Search results for: Jessica Morales Perdomo

Authors: Jéssica Ferreira Rodrigues, Júlio Silvio De Sousa Bueno Filho, Vanessa Rios De Souza, Ana Carla Marques Pinheiro

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This study aimed to evaluate the implications of the block size and testing order on efficiency and precision of preference estimation for Dulce de leche samples. Efficiency was defined as the inverse of the average variance of pairwise comparisons among treatments. Precision was defined as the inverse of the variance of treatment means (or effects) estimates. The experiment was originally designed to test 16 treatments as a series of 8 Sudoku 16x16 designs being 4 randomized independently and 4 others in the reverse order, to yield balance in testing order. Linear mixed models were assigned to the whole experiment with 112 testers and all their grades, as well as their partially balanced subgroups, namely: a) experiment with the four initial EU; b) experiment with EU 5 to 8; c) experiment with EU 9 to 12; and b) experiment with EU 13 to 16. To record responses we used a nine-point hedonic scale, it was assumed a mixed linear model analysis with random tester and treatments effects and with fixed test order effect. Analysis of a cumulative random effects probit link model was very similar, with essentially no different conclusions and for simplicity, we present the results using Gaussian assumption. R-CRAN library lme4 and its function lmer (Fit Linear Mixed-Effects Models) was used for the mixed models and libraries Bayesthresh (default Gaussian threshold function) and ordinal with the function clmm (Cumulative Link Mixed Model) was used to check Bayesian analysis of threshold models and cumulative link probit models. It was noted that the number of samples tested in the same session can influence the acceptance level, underestimating the acceptance. However, proving a large number of samples can help to improve the samples discrimination.

Keywords: acceptance, block size, mixed linear model, testing order, testing order

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Authors: Jessica Achebe, Susan Tighe

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The recent Canadian infrastructure report card reveals the unhealthy state of municipal infrastructure intensified challenged faced by municipalities to maintain adequate infrastructure performance thresholds and meet user’s required service levels. For a road agency, huge funding gap issue is inflated by growing concerns of the environmental repercussion of road construction, operation and maintenance activities. As the reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to optimal allocation of resources and reduced road user cost. Incorporating environmental sustainability measure into pavement management is solution widely cited and studied. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this study reviewed previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for sustainable network-level pavement management.

Keywords: pavement management, sustainability, network-level evaluation, environment measures

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Authors: Kirsten Wilson, Patrick M. Brauer, Sandra Babic, Diana Golubeva, Jessica Van Eyk, Tinya Wang, Avanti Karkhanis, Tim A. Le Fevre, Andy I. Kokaji, Allen C. Eaves, Sharon A. Louis, , Nooshin Tabatabaei-Zavareh

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Long-lived plasma cells are rare, non-proliferative B cells generated from antibody-secreting cells (ASCs) following an immune response to protect the host against pathogen re-exposure. Despite their therapeutic potential, the lack of in vitro protocols in the field makes it challenging to use B cells as a cellular therapeutic tool. As a result, there is a need to establish robust and reproducible methods for the generation of B cells. To address this, we have developed a culture system for generating B cells from hematopoietic stem and/or progenitor cells (HSPCs) derived from human umbilical cord blood (CB) or pluripotent stem cells (PSCs). HSPCs isolated from CB were cultured using the StemSpan™ B Cell Generation Kit and produced CD19+ B cells at a frequency of 23.2 ± 1.5% and 59.6 ± 2.3%, with a yield of 91 ± 11 and 196 ± 37 CD19+ cells per input CD34+ cell on culture days 28 and 35, respectively (n = 50 - 59). CD19+IgM+ cells were detected at a frequency of 31.2 ± 2.6% and were produced at a yield of 113 ± 26 cells per input CD34+ cell on culture day 35 (n = 50 - 59). The B cell receptor loci of CB-derived B cells were sequenced to confirm V(D)J gene rearrangement. ELISpot analysis revealed that ASCs were generated at a frequency of 570 ± 57 per 10,000 day 35 cells, with an average IgM+ ASC yield of 16 ± 2 cells per input CD34+ cell (n = 33 - 42). PSC-derived HSPCs were generated using the STEMdiff™ Hematopoietic - EB reagents and differentiated to CD10+CD19+ B cells with a frequency of 4 ± 0.8% after 28 days of culture (n = 37, 1 embryonic and 3 induced pluripotent stem cell lines tested). Subsequent culture of PSC-derived HSPCs increased CD19+ frequency and generated ASCs from 1 - 2 iPSC lines. This method is the first report of a serum- and feeder-free system for the generation of B cells from CB and PSCs, enabling further B lineage-specific research for potential future clinical applications.

Keywords: stem cells, B cells, immunology, hematopoiesis, PSC, differentiation

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Authors: Barry D. Kyle, Jessica Boyd, Robin Pickersgill, Nicole Squires, Cynthia Balion

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Background-Aim: Fentanyl is a highly-potent synthetic μ-opioid receptor agonist used for exceptional pain management. Its main metabolite, norfentanyl, is typically present in urine at significantly high concentrations (i.e. ~20%) representing an effective targeting molecule for immunoassay detection. Here, we evaluated the NCS^TM One Step Fentanyl Test Device© and the BTNX Rapid Response^TM Single Drug Test Strip© point of care (POC) test strips targeting norfentanyl (20 ng/ml) and fentanyl (100 ng/ml) molecules for potential risperidone interference. Methods: POC tests calibrated against norfentanyl (20 ng/ml) used [immunochromatographic] lateral flow devices to provide qualitative results within five minutes of urine sample contact. Results were recorded as negative if lines appeared in the test and control regions according to manufacturer’s instructions. Positive results were recorded if no line appeared in the test region (i.e., control line only visible). Pooled patient urine (n=20), that screened negative for drugs of abuse (using NCS One Step Multi-Line Screen) and fentanyl (using BTNX Rapid Response Strip) was used for spiking studies. Urine was spiked with risperidone alone and with combinations of fentanyl, norfentanyl and/or risperidone to evaluate cross-reactivity in each test device. Results: A positive screen result was obtained when 8,000 ng/mL of risperidone was spiked into drug free urine using the NCS test device. Positive screen results were also obtained in spiked urine samples containing fentanyl and norfentanyl combinations below the cut-off concentrations when 4000 ng/mL risperidone was present using the NCS testing device. There were no screen positive test results using the BTNX test strip with up to 8,000 ng/mL alone or in combination with concentrations of fentanyl and norfentanyl below the cut-off. Both devices screened positive when either fentanyl or norfentanyl exceeded the cut-off threshold in the absence and presence of risperidone. Conclusion: We report that urine samples containing risperidone may give a false positive result using the NCS One Step Fentanyl Test Device.

Keywords: fentanyl, interferences, point of care test, Risperidone

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Authors: Claire Baudry, Jessica Pearson, Laura-Emilie Savage, George Tarbulsy

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Introduction: Over the last decade, researchers have implemented attachment-based interventions to promote parental interactive sensitivity and child development among vulnerable families. In the context of the present study, these interventions have been shown to be effective to enhance cognitive development when child outcome was measured shortly after the intervention. Objectives: The goal of the study was to investigate the effects of an attachment-based intervention on child cognitive development one year post-intervention. Methods: Thirty-five mother-child dyads referred by Child Protective Services in the province of Québec, Canada, were included in this study: 21 dyads who received 6 to 8 intervention sessions and 14 dyads not exposed to the intervention and matched for the following variables: duration of child protective services, reason for involvement with child protection, age, sex and family status. Child cognitive development was measured using the WPPSI-IV, 12 months after the end of the intervention when the average age of children was 54 months old. Findings: An independent-samples t-test was conducted to compare the scores obtained on the WPPSI-IV for the two groups. In general, no differences were observed between the two groups. There was a significant difference on the fluid reasoning scale between children exposed to the intervention (M = 95,13, SD = 16,67) and children not exposed (M = 81, SD = 9,90). T (23) = -2,657; p= .014 (IC :-25.13;3.12). This difference was found only for children aged between 48 and 92 months old. Other results did not show any significant difference between the two groups (Global IQ or subscales). Conclusions: This first set of analyses suggest that relatively little effects of attachment-based intervention remain on the level of cognitive functioning 12-months post-intervention. It is possible that the significant findings concerning fluid reasoning may be pertinent in that fluid reasoning is linked to the capacity to analyse, to solve problems, and remember information, which may be important for promoting school readiness. As the study is completed and as more information is gained from other assessments of cognitive and socioemotional outcome, a clearer picture of the potential moderate-term impact of attachment-based intervention will emerge.

Keywords: attachment-based intervention, child development, child protective services, cognitive development

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Authors: Jessica BrodeFrank, Beka Bryer, Lacey Wilson, Sierra Van Ryck deGroot

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Museums are enjoying quite the moment in pop culture. From discussions of labor in Bob’s Burger to introducing cultural repatriation in The Black Panther, discussions of various museum issues are making their way to popular media. “Talking Back to Hollywood” analyzes the impact museums have on movies and television. The paper will highlight a series of cultural cameos and discuss what each reveals about critical themes in museums: repatriation, labor, obfuscated histories, institutional legacies, artificial intelligence, and holograms. Using a mixed methods approach to include surveys, descriptive research, thematic analysis, and context analysis, the authors of this paper will explore how we, as the museum staff, might begin to cite museums and movies together as texts. Drawing from their experience working in museums and public history, this contingent of mid-career professionals will highlight the impact museums have had on movies and television and the didactic lessons these portrayals can provide back to cultural heritage professionals. From tackling critical themes in museums such as repatriation, labor conditions/inequities, obfuscated histories, curatorial choice and control, institutional legacies, and more, this paper is grounded in the cultural zeitgeist of the 2000s and the message these media portrayals send to the public and the cultural heritage sector. In particular, the paper will examine how portrayals of AI, holograms, and more technology can be used as entry points for necessary discussions with the public on mistrust, misinformation, and emerging technologies. This paper will not only expose the legacy and cultural understanding of the museum field within popular culture but also will discuss actionable ways that public historians can use these portrayals as an entry point for discussions with the public, citing literature reviews and quantitative and qualitative analysis of survey results. As Hollywood is talking about museums, museums can use that to better connect to the audiences who feel comfortable at the cinema but are excluded from the museum.

Keywords: museums, public memory, representation, popular culture

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Authors: Amer Ali, Jessica Cecchinelli, Antonis Charalambous

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Cycling is one of the most environmentally friendly, economic and healthy modes of transport but it needs more efficient cycle infrastructure and more effective safety measures. This paper represents an investigation into the performance and operation of the London Cycle Hire Scheme which started to operate in July 2010 using 5,000 cycles and 315 docking stations and currently has more than 10,000 cycles and over 700 docking stations across London which are available 24/7, 365 days a year. The study, which was conducted during the second half of 2014, consists of two parts; namely, the longitudinal review of the hire scheme between its introduction in 2010 and November 2014, and a field survey in November 2014 in the form of face-face interviews of the users of the cycle scheme to ascertain the existing limitations and difficulties experienced by those users and how it could be improved in terms of capability and safety. The study also includes a correlation between the usage of the cycle scheme and the corresponding weather conditions. The main findings are that on average the number of users (hiring frequency) had increased from just over two millions hires in 2010 to just less than ten millions in 2014. The field survey showed that 80% of the users are satisfied with the performance of the scheme whilst 50% of the users raised concern about the safety level of using the available cycle routes and infrastructure. The study also revealed that a high percentage of the cycle trips were relatively short (less than 30 minutes). Although the weather condition had some effect on cycling, the cost of using the cycle scheme and the main events in London had more effect on the number of cycle hires. The key conclusions are that despite the safety concern and the lack of infrastructure for continuous routes there was an encouraging number of people who opted for cycling as a clean, affordable, and healthy mode of transport. There is a need to expand the scheme by providing more cycles and docking stations and to support that by more well-designed and maintained cycle routes. More details about the development of London Cycle Hire Scheme during the last five years, its performance and the key issues revealed by the surveyed users will be reported in the full version of the paper.

Keywords: cycling mode of transport, london cycle hire scheme, safety, environmental and health benefits, user satisfaction

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Authors: Simone F. Medeiros, Jessica M. Fonseca, Gizelda M. Alves, Danilo M. Santos, Sérgio P. Campana-Filho, Amilton M. Santos

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Stimuli responsive and biocompatible hydrogel nanoparticles have gained special attention as systems for potential applications in controlled release of drugs to improve their therapeutic efficacy while minimizing side effects. In this work, novel solid dispersions based on thermo- and pH-responsive poly(N-vinylcaprolactam-co-itaconic acid-co-ethylene- glycol dimethacrylate) hydrogel nanoparticles embedded in chitosan matrices were prepared via spray drying for controlled release of ketoprofen. Firstly, the hydrogel nanoparticles containing ketoprofen were prepared via precipitation polymerization and their stimuli-responsive behavior, thermal properties, chemical composition, encapsulation efficiency and morphology were characterized. Then, hydrogel nanoparticles with different particles size were embedded into chitosan matrices via spray-drying. Scanning electron microscopy (SEM) analyses were performed to investigate the particles size, dispersity and morphology. Finally, ketoprofen release profiles were studied as a function of pH and temperature. Chitosan/poly(NVCL-co-IA-co-EGDMA)-ketoprofen microparticles presented spherical shape, rough surface and pronounced agglomeration, indicating that hydrogels nanoparticles loaded with ketoprofen modified the surface of chitosan matrix. The maximum encapsulation efficiency of ketoprofen into hydrogel nanoparticles was 57.8% and the electrostatic interactions between amino groups from chitosan and carboxylic groups from hydrogel nanoparticles were able to control ketoprofen release. The hydrogel nanoparticles themselves were capable to retard the release of ketoprofen-loaded until 48h of in vitro release tests, while their incorporation into chitosan matrix achieved a maximum percentage of drug release of 45%, using a mass ratio of chitosan: poly(NVCL-co-IA-co-EGDMA equal to 10:7, and 69%, using a mass ratio of chitosan: poly(NVCL-co-IA-co-EGDMA equal to 5:2.

Keywords: hydrogel nanoparticles, poly(N-vinylcaprolactam-co-itaconic acid-co-ethylene- glycol dimethacrylate), chitosan, ketoprofen, spray-drying

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Authors: Kathrina Aseanne Acapulco-Gomez, Shayne Julieane Morales, Tzar Francis Verame

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Mean platelet volume (MPV) is the most accurate measure of the size of platelets and is routinely measured by most automated hematological analyzers. Several studies have shown associations between MPV and cardiovascular risks and outcomes. Although its measurement may provide useful data, MPV remains to be a diagnostic tool that is yet to be included in routine clinical decision making. The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios, and to determine the difference of the mean MPV values between those with MI and those in the non-MI controls. The primary search was done through search in electronic databases PubMed, Cochrane Review CENTRAL, HERDIN (Health Research and Development Information Network), Google Scholar, Philippine Journal of Pathology, and Philippine College of Physicians Philippine Journal of Internal Medicine. The reference list of original reports was also searched. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Studies were included if: (1) CBC was taken upon presentation to the ER or upon admission (within 24 hours of symptom onset); (2) myocardial infarction was diagnosed with serum markers, ECG, or according to accepted guidelines by the Cardiology societies (American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC); and, (3) if outcomes were measured as significant difference AND/OR sensitivity and specificity. The authors independently screened for inclusion of all the identified potential studies as a result of the search. Eligible studies were appraised using well-defined criteria. Any disagreement between the reviewers was resolved through discussion and consensus. The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. With a DOR of 2.92, MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. Thus, it is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.

Keywords: mean platelet volume, MPV, myocardial infarction, angina, chest pain

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Authors: Franco Lorenzo D. Morales

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‘Toshi-no-sakon,’ which translates to as ‘age gap marriage,’ is a term that has been popularized by celebrity couples in the Japanese entertainment industry. Japan is distinct for a developed nation for its rapidly aging population, declining marital and fertility rates, and the reinforcement of traditional gender roles. Statistical data has shown that the average age of marriage in Japan is increasing every year, showing a growing tendency for late marriage. As a result, the government has been trying to curb the declining trends by encouraging marriage and childbirth among the populace. This graduate thesis seeks to analyze the ‘toshi-no-sakon’ phenomenon in lieu of Japan’s current economic and social situation, and to see what the implications are for these kinds of married couples. This research also seeks to expound more on age gaps within married couples, which is a factor rarely-touched upon in Japanese family studies. A literature review was first performed in order to provide a framework to study ‘toshi-no-sakon’ from the perspective of four fields of study—marriage, family, aging, and gender. Numerous anonymous online statements by ‘toshi-no-sakon’ couples were then collected and analyzed, which brought to light a number of concerns. Couples wherein the husband is the older partner were prioritized in order to narrow down the focus of the research, and ‘toshi-no-sakon’ is only considered when the couple’s age gap is ten years or more. Current findings suggest that one of the perceived merits for a woman to marry an older man is that financial security would be guaranteed. However, this has been shown to be untrue as a number of couples express concern regarding their financial situation, which could be attributed to their husband’s socio-economic status. Having an older husband who is approaching the age of retirement presents another dilemma as the wife would be more obliged to provide care for her aging husband. This notion of the wife being a caregiver likely stems from an arrangement once common in Japanese families in which the wife must primarily care for her husband’s elderly parents. Childbearing is another concern as couples would be pressured to have a child right away due to the age of the husband, in addition to limiting the couple’s ideal number of children. This is another problematic aspect as the husband would have to provide income until his child has finished their education, implying that retirement would have to be delayed indefinitely. It is highly recommended that future studies conduct face-to-face interviews with couples and families who fall under the category of ‘toshi-no-sakon’ in order to gain a more in-depth perspective into the phenomenon and to reveal any undiscovered trends. Cases wherein the wife is the older partner in the relationship should also be given focus in future studies involving ‘toshi-no-sakon’.

Keywords: age gap, family structure, gender roles, marriage trends

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Authors: Jessica Federman

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The current research offers a longitudinal and qualitative study design to examine how reciprocity improves relations between the homeless and various stakeholders within a community. The study examines a homeless shelter that sought to establish a facility within a community of Los Angeles, that was initially met with strong resistance and opposition from a variety of organizations due to deeply entrenched views about the negative impact of having homeless individuals within the community. The project tested an intervention model that targets the reduction of stigmatization of homeless individuals and promotes synergistic exchanges between conflicted organizational entities in communities. Years later, the data show that there has been a remarkable reversal in the perception of the agency by the very forces that initially prevented it from being established. This reversal was achieved by a few key strategic decisions. Community engagement was the first step toward changing people’s minds and demonstrating how the homeless shelter was helping to alleviate the problem of homelessness instead of contributing to it. Central to the non-profit’s success was the agency’s pioneering formulation of a treatment model known as, Reciprocal Community Engagement Model (RCEM). The model works by reintegrating the homeless back into society through relationship building within a network of programs that foster positive human connections. This approach aims to draw the homeless out of the debilitating isolation of their situation, reintegrate them through purposeful roles in the community while simultaneously providing a reciprocal benefit to the community at large. Through multilevel, simultaneous social interaction, RCEM has a direct impact not only on the homeless shelter’s clients but also for the community as well. The agency’s approach of RCEM led to their homeless clients getting out of the shelter and getting to work in the community directly alongside other community volunteers and for the benefit of other city and community organizations. This led to several opportunities for community members and residents to interact in meaningful ways. Through each successive exposure, the resident and community members’ distrust in one another was gradually eased and a mutually supportive relationship restored. In this process, the community member becomes the locus of change as much as the residents of the shelter. Measurements of community trust and resilience increased while negative perceptions of homeless people decreased.

Keywords: stigma, homelessness, reciprocity, identity

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Authors: Urrutia Fernando, López Jessica, Sánchez Carlos, San Antonio Thalía

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Ecuador, as a signatory country of the convention of the rights of persons with disabilities (CRPD) has, in the recent years, strengthened the structures and legal framework required to protect this minority comprised of 13.2% of its total population. However, the reality is that this group has disproportionately low earnings and low educational attainment in comparison with the general population. The main struggles, to promote job placement of wheelchairs users, are environmental discrimination caused by accessibility in structures and transportation, this mainly due to the cost, for private and public entities, of performing the reasonable accommodation they require. It is widely known that product development and production is needed to support effective implementation of the CRPD and that walking and standing are the major life activities, in this context the objective of this investigation is to promote job placement of wheelchair user in the province of Tungurahua by means of the design, production and marketing of a customized stand up wheelchair. Exploratory interviews and measurements were performed in a representative sample of working age wheelchairs users that develop their disability after achieving their physical maturity and that are capable of performing professional activities with their upper limbs, this in order to detect the user’s preference and determine the local economic and anthropometric parameters to be included in the wheelchair design. The findings reveal factors that uniquely impact quality of life and development for people with a mobility disability within the context of the province, first that transportation is a big issue since public buses does not have accessibility for wheelchair users and the absence of curb cuts and the presence of trash bins over the sidewalks among other hinders an economic independent mobility, second that the proposal based in the idea of modifying the wheelchairs to make it able to overcome certain obstacles helps people in wheelchair to improve their independent living and by reducing the costs of modification for the employer could improve their chances of finding work.

Keywords: anthropometrics, job placement, stand up wheelchair, user centered design

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Authors: Eugene Y. C. Wong, Daniel Y. W. Mo, Cosmo T. Y. Ng, Jessica K. Y. Chan, Leith K. Y. Chan, Henry Y. K. Lau

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The real-time planning visualisation, precise allocation and loading optimisation in air cargo load planning operations are increasingly important as more considerations are needed on dangerous cargo loading, locations of lithium batteries, weight declaration and limited aircraft capacity. The planning of the unit load devices (ULD) can often be carried out only in a limited number of hours before flight departure. A dynamic air cargo load planning system is proposed with the optimisation of cargo load plan and visualisation of planning results in virtual reality systems. The system aims to optimise the cargo load planning and visualise the simulated loading planning decision on air cargo terminal operations. Adopting simulation tools, Cave Automatic Virtual Environment (CAVE) and virtual reality technologies, the results of planning with reference to weight and balance, Unit Load Device (ULD) dimensions, gateway, cargo nature and aircraft capacity are optimised and presented. The virtual reality system facilities planning, operations, education and training. Staff in terminals are usually trained in a traditional push-approach demonstration with enormous manual paperwork. With the support of newly customized immersive visualization environment, users can master the complex air cargo load planning techniques in a problem based training with the instant result being immersively visualised. The virtual reality system is developed with three-dimensional (3D) projectors, screens, workstations, truss system, 3D glasses, and demonstration platform and software. The content will be focused on the cargo planning and loading operations in an air cargo terminal. The system can assist decision-making process during cargo load planning in the complex operations of air cargo terminal operations. The processes of cargo loading, cargo build-up, security screening, and system monitoring can be further visualised. Scenarios are designed to support and demonstrate the daily operations of the air cargo terminal, including dangerous goods, pets and animals, and some special cargos.

Keywords: air cargo load planning, optimisation, virtual reality, weight and balance, unit load device

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Authors: Wenli Tsou, Jessica Wu

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Courses of English for specific academic purposes (ESAP) have become popular for higher education in Taiwan; however, no standardized tests have been developed for evaluating learners’ English proficiency in individual designated fields. Assuming a learner’s proficiency in a specific academic area is built up with one’s general proficiency in English with specific knowledge and vocabulary in the content areas, an adequate ESAP proficiency test may be constructed by some selected test items related to the designated academic areas. In this study, through collaboration between a language testing institution and a university in Taiwan, three sets of ESAP tests, covering three disciplinary areas of business and the workplace, science and engineering, and health and medicine majors, were developed and administered to sophomore students (N=1704) who were enrolled in ESAP courses at a university in southern Taiwan. For this study, the courses were grouped into the above-mentioned three disciplines, and students took the specialized proficiency test based on the ESAP course they were taking. Because students were free to select which ESAP course to take, each course had both major and non-major students. Toward the end of the one-semester course, ending in January, 2015, each student took two tests, one of general English (General English Proficiency Test, or GEPT) and the other ESAP. Following each test, students filled out a survey, reporting their test taking experiences. After comparing students’ two test scores, it was found that business majors and health and medical students performed better in ESAP than the non-majors in the class, whereas science and engineering majors did about the same as their non-major counterparts. In addition, test takers with CERF B2 (upper intermediate) level or above performed well in both tests, while students who are below B2 did slightly better in ESAP. The findings suggest that students’ test performance have been enhanced by their specialist content and vocabulary knowledge. Furthermore, results of the survey show that the difficulty levels reported by students are consistent with their test performances. Based on the item analysis, the findings can be used to develop proficiency tests for specific disciplines and to identify ability indicators for college students in their designated fields.

Keywords: english for specific academic purposes (ESAP), general english proficiency test (GEPT), higher education, proficiency test

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Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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Authors: Delphine Morales, Florian Lombart, Agathe Truchot, Pauline Maire, Pascale Vigneron, Antoine Galmiche, Catherine Lok, Muriel Vayssade

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Targeted therapy molecules are used as a first-line treatment for metastatic melanoma with B-Raf mutation. Nevertheless, these molecules can cause side effects to patients and are efficient on 50 to 60 % of them. Indeed, melanoma cell sensitivity to targeted therapy molecules is dependent on tumor microenvironment (cell-cell and cell-extracellular matrix interactions). To better unravel factors modulating cell sensitivity to B-Raf inhibitor, we have developed and compared several melanoma models: from metastatic melanoma cells cultured as monolayer (2D) to a co-culture in a 3D dermal equivalent. Cell response was studied in different melanoma cell lines such as SK-MEL-28 (mutant B-Raf (V600E), sensitive to Vemurafenib), SK-MEL-3 (mutant B-Raf (V600E), resistant to Vemurafenib) and a primary culture of dermal human fibroblasts (HDFn). Assays have initially been performed in a monolayer cell culture (2D), then a second time on a 3D dermal equivalent (dermal human fibroblasts embedded in a collagen gel). All cell lines were treated with Vemurafenib (a B-Raf inhibitor) for 48 hours at various concentrations. Cell sensitivity to treatment was assessed under various aspects: Cell proliferation (cell counting, EdU incorporation, MTS assay), MAPK signaling pathway analysis (Western-Blotting), Apoptosis (TUNEL), Cytokine release (IL-6, IL-1α, HGF, TGF-β, TNF-α) upon Vemurafenib treatment (ELISA) and histology for 3D models. In 2D configuration, the inhibitory effect of Vemurafenib on cell proliferation was confirmed on SK-MEL-28 cells (IC50=0.5 µM), and not on the SK-MEL-3 cell line. No apoptotic signal was detected in SK-MEL-28-treated cells, suggesting a cytostatic effect of the Vemurafenib rather than a cytotoxic one. The inhibition of SK-MEL-28 cell proliferation upon treatment was correlated with a strong expression decrease of phosphorylated proteins involved in the MAPK pathway (ERK, MEK, and AKT/PKB). Vemurafenib (from 5 µM to 10 µM) also slowed down HDFn proliferation, whatever cell culture configuration (monolayer or 3D dermal equivalent). SK-MEL-28 cells cultured in the dermal equivalent were still sensitive to high Vemurafenib concentrations. To better characterize all cell population impacts (melanoma cells, dermal fibroblasts) on Vemurafenib efficacy, cytokine release is being studied in 2D and 3D models. We have successfully developed and validated a relevant 3D model, mimicking cutaneous metastatic melanoma and tumor microenvironment. This 3D melanoma model will become more complex by adding a third cell population, keratinocytes, allowing us to characterize the epidermis influence on the melanoma cell sensitivity to Vemurafenib. In the long run, the establishment of more relevant 3D melanoma models with patients’ cells might be useful for personalized therapy development. The authors would like to thank the Picardie region and the European Regional Development Fund (ERDF) 2014/2020 for the funding of this work and Oise committee of "La ligue contre le cancer".

Keywords: 3D human skin model, melanoma, tissue engineering, vemurafenib efficiency

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Authors: Jessica Chorostecki, Aashka Shah, Fen Bao, Ginny Bao, Edwin George, Navid Seraji-Bozorgzad, Veronica Gorden, Christina Caon, Elliot Frohman

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Background: Parkinson’s Disease (PD) is a neuro degenerative disorder associated with the loss of dopaminergic cells and the presence α-synuclein (AS) aggregation in of Lewy bodies. Both dopaminergic cells and AS are found in the retina. Optical coherence tomography (OCT) allows high-resolution in-vivo examination of retinal structure injury in neuro degenerative disorders including PD. Methods: We performed a cross-section OCT study in patients with definite PD and healthy controls (HC) using Spectral Domain SD-OCT platform to measure the peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular volume (TMV). We performed intra-retinal segmentation with fully automated segmentation software to measure the volume of the RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and the outer nuclear layer (ONL). Segmentation was performed blinded to the clinical status of the study participants. Results: 101 eyes from 52 PD patients (mean age 65.8 years) and 46 eyes from 24 HC subjects (mean age 64.1 years) were included in the study. The mean pRNFL thickness was not significantly different (96.95 μm vs 94.42 μm, p=0.07) but the TMV was significantly lower in PD compared to HC (8.33 mm3 vs 8.58 mm3 p=0.0002). Intra-retinal segmentation showed no significant difference in the RNFL volume between the PD and HC groups (0.95 mm3 vs 0.92 mm3 p=0.454). However, GCL, IPL, INL, and ONL volumes were significantly reduced in PD compared to HC. In contrast, the volume of OPL was significantly increased in PD compared to HC. Conclusions: Our finding of the enlarged OPL corresponds with mRNA expression studies showing localization of AS in the OPL across vertebrate species and autopsy studies demonstrating AS aggregation in the deeper layers of retina in PD. We propose that the enlargement of the OPL may represent a potential biomarker of AS aggregation in PD. Longitudinal studies in larger cohorts are warranted to confirm our observations that may have significant implications in disease monitoring and therapeutic development.

Keywords: Optical Coherence Tomography, biomarker, Parkinson's disease, alpha-synuclein, retina

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Authors: Sera Ratu, Jane Chivers, Jessica Botfield

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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.

Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools

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Authors: Nathaniel Evans, Jessica Boersma, Kenneth Kass

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With technology and STEM fields growing every day, there is a significant projected shortfall in qualified cybersecurity workers. As such, it is essential to develop a cybersecurity curriculum that builds skills and cultivates interest in cybersecurity early on. With new jobs being created every day and an already significant gap in the job market, it is vital that educators are pro-active in introducing a cybersecurity curriculum where students are able to learn new skills and engage in an age-appropriate cyber curriculum. Within this growing world of cybersecurity, students should engage in age-appropriate technology and cybersecurity curriculum, starting with elementary school (k-5), extending through high school, and ultimately into college. Such practice will provide students with the confidence, skills, and, ultimately, the opportunity to work in the burgeoning information security field. This paper examines educational methods, pedagogical practices, current cybersecurity curricula, and other educational resources and conducts analysis for false assumptions and developmental appropriateness. It also examines and identifies common mistakes with current cyber curriculum and lessons and discuss strategies for improvement. Throughout the lessons that were reviewed, many common mistakes continued to pop up. These mistakes included age appropriateness, technology resources that were available, and consistency of student’s skill levels. Many of these lessons were written for the wrong grade levels. The ones written for the elementary level all had activities that assumed that every student in the class could read at grade level and also had background knowledge of the cyber activity at hand, which is not always the case. Another major mistake was that these lessons assumed that all schools had any kind of technology resource available to them. Some schools are 1:1, and others are only allotted three computers in their classroom where the students have to share. While coming up with a cyber-curriculum, it has to be kept in mind that not all schools are the same, not every classroom is the same. There are many students who are not reading at their grade level or have not had exposure to the digital world. We need to start slow and ease children into the cyber world. Once they have a better understanding, it will be easier to move forward with these lessons and get the students engaged. With a better understanding of common mistakes that are being made, a more robust curriculum and lessons can be created that no only spark a student’s interest in this much-needed career field but encourage learning while keeping our students safe from cyber-attacks.

Keywords: assumptions, cybersecurity, k-12, teacher

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Authors: E. Akdur Öztürk, F. İrvasa Bilgiç, A. Ludovisi , O. Gülbahar, D. Dirim Erdoğan, M. Korkmaz, M. Á. Gómez Morales

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Anisakidosis is a zoonotic human fish-borne parasitic disease caused by accidental ingestion of anisakid third-stage larvae (L3) of members of the Anisakidae family present in infected marine fish or cephalopods. Infection with anisakid larvae can lead to gastric, intestinal, extra-gastrointestinal and gastroallergic forms of the disease. Anisakid parasites have been reported in almost all seas, particularly in the Mediterranean Sea. There is a remarkably high level of risk exposure to these zoonotic parasites as they are present in economically and ecologically important fish of Europe. Anisakid L3 larvae have been also detected in several fish species from the Aegean Sea. Turkey is a peninsular country surrounded by Black, Aegean and the Mediterranean Sea. In this country, fishing habit and fishery product consumption are highly common. In recent years, there was also an increase in the consumption of raw fish due to the increasing interest in the cuisine of the Far East countries. In different regions of Turkey, A. simplex (inMerluccius Merluccius Scomber japonicus, Trachurus mediterraneus, Sardina pilchardus, Engraulis encrasicolus, etc.), Anisakis spp., Contraceucum spp., Pseudoterronova spp. and, C. aduncum were identified as well. Although it is accepted both the presence of anisakid parasites in fish and fishery products in Turkey and the presence of Turkish people with allergic manifestations after fish consumption, there are no reports of human anisakiasis in this country. Given the high prevalence of anisakid parasites in the country, the absence of reports is likely not due to the absence of clinical cases rather to the unavailability of diagnostic tools and the low awareness of the presence of this infection. The aim of the study was to set up an IgE-Western Blot (WB) based test to detect the anisakidosis sensitization among Turkish people with a history of allergic manifestation related to fish consumption. To this end, crude worm antigens (CWA) and allergen enriched fraction (50-66% ) were prepared from L3 of A. simplex (s.l.) collected from Lepidopus caudatus fished in the Mediterranean Sea. These proteins were electrophoretically separated and transferred into the nitrocellulose membranes. By WB, specific proteins recognized by positive control serum samples from sensitized patients were visualized on nitrocellulose membranes by a colorimetric reaction. The CWA and 50–66% fraction showed specific bands, mainly due to Ani s 1 (20-22 kD) and Ani s 4 (9-10 kD). So far, a total of 7 serum samples from people with allergic manifestation and positive skin prick test (SPT) after fish consumption, have been tested and all of them resulted negative by WB, indicating the lack of sensitization to anisakids. This preliminary study allowed to set up a specific test and evidence the lack of correlation between both tests, SPT and WB. However, the sample size should be increased to estimate the anisakidosis burden in Turkish people.

Keywords: anisakidosis, fish parasite, serodiagnosis, Turkey

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Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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Authors: Owen Cegielski, Kristi Maida, Danny Morales, Sylvia L. Mendez

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This study explores the challenges and threats US secondary educators experience in incorporating culturally relevant education (CRE) practices in their classrooms. CRE is a social justice pedagogical practice used to connect student’s cultural references to academic skills and content, to promote critical reflection, to facilitate cultural competence, and to critique discourses of power and oppression. Empirical evidence on CRE demonstrates positive student educational outcomes in terms of achievement, engagement, and motivation. Additionally, due to the direct focus on uplifting diverse cultures through the curriculum, students experience greater feelings of belonging, increased interest in the subject matter, and stronger racial/ethnic identities. When these teaching practices are in place, educators develop deeper relationships with their students and appreciate the multitude of gifts they (and their families) bring to the classroom environment. Yet, educators regularly report being unprepared to incorporate CRE in their daily teaching practice and identify substantive gaps in their knowledge and skills in this area. Often, they were not exposed to CRE in their educator preparation program, nor do they receive adequate support through school- or district-wide professional development programming. Through a descriptive phenomenological research design, 20 interviews were conducted with a diverse set of secondary school educators to explore the challenges and threats they experience in incorporating CRE practices in their classrooms. The guiding research question for this study is: What are the challenges and threats US secondary educators face when seeking to incorporate CRE practices in their classrooms? Interviews were grounded by the theory of challenge and threat states, which highlights the ways in which challenges and threats are appraised and how resources factor into emotional valence and perception, as well as the potential to meet the task at hand. Descriptive phenomenological data analysis strategies were utilized to develop an essential structure of the educators’ views of challenges and threats in regard to incorporating CRE practices in their secondary classrooms. The attitude of the phenomenological reduction method was adopted, and the data were analyzed through five steps: sense of the whole, meaning units, transformation, structure, and essential structure. The essential structure that emerged was while secondary educators display genuine interest in learning how to successfully incorporate CRE practices, they perceive it to be a challenge (and not a threat) due to lack of exposure which diminishes educator capacity, comfort, and confidence in employing CRE practices. These findings reveal the value of attending to emotional valence and perception of CRE in promoting this social justice pedagogical practice. Findings also reveal the importance of appropriately resourcing educators with CRE support to ensure they develop and utilize this practice.

Keywords: culturally relevant education, descriptive phenomenology, social justice practice, US secondary education

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Authors: Egemen Sert, Leila Hedayatifar, Rachel A. Rigg, Amir Akhavan, Olha Buchel, Dominic Elias Saadi, Aabir Abubaker Kar, Alfredo J. Morales, Yaneer Bar-Yam

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The complexity of providing timely and cost-effective distribution of finished goods from industrial facilities to customers makes effective operational coordination difficult, yet effectiveness is crucial for maintaining customer service levels and sustaining a business. Logistics planning becomes increasingly complex with growing numbers of customers, varied geographical locations, the uncertainty of future orders, and sometimes extreme competitive pressure to reduce inventory costs. Linear optimization methods become cumbersome or intractable due to a large number of variables and nonlinear dependencies involved. Here we develop a complex systems approach to optimizing logistics networks based upon dimensional reduction methods and apply our approach to a case study of a manufacturing company. In order to characterize the complexity in customer behavior, we define a “customer space” in which individual customer behavior is described by only the two most relevant dimensions: the distance to production facilities over current transportation routes and the customer's demand frequency. These dimensions provide essential insight into the domain of effective strategies for customers; direct and indirect strategies. In the direct strategy, goods are sent to the customer directly from a production facility using box or bulk trucks. In the indirect strategy, in advance of an order by the customer, goods are shipped to an external warehouse near a customer using trains and then "last-mile" shipped by trucks when orders are placed. Each strategy applies to an area of the customer space with an indeterminate boundary between them. Specific company policies determine the location of the boundary generally. We then identify the optimal delivery strategy for each customer by constructing a detailed model of costs of transportation and temporary storage in a set of specified external warehouses. Customer spaces help give an aggregate view of customer behaviors and characteristics. They allow policymakers to compare customers and develop strategies based on the aggregate behavior of the system as a whole. In addition to optimization over existing facilities, using customer logistics and the k-means algorithm, we propose additional warehouse locations. We apply these methods to a medium-sized American manufacturing company with a particular logistics network, consisting of multiple production facilities, external warehouses, and customers along with three types of shipment methods (box truck, bulk truck and train). For the case study, our method forecasts 10.5% savings on yearly transportation costs and an additional 4.6% savings with three new warehouses.

Keywords: logistics network optimization, direct and indirect strategies, K-means algorithm, dimensional reduction

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Authors: J. Roberto Lopez, Hened Saade, Graciela Morales, Javier Enriquez, Raul G. Lopez

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Implementation of systems based on nanostructures for drug delivery applications have taken relevance in recent studies focused on biomedical applications. Although there are several nanostructures as drugs carriers, the use of polymeric nanoparticles (PNP) has been widely studied for this purpose, however, the main issue for these nanostructures is the size control below 50 nm with a narrow distribution size, due to they must go through different physiological barriers and avoid to be filtered by kidneys (< 10 nm) or the spleen (> 100 nm). Thus, considering these and other factors, it can be mentioned that drug-loaded nanostructures with sizes varying between 10 and 50 nm are preferred in the development and study of PNP/drugs systems. In this sense, the Semicontinuous Heterophase Polymerization (SHP) offers the possibility to obtain PNP in the desired size range. Considering the above explained, methacrylic copolymer nanoparticles were obtained under SHP. The reactions were carried out in a jacketed glass reactor with the required quantities of water, ammonium persulfate as initiator, sodium dodecyl sulfate/sodium dioctyl sulfosuccinate as surfactants, methyl methacrylate and methacrylic acid as monomers with molar ratio of 2/1, respectively. The monomer solution was dosed dropwise during reaction at 70 °C with a mechanical stirring of 650 rpm. Nanoparticles of poly(methyl methacrylate-co-methacrylic acid) were loaded with acetylsalicylic acid (ASA, aspirin) by a chemical adsorption technique. The purified latex was put in contact with a solution of ASA in dichloromethane (DCM) at 0.1, 0.2, 0.4 or 0.6 wt-%, at 35°C during 12 hours. According to the boiling point of DCM, as well as DCM and water densities, the loading process is completed when the whole DCM is evaporated. The hydrodynamic diameter was measured after polymerization by quasi-elastic light scattering and transmission electron microscopy, before and after loading procedures with ASA. The quantitative and qualitative analyses of PNP loaded with ASA were measured by infrared spectroscopy, differential scattering calorimetry and thermogravimetric analysis. Also, the molar mass distributions of polymers were determined in a gel permeation chromatograph apparatus. The load capacity and efficiency were determined by gravimetric analysis. The hydrodynamic diameter results for methacrylic PNP without ASA showed a narrow distribution with an average particle size around 10 nm and a composition methyl methacrylate/methacrylic acid molar ratio equal to 2/1, same composition of Eudragit S100, which is a commercial compound widely used as excipient. Moreover, the latex was stabilized in a relative high solids content (around 11 %), a monomer conversion almost 95 % and a number molecular weight around 400 Kg/mol. The average particle size in the PNP/aspirin systems fluctuated between 18 and 24 nm depending on the initial percentage of aspirin in the loading process, being the drug content as high as 24 % with an efficiency loading of 36 %. These average sizes results have not been reported in the literature, thus, the methacrylic nanoparticles here reported are capable to be loaded with a considerable amount of ASA and be used as a drug carrier.

Keywords: aspirin, biocompatibility, biodegradable, Eudragit S100, methacrylic nanoparticles

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Authors: Jessica Gu, Yu Chen

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Knowledge Management (KM) is undoubtable crucial to organizational value creation, learning, and adaptation. Although the rapidly growing KM domain has been fueled with full-fledged methodologies and technologies, studies on KM evolution that bridge the organizational performance and adaptation to the organizational environment are still rarely attempted. In particular, creation (or generation) and diffusion (or share/exchange) of knowledge are of the organizational primary concerns on the problem-solving perspective, however, the optimized distribution of knowledge creation and diffusion endeavors are still unknown to knowledge workers. This research proposed an agent-based model of knowledge creation and diffusion in an organization, aiming at elucidating how the intertwining knowledge flows at microscopic level lead to optimized organizational performance at macroscopic level through evolution, and exploring what exogenous interventions by the policy maker and endogenous adjustments of the knowledge workers can better cope with different environmental conditions. With the developed model, a series of simulation experiments are conducted. Both long-term steady-state and time-dependent developmental results on organizational performance, network and structure, social interaction and learning among individuals, knowledge audit and stocktaking, and the likelihood of choosing knowledge creation and diffusion by the knowledge workers are obtained. One of the interesting findings reveals a non-monotonic phenomenon on organizational performance under turbulent environment while a monotonic phenomenon on organizational performance under a stable environment. Hence, whether the environmental condition is turbulence or stable, the most suitable exogenous KM policy and endogenous knowledge creation and diffusion choice adjustments can be identified for achieving the optimized organizational performance. Additional influential variables are further discussed and future work directions are finally elaborated. The proposed agent-based model generates evidence on how knowledge worker strategically allocates efforts on knowledge creation and diffusion, how the bottom-up interactions among individuals lead to emerged structure and optimized performance, and how environmental conditions bring in challenges to the organization system. Meanwhile, it serves as a roadmap and offers great macro and long-term insights to policy makers without interrupting the real organizational operation, sacrificing huge overhead cost, or introducing undesired panic to employees.

Keywords: knowledge creation, knowledge diffusion, agent-based modeling, organizational performance, decision making evolution

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Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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Authors: Isaac Martin, Abigail Lark, Sandra Morales, Eric W. Alton, Jane C. Davies

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Objectives: The cystic fibrosis (CF) lung is a unique microbiological niche, wherein harmful bacteria persist for many years despite antibiotic therapy. Pseudomonas aeruginosa (Pa), the major culprit leading to lung decline and increased mortality, thrives in the lungs of patients with CF due to several factors that have been linked with poor antibiotic performance. Our group is investigating alternative therapies including bacteriophage cocktails with which we have previously demonstrated efficacy against planktonic organisms. In this study, we explored the effects of a 4-phage cocktail on Pa grown in two different conditions, intended to mirror the CF lung: a) alongside standard antibiotic treatment in pre-formed biofilms (structures formed by Pa-secreted exopolysaccharides which provide both physical and cell division barriers to antimicrobials and host defenses and b) in an acidic environment postulated to be present in the CF airway due both to the primary defect in bicarbonate secretion and secondary effects of inflammation. Methods: 16 Pa strains from CF patients at the Royal Brompton Hospital were selected based on sensitivity to a) ceftazidime/ tobramycin and b) the phage cocktail in a conventional plaque assay. To assess efficacy of phage in biofilms, 96 well plates with Pa (5x10⁷ CFU/ ml) were incubated in static conditions, allowing adherent bacterial colonies to form for 24 hr. Ceftazidime and tobramycin (both at 2 × MIC) were added, +/- bacteriophage (4x10⁸ PFU/mL) for a further 24 hr. Cell viability and biomass were estimated using fluorescent resazurin and crystal violet assays, respectively. To evaluate the effect of pH, strains were grown planktonically in shaking 96 well plates at pH 6.0, 6.6, 7.0 and 7.5 with tobramycin or phage, at varying concentrations. Cell viability was quantified by fluorescent resazurin assay. Results: For the biofilm assay, treatment groups were compared with untreated controls and expressed as percent reduction in cell viability and biomass. Addition of the 4-phage cocktail resulted in a 1.3-fold reduction in cell viability and 1.7-fold reduction in biomass (p < 0.001) when compared to standard antibiotic treatment alone. Notably, there was a 50 ± 15% reduction in cell viability and 60 ± 12% reduction in biomass (95% CI) for the 4 biofilms demonstrating the most resistance to antibiotic treatment. 83% of strains tested (n=6) showed decreased bacterial killing by tobramycin at acidic pHs (p < 0.01). However, 25% of strains (n=12) showed improved phage killing at acidic pHs (p < 0.05), with none showing the pattern of reduced efficacy at acidic pH demonstrated by tobramycin. Conclusion: The 4-phage anti-Pa cocktail tested against Pa performs well in pre-formed biofilms and in acidic environments; two conditions intended to mimic the CF lung. To our knowledge, these are the first data looking at the effects of subtle pH changes on phage-mediated bacterial killing in the context of Pa infection. These findings contribute to a growing body of evidence supporting the use of nebulised lytic bacteriophage as a treatment in the context of lung infection.

Keywords: biofilm, cystic fibrosis, pH, Pseudomonas aeruginosa, lytic bacteriophage

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Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews

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Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.

Keywords: cognitive behaviour therapy, depression, diabetes, internet

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Authors: Jessica Scher Lisa, Eric Shyman

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Autism spectrum disorder (ASD) is a neuro-developmental disorder that is characterized by persistent deficits in social communication and social interaction (i.e. deficits in social-emotional reciprocity, nonverbal communicative behaviors, and establishing/maintaining social relationships), as well as by the presence of repetitive behaviors and perseverative areas of interest (i.e. stereotyped or receptive motor movements, use of objects, or speech, rigidity, restricted interests, and hypo or hyperactivity to sensory input or unusual interest in sensory aspects of the environment). Additionally, diagnoses of ASD require the presentation of symptoms in the early developmental period, marked impairments in adaptive functioning, and a lack of explanation by general intellectual impairment or global developmental delay (although these conditions may be co-occurring). Over the past several decades, many theories have been developed in an effort to explain the root cause of ASD in terms of atypical central cognitive processes. The field of neuroscience is increasingly finding structural and functional differences between autistic and neurotypical individuals using neuro-imaging technology. One main area this research has focused upon is in visuospatial processing, with specific attention to the notion of ‘weak central coherence’ (WCC). This paper offers an analysis of findings from selected studies in order to explore research that challenges the ‘deficit’ characterization of a weak central coherence theory as opposed to a ‘superiority’ characterization of strong local coherence. The weak central coherence theory has long been both supported and refuted in the ASD literature and has most recently been increasingly challenged by advances in neuroscience. The selected studies lend evidence to the notion of amplified localized perception rather than deficient global perception. In other words, WCC may represent superiority in ‘local processing’ rather than a deficit in global processing. Additionally, the right hemisphere and the specific area of the extrastriate appear to be key in both the visual and lexicosemantic process. Overactivity in the striate region seems to suggest inaccuracy in semantic language, which lends itself to support for the link between the striate region and the atypical organization of the lexicosemantic system in ASD.

Keywords: autism spectrum disorder, neurology, visual processing, weak coherence

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

Abstract:

Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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