Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14

Search results for: Pascale Auban Senzier

14 Effects of Voltage Pulse Characteristics on Some Performance Parameters of LiₓCoO₂-based Resistive Switching Memory Devices

Authors: Van Son Nguyen, Van Huy Mai, Alec Moradpour, Pascale Auban Senzier, Claude Pasquier, Kang Wang, Pierre-Antoine Albouy, Marcelo J. Rozenberg, John Giapintzakis, Christian N. Mihailescu, Charis M. Orfanidou, Thomas Maroutian, Philippe Lecoeur, Guillaume Agnus, Pascal Aubert, Sylvain Franger, Raphaël Salot, Nathalie Brun, Katia March, David Alamarguy, Pascal ChréTien, Olivier Schneegans


In the field of Nanoelectronics, a major research activity is being developed towards non-volatile memories. To face the limitations of existing Flash memory cells (endurance, downscaling, rapidity…), new approaches are emerging, among them resistive switching memories (Re-RAM). In this work, we analysed the behaviour of LixCoO2 oxide thin films in electrode/film/electrode devices. Preliminary results have been obtained concerning the influence of bias pulses characteristics (duration, value) on some performance parameters, such as endurance and resistance ratio (ROFF/RON). Besides, Conducting Probe Atomic Force Microscopy (CP-AFM) characterizations of the devices have been carried out to better understand some causes of performance failure, and thus help optimizing the switching performance of such devices.

Keywords: non volatile resistive memories, resistive switching, thin films, endurance

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13 CONDUCTHOME: Gesture Interface Control of Home Automation Boxes

Authors: J. Branstett, V. Gagneux, A. Leleu, B. Levadoux, J. Pascale


This paper presents the interface CONDUCTHOME which controls home automation systems with a Leap Motion using ‘invariant gesture protocols’. The function of this interface is to simplify the interaction of the user with its environment. A hardware part allows the Leap Motion to be carried around the house. A software part interacts with the home automation box and displays the useful information for the user. An objective of this work is the development a natural/invariant/simple gesture control interface to help elder people/people with disabilities.

Keywords: automation, ergonomics, gesture recognition, interoperability

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12 Study for a Non-Invasive Method of Respiratory Resistance Measurement among Patients with Airways Obstructions

Authors: Aicha Laouani, Pascale Calabrese, Sonia Rouatbi, Saad Saguem


Distances between signals (S d) and between asters (A d) calculated from respiratory inductive plethysmography signals has been used in order to evaluation airways resistances (Raw) during reversibility test among 28 subject with airways obstructions. Correlations studies between these distances and Raw measured by body plethysmography (BP) showed that these RIP variables could be potentially used in airway resistance assessment in patients with airway obstruction. Significant correlation was found between ΔAd and airway resistance changes (ΔRaw) (r= 0.407, p=0.03) and not between ΔSd and ΔRaw. This assumption was supported by the high correlations found when relating the average of ΔS and of ΔA calculated on successive intervals of ΔRaw, with the ΔRaw averages calculated for each interval (r= 0.892, p= 0.006 and r= 0.857, p=0.006 respectively).

Keywords: airways obstruction, distances, respiratory inductive plethysmography, reversibility test

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11 Airway Resistance Evaluation by Respiratory İnductive Plethysmography in Subjects with Airway Obstructions

Authors: Aicha Laouani, Sonia Rouatbi, Saad Saguem, Gila Benchetrit, Pascale calabrese


A new approach based on respiratory inductive plethysmography (RIP) signal analysis has been used for bronchoconstriction changes evaluation in 50 healthy controls and in 44 adults with moderate bronchial obstruction treated with a bronchodilatation protocol. Thoracic and abdominal motions were recorded ( 5 min) by RIP. For each recording the thoracoabdominal signals were analysed and a mean distance (D) was calculated. Airway resistance (Raw) and spirometric data were measured with a body plethysmograph. The results showed that both D and Raw were higher in subjects compared to the healthy group. Significant decreases of D and Raw were also observed after bronchodilatation in the obstructive group. There was also a positive and a significant correlation between D and Raw in subjects before and after bronchodilatation. This D calculated from RIP Signals could be used as a non invasive tool for continuous monitoring of bronchoconstriction changes.

Keywords: airway resistance, bronchoconstriction, thorax, respiratory inductive plethysmography

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10 U11 Functionalised Luminescent Gold Nanoclusters for Pancreatic Tumor Cells Labelling

Authors: Regina M. Chiechio, Rémi Leguevél, Helene Solhi, Marie Madeleine Gueguen, Stephanie Dutertre, Xavier, Jean-Pierre Bazureau, Olivier Mignen, Pascale Even-Hernandez, Paolo Musumeci, Maria Jose Lo Faro, Valerie Marchi


Thanks to their ultra-small size, high electron density, and low toxicity, gold nanoclusters (Au NCs) have unique photoelectrochemical and luminescence properties that make them very interesting for diagnosis bio-imaging and theranostics. These applications require control of their delivery and interaction with cells; for this reason, the surface chemistry of Au NCs is essential to determine their interaction with the targeted biological objects. Here we demonstrate their ability as markers of pancreatic tumor cells. By functionalizing the surface of the NCs with a recognition peptite (U11), the nanostructures are able to preferentially bind to pancreatic cancer cells via a receptor (uPAR) overexpressed by these cells. Furthermore, the NCs can mark even the nucleus without the need of fixing the cells. These nanostructures can therefore be used as a non-toxic, multivalent luminescent platform, capable of selectively recognizing tumor cells for bioimaging, drug delivery, and radiosensitization.

Keywords: gold nanoclusters, luminescence, biomarkers, pancreatic cancer, biomedical applications, bioimaging, fluorescent probes, drug delivery

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9 Availability of Safety Measures and Knowledge Towards Hazardous Waste Management among Workers in Scientific Laboratories of Two Universities in Lebanon

Authors: Inaam Nasrallah, Pascale Salameh, Abbas El-Outa, Assem Alkak, Rihab Nasr, Wafa Toufic Bawab


Background: Hazardous Waste Management(HWM). is critical to human health outcomes and environmental protection. This study evaluated the knowledge regarding safety measures to be applied when collecting and storing waste in scientific laboratories of two universities in Lebanon.Method: A survey-based observational study was conducted in scientific laboratories of the public university and that of a private university, where a total of 309 participants were recruited.Result: The mean total knowledge score on safety measures of HWM was 9.02±4.34 (maximum attainable score, 13). Significant association (p<0.05) was found between knowledge score and job function, years of experience, educational level, professional status, work schedule, and training on proper HWM. Participants had adequate perceptions regarding the impact of HWM on health and the environment. Linear regression modeling revealed that knowledge score was significantly higher among bachelor level lab workers compared to those with doctoral degrees (p=0.043), full-time schedule workers versus part-timers (p=0.03), and among public university participants as compared to those of the private university (p<0.001).Conclusion: This study showed good knowledge concerning HWM in the scientific laboratoriesof the studied universities in Lebanon and a good awareness of the HWM on health and the environment. It highlights the importance of culture, attitude, and practice on proper HWM in the academic scientific laboratory.

Keywords: hasardous waste, safety measures, waste management, knwoledge score, scientific laboratory workers

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8 Effect of Environmental Parameters on the Water Solubility of the Polycyclic Aromatic Hydrocarbons and Derivatives using Taguchi Experimental Design Methodology

Authors: Pranudda Pimsee, Caroline Sablayrolles, Pascale De Caro, Julien Guyomarch, Nicolas Lesage, Mireille Montréjaud-Vignoles


The MIGR’HYCAR research project was initiated to provide decisional tools for risks connected to oil spill drifts in continental waters. These tools aim to serve in the decision-making process once oil spill pollution occurs and/or as reference tools to study scenarios of potential impacts of pollutions on a given site. This paper focuses on the study of the distribution of polycyclic aromatic hydrocarbons (PAHs) and derivatives from oil spill in water as function of environmental parameters. Eight petroleum oils covering a representative range of commercially available products were tested. 41 Polycyclic Aromatic Hydrocarbons (PAHs) and derivate, among them 16 EPA priority pollutants were studied by dynamic tests at laboratory scale. The chemical profile of the water soluble fraction was different from the parent oil profile due to the various water solubility of oil components. Semi-volatile compounds (naphtalenes) constitute the major part of the water soluble fraction. A large variation in composition of the water soluble fraction was highlighted depending on oil type. Moreover, four environmental parameters (temperature, suspended solid quantity, salinity, and oil: water surface ratio) were investigated with the Taguchi experimental design methodology. The results showed that oils are divided into three groups: the solubility of Domestic fuel and Jet A1 presented a high sensitivity to parameters studied, meaning they must be taken into account. For gasoline (SP95-E10) and diesel fuel, a medium sensitivity to parameters was observed. In fact, the four others oils have shown low sensitivity to parameters studied. Finally, three parameters were found to be significant towards the water soluble fraction.

Keywords: mornitoring, PAHs, water soluble fraction, SBSE, Taguchi experimental design

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7 Modelling of Reactive Methodologies in Auto-Scaling Time-Sensitive Services With a MAPE-K Architecture

Authors: Óscar Muñoz Garrigós, José Manuel Bernabeu Aubán


Time-sensitive services are the base of the cloud services industry. Keeping low service saturation is essential for controlling response time. All auto-scalable services make use of reactive auto-scaling. However, reactive auto-scaling has few in-depth studies. This presentation shows a model for reactive auto-scaling methodologies with a MAPE-k architecture. Queuing theory can compute different properties of static services but lacks some parameters related to the transition between models. Our model uses queuing theory parameters to relate the transition between models. It associates MAPE-k related times, the sampling frequency, the cooldown period, the number of requests that an instance can handle per unit of time, the number of incoming requests at a time instant, and a function that describes the acceleration in the service's ability to handle more requests. This model is later used as a solution to horizontally auto-scale time-sensitive services composed of microservices, reevaluating the model’s parameters periodically to allocate resources. The solution requires limiting the acceleration of the growth in the number of incoming requests to keep a constrained response time. Business benefits determine such limits. The solution can add a dynamic number of instances and remains valid under different system sizes. The study includes performance recommendations to improve results according to the incoming load shape and business benefits. The exposed methodology is tested in a simulation. The simulator contains a load generator and a service composed of two microservices, where the frontend microservice depends on a backend microservice with a 1:1 request relation ratio. A common request takes 2.3 seconds to be computed by the service and is discarded if it takes more than 7 seconds. Both microservices contain a load balancer that assigns requests to the less loaded instance and preemptively discards requests if they are not finished in time to prevent resource saturation. When load decreases, instances with lower load are kept in the backlog where no more requests are assigned. If the load grows and an instance in the backlog is required, it returns to the running state, but if it finishes the computation of all requests and is no longer required, it is permanently deallocated. A few load patterns are required to represent the worst-case scenario for reactive systems: the following scenarios test response times, resource consumption and business costs. The first scenario is a burst-load scenario. All methodologies will discard requests if the rapidness of the burst is high enough. This scenario focuses on the number of discarded requests and the variance of the response time. The second scenario contains sudden load drops followed by bursts to observe how the methodology behaves when releasing resources that are lately required. The third scenario contains diverse growth accelerations in the number of incoming requests to observe how approaches that add a different number of instances can handle the load with less business cost. The exposed methodology is compared against a multiple threshold CPU methodology allocating/deallocating 10 or 20 instances, outperforming the competitor in all studied metrics.

Keywords: reactive auto-scaling, auto-scaling, microservices, cloud computing

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6 The Effect of the Spinacia oleracea Extract on the Control of the Green Mold 'Penilillium digitatum' at the Post Harvested Citrus

Authors: Asma Chbani, Douaa Salim, Josephine Al Alam, Pascale De Caro


Penicillium digitatum, the causal agent of citrus green mold, is responsible for 90% of post-harvest losses. Chemical fungicides remain the most used products for protection against this pathogen but are also responsible for damage to human health and the environment. The aim of this study is to evaluate the ability of Spinacia oleracea extract to serve as biological control agents, an alternative to harmful synthetic fungicides, against orange decay for storing fruit caused by P. digitatum. In this study, we studied the implication of a crude extract of a green plant, Spinacia oleracea, in the protection of oranges against P. digitatum. Thus, in vivo antifungal tests as well as adhesion test were done. For in vivo antifungal test, oranges were pulverized with the prepared crude extracts at different concentrations ranged from 25 g L⁻¹ to 200 g L⁻¹, contaminated by the fungus and then observed during 8 weeks for their macroscopic changes at 24°C. For adhesion test, the adhesion index is defined as the number of Penicillium digitatum spores fixed per orange cell. An index greater than 25 is the indicator of a strong adhesion, whereas for an index less than 10, the adhesion is low. Ten orange cells were examined in triplicate for each extract, and the averages of adherent cells were calculated. Obtained results showed an inhibitory activity of the Penicillium development with the aqueous extract of dry Spinacia oleracea with a concentration of 50 g L⁻¹ considered as the minimal protective concentration. The prepared extracts showed a greater inhibition of the development of P. digitatum up to 10 weeks, even greater than the fungicide control Nystatin. Adhesion test’s results showed that the adhesion of P. digitatum spores to the epidermal cells of oranges in the presence of the crude spinach leaves extract is weak; the mean of the obtained adhesion index was estimated to 2.7. However, a high adhesion was observed with water used a negative control. In conclusion, all these results confirm that the use of this green plant highly rich in chlorophyll having several phytotherapeutic activities, could be employed as a great treatment for protection of oranges against mold and also as an alternative for chemical fungicides.

Keywords: Penicillium digitatum, Spinacia oleracea, oranges, biological control, postharvest diseases

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5 Journal Bearing with Controllable Radial Clearance, Design and Analysis

Authors: Majid Rashidi, Shahrbanoo Farkhondeh Biabnavi


The hydrodynamic instability phenomenon in a journal bearing may occur by either a reduction in the load carried by journal bearing, by an increase in the journal speed, by change in the lubricant viscosity, or a combination of these factors. The previous research and development work done to overcome the instability issue of journal bearings, operating in hydrodynamic lubricate regime, can be categorized as follows: A) Actively controlling the bearing sleeve by using piezo actuator, b) Inclusion of strategically located and shaped internal grooves within inner surface of the bearing sleeve, c) Actively controlling the bearing sleeve using an electromagnetic actuator, d)Actively and externally pressurizing the lubricant within a journal bearing set, and e)Incorporating tilting pads within the inner surface of the bearing sleeve that assume different equilibrium angular position in response to changes in the bearing design parameter such as speed and load. This work presents an innovative design concept for a 'smart journal bearing' set to operate in a stable hydrodynamic lubrication regime, despite variations in bearing speed, load, and its lubricant viscosity. The proposed bearing design allows adjusting its radial clearance for an attempt to maintain a stable bearing operation under those conditions that may cause instability for a bearing with a fixed radial clearance. The design concept allows adjusting the radial clearance at small increments in the order of 0.00254 mm. This is achieved by axially moving two symmetric conical rigid cavities that are in close contact with the conically shaped outer shell of a sleeve bearing. The proposed work includes a 3D model of the bearing that depicts the structural interactions of the bearing components. The 3D model is employed to conduct finite element Analyses to simulate the mechanical behavior of the bearing from a structural point of view. The concept of controlling of the radial clearance, as presented in this work, is original and has not been proposed and discuss in previous research. A typical journal bearing was analyzed under a set of design parameters, namely r =1.27 cm (journal radius), c = 0.0254 mm (radial clearance), L=1.27 cm (bearing length), w = 445N (bearing load), μ = 0.028 Pascale (lubricant viscosity). A shaft speed as 3600 r.p.m was considered, and the mass supported by the bearing, m, is set to be 4.38kg. The Summerfield Number associated with the above bearing design parameters turn to be, S=0.3. These combinations resulted in stable bearing operation. Subsequently, the speed was postulated to increase from 3600 r.p.mto 7200 r.p.m; the bearing was found to be unstable under the new increased speed. In order to regain stability, the radial clearance was increased from c = 0.0254 mm to0.0358mm. The change in the radial clearance was shown to bring the bearing back to stable an operating condition.

Keywords: adjustable clearance, bearing, hydrodynamic, instability, journal

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4 A Systematic Review of Efficacy and Safety of Radiofrequency Ablation in Patients with Spinal Metastases

Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton


Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

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3 Human 3D Metastatic Melanoma Models for in vitro Evaluation of Targeted Therapy Efficiency

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


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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2 Bio-Functionalized Silk Nanofibers for Peripheral Nerve Regeneration

Authors: Kayla Belanger, Pascale Vigneron, Guy Schlatter, Bernard Devauchelle, Christophe Egles


A severe injury to a peripheral nerve leads to its degeneration and the loss of sensory and motor function. To this day, there still lacks a more effective alternative to the autograft which has long been considered the gold standard for nerve repair. In order to overcome the numerous drawbacks of the autograft, tissue engineered biomaterials may be effective alternatives. Silk fibroin is a favorable biomaterial due to its many advantageous properties such as its biocompatibility, its biodegradability, and its robust mechanical properties. In this study, bio-mimicking multi-channeled nerve guidance conduits made of aligned nanofibers achieved by electrospinning were functionalized with signaling biomolecules and were tested in vitro and in vivo for nerve regeneration support. Silk fibroin (SF) extracted directly from silkworm cocoons was put in solution at a concentration of 10wt%. Poly(ethylene oxide) (PEO) was added to the resulting SF solution to increase solution viscosity and the following three electrospinning solutions were made: (1) SF/PEO solution, (2) SF/PEO solution with nerve growth factor and ciliary neurotrophic factor, and (3) SF/PEO solution with nerve growth factor and neurotrophin-3. Each of these solutions was electrospun into a multi-layer architecture to obtain mechanically optimized aligned nanofibrous mats. For in vitro studies, aligned fibers were treated to induce β-sheet formation and thoroughly rinsed to eliminate presence of PEO. Each material was tested using rat embryo neuron cultures to evaluate neurite extension and the interaction with bio-functionalized or non-functionalized aligned fibers. For in vivo studies, the mats were rolled into 5mm long multi-, micro-channeled conduits then treated and thoroughly rinsed. The conduits were each subsequently implanted between a severed rat sciatic nerve. The effectiveness of nerve repair over a period of 8 months was extensively evaluated by cross-referencing electrophysiological, histological, and movement analysis results to comprehensively evaluate the progression of nerve repair. In vitro results show a more favorable interaction between growing neurons and bio-functionalized silk fibers compared to pure silk fibers. Neurites can also be seen having extended unidirectionally along the alignment of the nanofibers which confirms a guidance factor for the electrospun material. The in vivo study has produced positive results for the regeneration of the sciatic nerve over the length of the study, showing contrasts between the bio-functionalized material and the non-functionalized material along with comparisons to the experimental control. Nerve regeneration has been evaluated not only by histological analysis, but also by electrophysiological assessment and motion analysis of two separate natural movements. By studying these three components in parallel, the most comprehensive evaluation of nerve repair for the conduit designs can be made which can, therefore, more accurately depict their overall effectiveness. This work was supported by La Région Picardie and FEDER.

Keywords: electrospinning, nerve guidance conduit, peripheral nerve regeneration, silk fibroin

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1 Understanding Stock-Out of Pharmaceuticals in Timor-Leste: A Case Study in Identifying Factors Impacting on Pharmaceutical Quantification in Timor-Leste

Authors: Lourenco Camnahas, Eileen Willis, Greg Fisher, Jessie Gunson, Pascale Dettwiller, Charlene Thornton


Stock-out of pharmaceuticals is a common issue at all level of health services in Timor-Leste, a small post-conflict country. This lead to the research questions: what are the current methods used to quantify pharmaceutical supplies; what factors contribute to the on-going pharmaceutical stock-out? The study examined factors that influence the pharmaceutical supply chain system. Methodology: Privett and Goncalvez dependency model has been adopted for the design of the qualitative interviews. The model examines pharmaceutical supply chain management at three management levels: management of individual pharmaceutical items, health facilities, and health systems. The interviews were conducted in order to collect information on inventory management, logistics management information system (LMIS) and the provision of pharmaceuticals. Andersen' behavioural model for healthcare utilization also informed the interview schedule, specifically factors linked to environment (healthcare system and external environment) and the population (enabling factors). Forty health professionals (bureaucrats, clinicians) and six senior officers from a United Nations Agency, a global multilateral agency and a local non-governmental organization were interviewed on their perceptions of factors (healthcare system/supply chain and wider environment) impacting on stock out. Additionally, policy documents for the entire healthcare system, along with population data were collected. Findings: An analysis using Pozzebon’s critical interpretation identified a range of difficulties within the system from poor coordination to failure to adhere to policy guidelines along with major difficulties with inventory management, quantification, forecasting, and budgetary constraints. Weak logistics management information system, lack of capacity in inventory management, monitoring and supervision are additional organizational factors that also contributed to the issue. There were various methods of quantification of pharmaceuticals applied in the government sector, and non-governmental organizations. Lack of reliable data is one of the major problems in the pharmaceutical provision. Global Fund has the best quantification methods fed by consumption data and malaria cases. There are other issues that worsen stock-out: political intervention, work ethic and basic infrastructure such as unreliable internet connectivity. Major issues impacting on pharmaceutical quantification have been identified. However, current data collection identified limitations within the Andersen model; specifically, a failure to take account of predictors in the healthcare system and the environment (culture/politics/social. The next step is to (a) compare models used by three non-governmental agencies with the government model; (b) to run the Andersen explanatory model for pharmaceutical expenditure for 2 to 5 drug items used by these three development partners in order to see how it correlates with the present model in terms of quantification and forecasting the needs; (c) to repeat objectives (a) and (b) using the government model; (d) to draw a conclusion about the strength.

Keywords: inventory management, pharmaceutical forecasting and quantification, pharmaceutical stock-out, pharmaceutical supply chain management

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