internal validation. To assess discrimination and calibration, receiver operator characteristics (ROC) and calibration curves were generated in the derivation and validation groups. Results: A total of 1340 cases of vaginal delivery were enrolled, with 81 (6.04%) having PPH. Logistic regression indicated that history of uterine surgery, induction of labor, duration of first labor, neonatal weight, WBC value (during the first stage of labor), and cervical lacerations were all independent risk factors of hemorrhage (P <0.05). The area-under-curve (AUC) of ROC curves of the derivation group and the validation group were 0.817 and 0.821, respectively, indicating good discrimination. Two calibration curves showed that nomogram prediction and practical results were highly consistent (P = 0.105, P = 0.113). Conclusion: The developed individualized risk prediction nomogram model can assist midwives in recognizing and diagnosing high-risk groups of PPH and initiating early warning to reduce PPH incidence.

Keywords: vaginal delivery, postpartum hemorrhage, risk factor, nomogram

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Authors: A. Nazilah

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Floods are classified among sudden onset phenomenon and the highest natural disasters happen in Malaysia. Floods have a negative impact on mental health. Measuring the psychopathology symptoms among flood victims is an important step for intervention and treatment. However, there is a gap of a valid, reliable and an efficient instrument to measure flood victims' mental health, especially in Malaysia. This study aims to replicate the earlier studies of developing e-Psychological Instrument for Flood Victims (e-PIFV). The e-PIFV is a digital self-report inventory that has 84 items with 4 dimension scales namely stress, anxiety, depression, and trauma. Two replicated studies have been done to validate the instrument using expert judgment method. Results showed that content coefficient validity for each sub-scale of the instrument ranging from moderate to very strong validity. In study I, coefficient values of stress was 0.7, anxiety was 0.9, depression was 1.0, trauma was 0.6 and overall was 0.8. In study II, the coefficient values for two subscales and overall scale were increased. The coefficient value of stress was 0.8, anxiety was 0.9, depression was 1.0, trauma was 0.8 and overall was 0.9. This study supports the theoretical framework and provides practical implication in the field of clinical psychology and flood management.

Keywords: developing e-psychological instrument, content validity, instrument, mental health management, flood victims, psychopathology, validity

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Authors: S. H. Liao, J. M. Huang

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The delivery service business model is the final link in logistics for both online-and-offline businesses. The online-and-offline business model focuses on the entire customer purchasing process online and offline, placing greater emphasis on the importance of data to optimize overall retail operations. For the retail industry, it is an important task of information and management to strengthen the collection and investigation of consumers' online and offline purchasing data to better understand customers and then recommend products. This study implements two-stage data mining analytics for clustering and association rules analysis to investigate Taiwanese consumers' (n=2,209) preferences for delivery service. This process clarifies online-and-offline purchasing behaviors and preferences to find knowledge profiles/patterns/rules for cross-channel collaborative recommendations. Finally, theoretical and practical implications for methodology and enterprise are presented.

Keywords: delivery service, online-and-offline purchasing, retail cross-channel, collaborative recommendations, data mining analytics

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Authors: Temesgen Geremew

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Functionalized nanoparticles have emerged as a revolutionary platform for drug delivery, offering significant advantages over traditional methods. By strategically modifying their surface properties, these nanoparticles can be designed to target specific tissues and cells, significantly reducing off-target effects and enhancing therapeutic efficacy. This targeted approach allows for lower drug doses, minimizing systemic exposure and potential side effects. Additionally, functionalization enables controlled release of the encapsulated drug, improving drug stability and reducing the frequency of administration, leading to improved patient compliance. This work explores the immense potential of functionalized nanoparticles in revolutionizing drug delivery, addressing limitations associated with conventional therapies and paving the way for personalized medicine with precise and targeted treatment strategies.

Keywords: nanoparticles, drug, nanomaterials, applications

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Authors: Ahmed Tarek, Ahmed Alveed

Abstract:

Vehicle routing problem is a well-known re-search avenue in computing. Modern vehicle routing is more focused with the GPS-based coordinate system, as the state-of-the-art vehicle, and trucking systems are equipped with digital navigation. In this paper, a new two dimensional coordinate-based algorithm for addressing the vehicle routing problem for a supply chain network is proposed and explored, and the algorithm is compared with other available, and recently devised heuristics. For the algorithms discussed, which includes the pro-posed coordinate-based search heuristic as well, the advantages and the disadvantages associated with the heuristics are explored. The proposed algorithm is studied from the stand point of a small supermarket chain delivery network that supplies to its stores in four different states around the East Coast area, and is trying to optimize its trucking delivery cost. Minimizing the delivery cost for the supply network of a supermarket chain is important to ensure its business success.

Keywords: coordinate-based optimal routing, Hamiltonian Circuit, heuristic algorithm, traveling salesman problem, vehicle routing problem

Procedia PDF Downloads 147

Authors: Mihail Nagea, Olivera Lupescu, Nicolae Ciurea, Alexandru Dimitriu, Alina Grosu

Abstract:

Introduction: As severe open injuries are more and more frequent in modern traumatology, threatening not only the integrity of the affected limb but even the life of the patients, new methods desired to cope with the consequences of these traumas were described. Vacuum therapy is one such method which has been described as enhancing healing in trauma with extensive soft-tissue injuries, included those with septic complications. Material and methods: Authors prospectively analyze 15 patients with severe lower limb trauma with MESS less than 6, with considerable soft tissue loss following initial debridement and fracture fixation. The patients needed serial debridements and vacuum therapy was applied after delayed healing due to initial severity of the trauma, for an average period of 12 days (7 - 23 days).In 7 cases vacuum therapy was applied for septic complications. Results: Within the study group, there were no local complications; secondary debridements were performed for all the patients and vacuum system was re-installed after these debridements. No amputations were needed. Medical records were reviewed in order to compare the outcome of the patients: the hospital stay, anti-microbial therapy, time to healing of the bone and soft tissues (there is no standard group to be compared with) and the result showed considerable improvements in the outcome of the patients. Conclusion: Vacuum therapy improves healing of the soft tissues, including those infected; hospital stay and the number of secondary necessary procedures are reduced. Therefore it is considered a valuable support in treating trauma of the limbs with severe soft tissue injuries.

Keywords: complex injuries, negative pressure, open fractures, wound therapy

Procedia PDF Downloads 295

Authors: A. M. Prasad

Abstract:

Knowledge of variations of nerves of gluteal region is important for clinicians administering intramuscular injections, for orthopedic surgeons dealing with the hip surgeries, possibly for physiotherapists managing the painful conditions and paralysis of this region. Herein, we report multiple variations of the nerves of gluteal region. In the current case, the sciatic nerve was absent. The common peroneal and tibial nerves arose from sacral plexus and reached the gluteal region through greater sciatic foramen above and below piriformis respectively. The common peroneal nerve gave a muscular branch to the gluteus maximus. The inferior gluteal nerve and posterior cutaneous nerve of the thigh arose from a common trunk. The common trunk was formed by three roots. Upper and middle roots arose from sacral plexus and entered gluteal region through greater sciatic foramen respectively above and below piriformis. The lower root arose from the pudendal nerve and joined the common trunk. These variations were seen in the right gluteal region of an adult male cadaver aged approximately 70 years. Innervation of gluteus maximus by common peroneal nerve and presence of a common trunk of inferior gluteal nerve and posterior cutaneous nerve of the thigh make this case unique. The variant nerves may be subjected to iatrogenic injuries during surgical approach to the hip. They may also get compressed if there is a hypertrophy of the piriformis syndrome. Hence, the knowledge of these variations is of importance to clinicians, orthopedic surgeons and possibly for physiotherapists.

Keywords: gluteal region, multiple variations, nerve injury, sciatic nerve

Procedia PDF Downloads 345

Authors: Afsaneh Ghorbanzadeh, Afshin Farahbakhsh, Zakieh Bayat

Abstract:

The drug capsulation was used for release and targeted delivery in determined time, place and temperature or pH. The DOX nanocapsules were used to reduce and to minimize the unwanted side effects of drug. In this paper, the encapsulation methods of doxorubicin (DOX) and the labeling it by the magnetic core of iron (Fe3O4) has been studied. The Fe3O4 was conjugated with DOX via hydrazine bond. The solution was capsuled by the sensitive polymer of heat or pH such as chitosan-g-poly (N-isopropylacrylamide-co-N,N-dimethylacrylamide), dextran-g-poly(N-isopropylacrylamide-co-N,N-dimethylacrylamide) and mPEG-G2.5 PAMAM by hydrazine bond. The drug release was very slow at temperatures lower than 380°C. There was a rapid and controlled drug release at temperatures higher than 380°C. According to experiments, the use mPEG-G2.5PAMAM is the best method of DOX nanocapsules synthesis, because in this method, the drug delivery time to certain place is lower than other methods and the percentage of released drug is higher. The synthesized magnetic carrier system has potential applications in magnetic drug-targeting delivery and magnetic resonance imaging.

Keywords: drug carrier, drug release, doxorubicin, iron oxide NPs

Procedia PDF Downloads 418