With the rapidly growing pandemic of COVID-19 caused by the new and challenging to treat zoonotic SARS-CoV2 coronavirus, there is an urgent need for new therapies and prevention strategies that can help curtail disease spread and reduce mortality. Inhibition of viral entry and thereby spread constitute plausible therapeutic avenues. Similar to other respiratory pathogens, SARS-CoV2 is transmitted through respiratory droplets, with potential for aerosol and contact spread. It uses receptor-mediated entry into the human host via angiotensin-converting enzyme II (ACE2) that is expressed in lung tissue, as well as oral and nasal mucosa, kidney, testes, and the gastrointestinal tract. Modulation of ACE2 levels in these gateway tissues may prove a plausible strategy for decreasing disease susceptibility. Cannabis sativa, especially one high in the anti-inflammatory cannabinoid cannabidiol (CBD), has been proposed to modulate gene expression and inflammation and harbour anti-cancer and anti-inflammatory properties. Working under the Health Canada research license, we have developed over 800 new Cannabis sativa lines and extracts and hypothesized that high-CBD C. sativa extracts may be used to modulate ACE2 expression in COVID-19 target tissues. Screening C. sativa extracts using artificial human 3D models of oral, airway, and intestinal tissues, we identified 13 high CBD C. sativa extracts that modulate ACE2 gene expression and ACE2 protein levels. Our initial data suggest that some C. sativa extract down-regulate serine protease TMPRSS2, another critical protein required for SARS-CoV2 entry into host cells. While our most effective extracts require further large-scale validation, our study is crucial for the future analysis of the effects of medical cannabis on COVID-19. The extracts of our most successful and novel high CBD C. sativa lines, pending further investigation, may become a useful and safe addition to the treatment of COVID-19 as an adjunct therapy. They can be used to develop easy-to-use preventative treatments in the form of mouthwash and throat gargle products for both clinical and at-home use. Such products ought to be tested for their potential to decrease viral entry via the oral mucosa. Given the current dire and rapidly evolving epidemiological situation, every possible therapeutic opportunity and avenue must be considered.

The 2019 Coronavirus pandemic which was initially referred to as 2019-nCoV, was first identified in Wuhan, China. Early response from the Chinese government included quarantine of infected persons, isolation and total lockdown of Wuhan province to prevent further spread. With the spread of the disease across national borders and declaration of the disease as a global pandemic, there has been a robust response by the international community to contain this deadly virus and prevent its further spread worldwide. Africa is not left out of this rampaging pandemic with documented cases in over 40 countries and still rising. Although extensive studies have been carried out on the novel SARS-CoV-2 on its pathogenesis, mode of infection and virulence but much is still unknown. However, potentially infectious samples are received routinely in the medical laboratory for analysis. This technical note reviews good laboratory practice (GLP) and processes across the different specialities of Medical Laboratory practice that should minimize the risk of infection to laboratory staff especially in resource-limited settings.

Bacteriophages can provide alternative measures for the control of E. coli O157:H7 that is currently an emerging food-borne pathogen of severe public health concern. This study was aimed at characterising E. coli O157:H7 specific phages as potential biocontrol agents for these pathogens. Fifteen phages were isolated and screened against 69 environmental E. coli O157:H7. Only 3 phages displayed broad lytic spectra against environmental shiga toxin-producing E. coli O157:H7 strains. These 3 lytic phages were designated V3, V7 and V8. Subsequent characterization indicated that they displayed very high degree of similarities despite isolation from different locations. Transmission Electron microscopy (TEM) of the phages revealed that they all had isometric heads of about 73 – 77 nm in diameter and short tails ranging from 20 - 25 nm in diameter. Phages V3, V7 and V8 were assigned to the family Podoviridae based on their morphology. Pulsed field gel electrophoresis (PFGE) genome estimation of the 3 phages demonstrated identical genome sizes of ~ 69 nm. The latent periods of these phages were 20 min, 15 min, and 20 min for V3, V7 and V8 respectively while the burst sizes were 374, 349 and 419 PFU/ infected cell respectively. While all the phages were relatively stable over a wide range of salinity, temperatures and pH values, their range of infectivity or lytic profile was rather narrow on environmental E. coli O157:H7 strains isolated from cattle faeces. This study showed that the Podoviridae bacteriophages are the dominant E. coli O57:H7-infecting phages harboured in cattle faeces in the North-West Province of South Africa and due to their favourable characteristics can be exploited in the formulation of phage cocktails for the bio-control of E. coli O157:H7 in meat and other meat products.

Malaysia implemented a movement control order (MCO) to curb the spread of the SARS-CoV-2 virus in March 2020. Despite healthcare services remaining operational, rising COVID-19 infections and MCO restrictions have forced healthcare professionals to seek a compromise between service capacity and standard operating procedure compliance. A cross-sectional survey was conducted among public and private sector doctors, dentists and pharmacists to determine how lockdown measures impacted healthcare services. Responses from 413 doctors, 193 dentists, and 163 pharmacists were analysed. Pharmacy services remained mostly unaffected throughout the MCO. In contrast, operational capacities for surgical and dental services were severely affected during the MCO. All service sectors reported restricting patients or accompanying individuals at the workplace, reductions in staffing capacity, and shortened patient contact time at various degrees. Many pharmacy and medical participants reported supplying extended medication supplies to patients. Adoption of virtual healthcare services was generally poor. All private service sectors suffered financial losses ranging between 59 to 75%. Periodic assessments of the healthcare system throughout the pandemic are required to identify which patients have their treatment compromised so that healthcare managers and policy makers can plan and implement appropriate interventions that help alleviate pressure within the health system.

Instead of simplified steady-state models, with modern computers, one can solve the complete aero-thermodynamics happening in gas turbine engines. In the present article, we describe a mathematical model and numerical procedure to represent the transient response of a PT6A gas turbine engine operating at off-design conditions. The aero-thermal model consists of a set of algebraic and ordinary differential equations that arise from the application of the mass, linear momentum, angular momentum, and energy balances in each engine's component. The solution code has been developed in Matlab-Simulink using a block-oriented approach. Transient simulations of the PT6A engine start-up have been carried out by changing the original Jet-A1 fuel with biodiesel blends. Time plots of the main thermodynamic variables are shown, especially those regarding the structural integrity of the burner. Numerical results have been validated against reported experimental measurements and GasTurb simulations. The computer model has been capable to predict acceptable fuel blends, such that the real PT6A engine can be substituted to avoid the risk of damaging it.

Food handlers’ medical examinations are mandated by most countries as a way of safeguarding the health and safety of consumers. Food-borne diseases are an important cause of morbidity and mortality. In Zimbabwe, the use of chest radiographs and throat and rectal swab tests are a requirement during food handlers’ medical examinations. This study aimed at exploring the patterns and outcomes of physical medical examinations, chest radiographs, and other tests of food handlers. A cross-sectional review of retrospective occupational health records was carried out. The mean age for the study population was 37 years with an age range of 21 to 56 years. Males accounted for 73% of the study participants. All of the 157 rectal swabs were normal and did not culture any organism. Fifteen percent (24) of the throat swabs cultured one or more organisms. Ninety-seven percent of chest radiographs were normal. Ninety-seven percent of employees were certified as fit. Thirty-six percent of the food handlers were in the overweight and obese categories. Hypertension and high blood pressure were common conditions in the study sample. It can be concluded that routine radiological and laboratory testing of the food handlers in this study was of little value.

Thermal sterilization is generally avoided for 3-D printed components because of the relatively low deformation temperatures for common thermoplastics used for material extrusion-based additive manufacturing. 3-D printing materials required for high-temperature heat sterilizable components for COVID-19 and other applications demands 3-D printers with heated beds, hot ends that can reach higher temperatures than polytetrafluoroethylene (PTFE) hot ends and heated chambers to avoid part warping and delamination. There are several high temperature printers on the market, but their high costs make them inaccessible for full home-based distributed manufacturing required during pandemic lockdowns. To allow for all these requirements to be met for under $1,000, the Cerberus – an open source three-headed self-replicating rapid prototyper (RepRap) was designed and tested with the following capabilities: i) 200^oC-capable heated bed, ii) 500^oC-capabel hot end, iii) isolated heated chamber with 1kW space heater core and iv) mains voltage chamber and bed heating for rapid start. The Cereberus successfully prints polyetherketoneketone (PEKK) and polyetherimide (PEI, ULTEM) with tensile strengths of 77.5 and 80.5 MPa, respectively. As a case study, open source face masks were 3-D printed in PEKK and shown not to warp upon widely home-accessible oven-based sterilization.

In the era when the market segment of Internet of Things (IoT) tops the chart in various business reports, it is apparently envisioned that the field of medicine expects to gain a large benefit from the explosion of wearables and internet-connected sensors that surround us to acquire and communicate unprecedented data on symptoms, medication, food intake, and daily-life activities impacting one’s health and wellness. However, IoT-driven healthcare would have to overcome many barriers, such as: 1) There is an increasing demand for data storage on cloud servers where the analysis of the medical big data becomes increasingly complex; 2) The data, when communicated, are vulnerable to security and privacy issues; 3) The communication of the continuously collected data is not only costly but also energy hungry; 4) Operating and maintaining the sensors directly from the cloud servers are non-trial tasks.This book chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog Computing is a serviceoriented intermediate layer in IoT, providing the interfaces between the sensors and cloud servers for facilitating connectivity, data transfer, and queryable local database. The centerpiece of Fog computing is a low-power, intelligent, wireless, embedded computing node that carries out signal conditioning and data analytics on raw data collected from wearables or other medical sensors and offers efficient means to serve telehealth interventions. We implemented and tested an fog computing system using the Intel Edison and Raspberry Pi that allows acquisition, computing, storage and communication of the various medical data such as pathological speech data of individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate estimation, and Electrocardiogram (ECG)-based Q, R, S detection. The book chapter ends with experiments and results showing how fog computing could lessen the obstacles of existing cloud-driven medical IoT solutions and enhance the overall performance of the system in terms of computing intelligence, transmission, storage, configurable, and security. The case studies on various types of physiological data shows that the proposed Fog architecture could be used for signal enhancement, processing and analysis of various types of bio-signals.

At present, medical institutes generally use EMR to record patient's condition, including diagnostic information, procedures performed and treatment results. EMR has been recognized as a valuable resource for large scale analysis. However, EMR has the characteristics of diversity, incompleteness, redundancy and privacy, which make it difficult to carry out data mining and analysis directly. Therefore, it is necessary to preprocess the source data in order to improve data quality and improve the data mining results. Different types of data require different processing technologies. Most structured data commonly needs classic preprocessing technologies, including data cleansing, data integration, data transformation and data reduction. For semi-structured or unstructured data, such as medical text, containing more health information, it requires more complex and challenging processing methods. The task of information extraction for medical texts mainly includes NER (Named Entity Recognition) and RE (Relation Extraction). In this paper, we introduce the process of EMR processing, including data collection, data preprocessing, data mining, evaluation and knowledge application, analyze the current status of the key technologies, such as data preprocessing and data mining, and provide an overview of the application domains and prospects of EMR mining technologies. Finally, we summarize the existing problems in the research of EMR mining, and review the development trends.

This study was undertaken to investigate and analyze noise pollution in a large Chinese governmental hospital’s medical intensive care unit and compare to the WHO guidelines.This cross-sectional study was conducted in a MICU at a public governmental teaching hospital in Fujian province between July and August of 2017. A WENSN® WS1361 Integrated Sound Level Meter (China) was used for continuous every five seconds one week noise levels recording. After this measurement, the decibel meter was used for recording different location of isolation rooms and open bays, including occupied and unoccupied patient, and recording sound events occurs in the ICU to identify sources of noise. Peak and average noise levels were obtained from the meter, and data were downloaded from the WS1361 into a laptop computer. The measured mean equivalent sound pressure levels (L) and standard Aeq deviation over one week period were 66.64±7.57 dB(A), with acute spikes reaching 119.7 dB(A), the average sound level for a 24 hour period in a work day was 68.03±5.07 dB(A). These are higher than the current daytime environmental noise limit of 40-45 decibels in China and WHO. Mean work day noise was significantly louder than weekend time, there was a significant difference in work days and weekend (t=16.85;P=0.000).There was a statistical difference between the day time and night time shifts (t=34.67;P=0.000). The isolation rooms were significantly quieter than the open-bay rooms(t=46.15; p=0.00), sound levels in the occupied and unoccupied rooms also had significant difference(t=17.26; P=0.000).Two types of noise resources, including twenty kinds sources were identified and measured, mean noise levels ranged from of 61.33 to 79.21 dB(A). This study shows noise levels in intensive care units were exceeded the recommended. The study of the influence of noise on patient and staff is needed, and noise reduction strategies must be conduct in ICU.

Not a lot is known about either death or the dying process. Politicians and many in the medical profession in the UK tend to shy away from interfering with it by not allowing euthanasia as an end of life option for the patient. This is the first paper in a series of two, comparing the situation in human medicine and veterinary medicine, in which euthanasia is well practiced for relieving suffering at the end of an animal’s life. This first part takes the form of a literature review including best practice around end of life care, its deficiencies and the need for assisted dying. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. In countries which have legalized physician assisted suicide for the terminally ill reporting indicates that it works well, without increases in involuntary euthanasia and most importantly without intimidation of the vulnerable. However, there is still an ever increasing tendency to overuse sedation and opioids at the end of life, which merits further investigation. With advances in medical science able to significantly prolong the dying process, patient autonomy demands a review of the law in the UK.

Background: Since the advent of virtual reality (VR), it has been used in medical education for surgical training and anatomy teaching. Recently, other modalities of extended reality (XR) such as augmented reality (AR) and mixed reality (MR) has also made its way into medical education. Although there has been research validating XR’s use in medical education, there have been few studies on the research trends of the different XR modalities. The paper aims to compare the research trends of the XR modalities in general and in terms of the medical fields studied and outcomes measured. Methods: Web of Science was searched, and preliminary data was extracted to analyze the general trend. Inclusion and exclusion criteria were then applied, and finalized articles were analyzed and grouped based on the medical field studied and outcomes measured. Results: 31 articles on VR, eight on AR and one on MR were included in the final analysis. We found that there is increasing research in VR since 1990 and AR since 2008. The research in MR is constant. Most of the papers on VR studied endoscopic surgery and anatomy whereas AR studied mostly anatomy and endovascular procedures. Using Miller’s prism of clinical competence, the competency measured most for VR and AR is “show”. Discussion and conclusion: Advancement in computing, communication and display technologies since 1990 may contribute to the increase in research on VR whereas the ubiquity of smartphone since 2008 may explain the increase in research on AR. Although both VR and AR are used in surgical training and anatomy teaching, we found possible strengths of VR in counseling and AR in practical skills. The competency "show" was measured most as most of the papers were on surgery, and the XR simulators used can capture surgical parameters

Rice is considered as the most important crop for most of the world population. Utilization of seaweed as bio-stimulant can be an alternative way to enhance rice plant growth and productivity, as well as a strategic move to reduce the use of inorganic fertilizer that is harmful to the environment. Seaweed and its derivative products have been widely used as bio-stimulant in the agricultural industry because of their potential use in increasing plant growth and productivity. Auxins, gibberellins, and cytokinin are some of growth regulators found in seaweed extract, as well as macro and micronutrients required for plant growth and development. Several studies have found that seaweed extract has a variety of favorable effects as a plant growth promoter, including early seed germination and establishment, improved nutritional quality, increased yield and crop performance, and increased tolerance to environmental stress. The purpose of this paper is to give a comprehensive overview of the impacts of several seaweed species on seed germination, crop development and production, enhancement of rice plants (Oryza sativa) nutritional quality and the modes of action of seaweed extract includes the chemical components that might be causing plant physiological changes.

With recent focus on deep neural network architectures for development of algorithms for computer-aided diagnosis (CAD), we provide a review of studies within the last 3 years (2015-2017) reported in selected top journals and conferences. 29 studies that met our inclusion criteria were reviewed to identify trends in this field and to inform future development. Studies have focused mostly on cancer-related diseases within internal medicine while diseases within gender-/age-focused fields like gynaecology/pediatrics have not received much focus. All reviewed studies employed image datasets, mostly sourced from publicly available databases (55.2%) and few based on data from human subjects (31%) and non-medical datasets (13.8%), while CNN architecture was employed in most (70%) of the studies. Confirmation of the effect of data manipulation on quality of output and adoption of multi-class rather than binary classification also require more focus. Future studies should leverage collaborations with medical experts to aid future with actual clinical testing with reporting based on some generally applicable index to enable comparison. Our next steps on plans for CAD development for osteoarthritis (OA), with plans to consider multi-class classification and comparison across deep learning approaches and unsupervised architectures were also highlighted.

Water and sanitation facilities in sub-Saharan Africa and Africa in general are appalling and for the most part absent. Progress continues with respect to the development of plant materials as potent adsorbents, disinfectants, coagulants, flocculants, wetland species and lots more as substitutes for the dangerous chemical disinfectants. This research presents the potential of phyto-active components of Zanthoxylum zanthoxyloides and Gongronema latifolium as effective biocides against water microbial contaminants. Dry powder of Zanthoxylum zanthoxyloides and Gongronema latifolium were extracted and prepared into different concentrations with ethyl acetate and chloroform, ranging from 25 to 500 mg/ml. These fractions were then examined for antimicrobial activities against inherent bacterial and fungal water contaminants using disc diffusion assay. Fractions were afterwards screened for phytochemical active compounds using standard methods. Crude extracts of the different plant examined selectively comprise saponins, tannins, reducing sugars, anthraquinones, flavonoids, terpenoids, phlobatanins and alkaloids. All plant extracts showed broad spectrum antibiosis against selected gram positive and gram negative bacteria including E. coli, P. aeruginosa, Klebsiella sp, S. pneumoniae and B. cereus, as well as tested fungi, including A. niger, A. flavus, Trichoderma sp and Candida sp. While all extracts exhibited maximum antibiosis at 500 mg/ml, the chloroform extracts compared well than ethyl acetate extracts. The overall results revealed that antimicrobial activities of the plant extracts are dose dependent with comparative activity greater than that of commercial antibiotics at the concentration of extracts tested. E.coli was the most susceptible microbial isolate tested and represents the potential of the extract against a group of coliform which are important indicators of microbial pollution in water. Other microbial isolates also recorded sensitivity to extracts tested at varying degrees. The findings indicate that microbes tested were mostly susceptible to chloroform extract of Z. zanthoxyloides and G. latifolium except for the activity of ethyl acetate extract of Z. zanthoxyloide against E.coli. Results of phytochemical screening of the extract also showed the varied presence of alkaloids, saponins, tannins, flavonoids, terpenoids and anthraquinones The results indicated that plant materials investigated can be developed as effective biocides against water microbial contaminants

This paper presents an overview of the principal structural and dynamics characteristics of reverse micelles (RMs) in order to highlight their structural flexibility and versatility, along with the possibility to modulate their parameters in a controlled-manner. The multifunctionality in a large range of different scientific fields is exemplified in two distinct directions: a theoretical model for mimicry of biological microenvironment and practical application in the field of nanotechnology and nano-based sensors. RMs represents a convenient experimental approach that limits the drawbacks of the conventionally biological studies in vitro, while the particular structure confers them the status of simplified mimics of cells by reproducing a complex supramolecular organization in an artificial system. The biological relevance of RMs is discussed in some particular cases referring to the confinement and crowding environment, molecular dynamics of water and cell membrane structure. The use of RMs in different range of applications seems to be more promising due to their structural and compositional flexibility, a high efficiency and selectivity being achieved. The advance in nanotechnology is based on developing new methods of nanomaterials synthesis and deposition. This review highlighting the advantages of using RMs in synthesis of nanoparticles with specific properties and in nano (bio)sensors design.

1) Background: The environmental, financial and social questions in Africa remain unanswered up-to-date, with the rapid increase in human population and the demand for fuel energy, trigger the need to generate data on the socio-economic factors influencing the knowledge of use and adoption of family-sized bio-digesters. The increasing prices of fossil fuels and taxes on energy sources require finding the alternative, clean and economical sources of energy for households in developing countries. Moreover, in Africa, the consumption of firewood and charcoal continues to increase, with wood fuel consumption predicted to increase by 2030 to over 140%. The study objectives were 1) to determine the socio-economic characteristics of the people in Ngoma district, 2) to assess socio-economic factors influencing people to use and adopt family-sized bio-digesters. 2) Methods: Quantitative data collected with semi-structured questionnaires and interviews were analyzed using descriptive statistics. 3) Results: The results show that many households had not realized the potential benefits of biogas use and adoption in Rwanda. The study further found that a number of factors such as household income levels, socio-economic, technological, and institutional influence the household use and adoption of biogas energy. 4) Conclusions: At the end, the study suggests the need for all players such as Government, Non-Governmental Organizations (NGO's) and local communities to work together to provide incentives and favorable environment that can attract individual households to invest in biogas energy production and utilization.

This is the second of a series of two papers comparing the end of life issues in human and veterinary medicine. We outline the main differences between human and animal patients such as patient communication, finance and ‘conflicts of interest’ between animal, owner and veterinarian. We discuss striking similarities between human and veterinary issues such as assessing quality of life and the primary role of the attending veterinarian or doctor being the welfare and care of the patient. This paper takes the form of an ethical argument in favour of allowing euthanasia in human medicine, by providing insights into end of life issues for humans from an independent veterinary perspective. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. Doctors in the UK are limited and unwilling to put forward a case for the option of euthanasia for those patients who face a slow and agonizing death. With advances in medical science being able to significantly prolong the dying process, autonomy for the patient demands a review of the law regarding patient choice in the UK.

The possibility of using additive manufacturing (AM) in the medicine area has created a new opportunities in health care. This has contributed to a sharp increase in demand for 3D printers, their systems and materials that are adapted to strict medical requirements. We described herein a medical-grade thermoplastic polyurethane (S-TPU), which was developed and then formed into a filament for Fused Deposition Modeling (FDM) 3D printers during a melt-extrusion process. S-TPU consisting of aliphatic hexamethylene 1,6-diisocyanate (HDI), amorphous α,ω-dihydroxy(ethylene-butylene adipate) (PEBA) and 1,4 butandiol (BDO) as a chain extender, was synthesized without the use of a catalyst. The filament properties were characterized by rheological, mechanical, physico-chemical and in vitro biological properties. The tests showed biocompatibility of the obtained filament as well as revealed no significant effect of the filament formation process on its properties. This study may contribute to expanding the range of medical-grade flexible filaments for standard low-budget FDM printers.

Mechanical ventilation systems, which are used for breathing support when a person is not able to do it by their own, requires a device for measuring the air flow to the patient in order to monitoring and a assure the magnitude establish by a medical staff. Flow sensors are the conventional devices used for the air flow measuring; however, there were not available in Peru, because of the international demand during COVID-19 pandemic. In this sense, a novel air flow sensor based on orifice plate and an intelligent transducer stage were developed as an integrated design. Advanced methodologies in simulations and experiments using specially designed equipment for this application were carried out. The obtained data was used for a mathematical characterization and dimensions validation of the integrated design. The device was tested in its real working conditions, it was implemented in a breathing circuit connected to a low-cost mechanical ventilation system based on cams. Results indicate that the designed air flow sensor/transducer is a low-cost complete medical device for mechanical ventilators able to provide satisfactorily all the ventilation parameters air flow, pressure and volume over time by measuring the air flow and calculating the others. Furthermore, this device provides directly a filtered equivalent electrical signal for a display or a computer.

During the COVID-19 pandemic, conducting face-to-face medical residency interviews was challenging due to infection prevention precautions, social distancing and travel restrictions. Virtual interviews were implemented by the Saudi Commission for Health Specialties (SCFHS) as an alternative process for residency matching while striving to maintain the same quality standards. This national survey was conducted to assess the satisfaction and perceptions of faculty members’ virtual interviews performance in the assessment for the medical training residency programs. Among the participating 173 faculty members (34.1%) did not have previous experience with video-conferencing. Zoom application was the most commonly used platform (65.9%). Most (89.6%) of the faculty perceived virtual interviews as “adequate” for the candidates to express themselves, while almost half of the faculty (53.8%) agreed that virtual interviews allowed them to accurately reach an impression about the candidates. Overall, 73.4% of faculty felt comfortable ranking the virtually interviewed candidates. We conclude that the acceptance of participating faculty members in the first Saudi medical residency training matching cycle virtual interviewing event was well perceived. This study provides evidence for future application and research of virtual interviews in residency candidates' assessment, especially after the pandemic crisis resolves.

Crosslinking of proteins for their irreversible immobilization on surfaces is a proven and popular method. However, many protocols lead to random orientation and the formation of undefined or even inactive by-products. Most concepts to obtain a more targeted conjugation or immobilization requires the recombinant modification of at least one binding partner, which is often impractical or prohibitively expensive. Here a novel method is presented, which is based on the chemical preactivation of Protein A or G with selected conventional crosslinkers. In a second step, the antibody is added, which is subsequently crosslinked in the Fc part. This leads to an oriented and covalent immobilization of the immunoglobulin with a very high yield. Protocols for Protein A and Protein G with murine and human IgG are presented. This method may be useful for the preparation of columns for affinity chromatography, immunoprecipitation, antibodies conjugated to magnetic particles, permanent and oriented immobilization of antibodies in biosensor systems, microarrays, microtitration plates or any other system, where the loss of antibodies needs to be avoided, and maximum binding capacity is desired. This method is directly applicable even to antibodies in crude cell culture supernatants, raw sera or protein-stabilized antibody preparations without any purification nor enrichment of the IgG. This new method delivered much higher signals as a traditional method and, hence, seems to be preferable in many applications.

In this paper, the far field and near field optical responses of a gold nanoparticle are studied and simulated numerically. The electromagnetic field was excited by an electric dipole located near one end of the nanorod, which is used to model the emission of a quantum dot. Another excitation method was also simulated in which an incident plane wave is used. The excitation of dark plasmon modes of the gold nanorod is presented. The Poynting equation was solved numerically to study the influence of the gold nanorod on the dipole radiative power. In addition, the extinction cross section of the gold nanoparticle illuminated by the incident plane wave was calculated to estimate the amount of the scattered and absorbed light.

This paper investigates existing mathematical morphology based techniques applied for performing malaria parasites detection and identification in both Giemsa and Leishman stained blood smears images. Malaria is an epidemic health disease and a rapid, accurate diagnosis is necessary for proper intervention. Generally, pathologists visually examine blood stained slides for malaria diagnosis; this kind of visual inspection is subjective, errorprone and time consuming. In order to cope with such issues, computer-aided methods have been increasingly evolved for abnormal erythrocyte and/or parasites detection, segmentation and semi/fully automated classification. The aim of this paper is to present a review of recent mathematical morphology based methods for malaria parasite detection.

Phloem-feeding insects strive to offset the disadvantageous effects of stressors to sustain their offspring and survive. Adaptive responses to environmental stress are not well understood under complex influences of companion planting, natural enemies, and host gradient. In this study, under predation by lacewing Chrysoperla carnea Stephens (Neuroptera: Chrysopidae), we survey the responses of green peach aphid Myzus persicae Sulzer (Hemiptera: Aphididae), reared on different densities of cabbage Brassica oleracea L. (Brassicales: Brassicaceae) to its shallot companion Allium cepa (L.) var. aggregatum G. Don (Asparagales: Amaryllidaceae). Firstly, aphid aggregative abundance was strongly influenced by shallot perturbation, predator presence and changes in cabbage-host biomass, altering aphid phenotypic plasticity. Interestingly, the shallot and predation negative impacts can be of similar magnitudes. Secondly, changes in the cabbage-host availability and biomass, especially under predation, had a strong impact on aphid traits. Our study underscores the benefits of including shallots as crop-companions in augmenting pest control, but also suggests that the outcome of coupling companion planting with natural enemies is context-dependent and thus should be empirically applied. At the confluence of ecology and agronomy, this work provides insights on how manipulated functional biodiversity may function as an alternative strategy for pestilent herbivory management in model and green-house systems.

The COVID-19 pandemic has wreaked havoc on the whole world, taking over half a million lives and capsizing the world economy in unprecedented magnitudes. With the world scampering for a vaccine, early detection and containment is the only redress. Existing diagnostic technologies with high accuracy like RT-PCRs are expensive and sophisticated, requiring skilled individuals for specimen collection and screening, resulting in lower outreach. So, methods excluding direct human intervention are much sought after, and artificial intelligence-driven automated diagnosis, especially with radiography images, captured the researchers' interest. This survey marks a detailed inspection of the deep-learning-based automated detection of COVID-19 works done to date, a comparison of the available datasets, methodical challenges like imbalanced datasets, and others, along with probable solutions with different pre-processing methods, and scopes of future exploration in this arena. We also benchmarked the performance of 315 deep models in diagnosing COVID-19, Normal, and Pneumonia from x-ray images of a custom dataset created from four others. The dataset is publicly available at https://github.com/rgbnihal2/COVID-19-X-ray-Dataset. Our results show that DenseNet201 model with Quadratic SVM classifier performs the best (accuracy: 98.16%, sensitivity: 98.93%, specificity: 98.77%) and maintains high accuracies in other similar architectures as well. This proves that even though radiography images might not be conclusive for radiologists, but it is so for deep learning algorithms for detecting COVID-19. We hope this extensive review will provide a comprehensive guideline for researchers in this field.

Background: medical devices are designed, tested and placed on the market in a highly regulated environment. Wearable sensors are crucial components of various medical devices: design and validation of wearable sensors, if managed according to international standards, can foster innovation while respecting regulatory requirements. Material and methods: the purpose of this paper is to take into consideration the upcoming EU Medical Device Regulation 2017/245 and the current and future IEC and ISO standards that set methods for design and validation of medical devices, with a focus on wearable sensors. Risk classification according to the regulation is described. The international standards IEC 62304, IEC 60601, ISO 14971 and ISO 13485 are reviewed to define regulatory restrictions during design, pre-clinical validation and clinical validation of devices that include wearable sensors as crucial components. Results: current and future regulatory restrictions are described, and an integrated method for design planning, validation and clinical testing is described Discussion: application of this method to design wearable sensors should be evaluated in the future in order to assess its potentially positive impact to fostering innovation and to the time-to-market of the device.

Distributed digital manufacturing offers a solution to medical supply and technology shortages during pandemics. To prepare for the next pandemic, this study reviews the state-of-the-art for open hardware designs needed in a COVID-19-like pandemic. It evaluates the readiness of the top twenty technologies requested by the Government of India. The results show that the majority of the actual medical products have had some open source development, however, only 15% of the supporting technologies that make the open source device possible are freely available. The results show there is still considerable work needed to provide open source paths for the development of all the medical hardware needed during pandemics. Five core areas of future work are discussed that include: i) technical development of a wide-range of open source solutions for all medical supplies and devices, ii) policies that protect the productivity of laboratories, makerspaces and fabrication facilities during a pandemic, as well as iii) streamlining the regulatory process, iv) developing Good-Samaritan laws to protect makers and designers of open medical hardware, as well as to compel those with knowledge that will save lives to share it, and v) requiring all citizen-funded research to be released with free and open source licenses.

This article presents a new input device for spastic patients and others with similar symptoms. The sensor consists of a disc used to determine positions and can replace standard joysticks in medical devices such as electric-powered wheelchairs. Using a standard joystick while operating a powered wheelchair can result in dangerous situations when spastic movements occur and extremities cramp making them uncontrollable. To avoid this, a disc was developed that can be controlled with any body part. By shifting weight (x- and y-axis) the disc can tilt in any direction creating a proportional output signal and can also be pushed down in the center (z-axis) to open a menu on a screen for example. When spasms occur it is impossible for users to get stuck on the input device because the disc is flat and can be mounted within a control panel. Body parts coming into contact with the disc would merely slide across the disc without triggering unintentional actions. The sensor presented here is also adaptive and can be adjusted to fit a user’s strength and range of motion. This proposal aims to develop an input device that enables spastic patients to operate sensitive systems safely.

How did life begin on Earth? And is there life elsewhere in the Cosmos? Challenging questions, indeed. The series of conferences established by NoR CEL in 2013, addresses these very same questions. The basis for this paper is the summary report of oral presentations that were delivered by NoR CEL’s network members during the 2018 Athens conference and, as such, disseminates the latest research which they have put forward. More in depth material can be found by consulting the contributors referenced papers. Overall, the outcome of this conspectus on the conference demonstrates a case for the existence of “probable chemistry” during the prebiotic epoch.

ChatGPT is gaining widespread acceptance for its ability to generate natural language sentences in response to various inputs and is expected to become a supplementary tool for diagnosing and determining treatment policies in clinical settings. ChatGPT was used to evaluate its ability to perform clinical inference and accuracy in answering questions on the 117th Japanese National Medical Licensing Examination held in February 2023. The exam questions were manually inputted into ChatGPT's window, and the accuracy of ChatGPT's responses was determined based on answers provided by a preparatory school. ChatGPT provided answers for 389 out of 400 questions, and its overall correct answer rate was 55.0%. The correct answer rate for 5-choice-1, 5-choice-2, and 5-choice-3 were 57.8%, 42.9%, and 41.2%, respectively. The highest correct answer rate was for the compulsory exam (67.0%), followed by the specific knowledge exam (54.1%) and the cross category exam (47.9%). The correct answer rate for non-image questions was 56.2% and for image questions, it was 51.5%. The study suggests that ChatGPT has potential to support healthcare professionals in clinical decision-making in Japanese clinical settings, but caution should be exercised in interpreting and using the answers generated by ChatGPT due to room for improvement in performance.

Two of the most common activation functions (AF) in deep neural networks (DNN) training are Sigmoid and ReLU. Sigmoid was tend to be more popular the previous decades, but it was suffering with the common vanishing gradient problems. ReLU has resolved these problems by using zero gradient and not tiny values for negative weights and the value “1” for all positives. Although it significant resolves the vanishing of the gradients, it poses new issues with dying neurons of the zero values. Recent approaches for improvements are in a similar direction by just proposing variations of the AF, such as Leaky ReLU (LReLU), while maintaining the solution within the same unresolved gradient problems. In this paper, the combining of the Sigmoid and ReLU in one single function is proposed, as a way to take the advantages of the two. The experimental results demonstrate that by using the ReLU’s gradient solution on positive weights, and Sigmoid’s gradient solution on negatives, has a significant improvement on performance of training Neural Networks on image classification of diseases such as COVID-19, text and tabular data classification tasks on five different datasets.

The natural forests of Northern Thailand are the mother source of many utilisable natural products because of their diverse flora and fauna. Among many plant species found within Northern Thai forests, detergent plants are known for its distinctive cleansing properties. Several local species of detergent plants in Thailand are traditionally used by the locals and indigenous people. However, these plants may become extinct because their habitats have been replaced by industrial agriculture, and their uses have been replaced by chemically synthesised detergents. Researchers need to study and communicate the biology, phytochemistry, and the importance of these plants to conserve natural biodiversity of Northern Thailand. Of many utilisable detergent phytochemicals, natural saponins are known as bio-surfactant and foaming agents. Their physiochemical and biological properties feature structural diversity, which leads to many industrial applications. In this review, we explained the term “detergent” from the physiological mechanism perspective and the detergent effects of saponin. We also compiled a list of Thai local plants with cleansing properties focusing on the saponin-containing plants. Future studies should investigate information relative to plant environment, ethnobotanical data and bioactive compound content of these plants. The knowledge acquired from this study will promote the maintenance of the local biodiversity and the conservation of the detergent plant species found in Thailand.

In this research paper a novel Ultra Violet Photo Catalyst Oxidation (UVPCO) sensor for air and surface sanitization using Common Source (CS) amplifier is presented. The ultra violet photo catalysis is the process in which the highly reactive radicals like H+, OH-and peroxides ions are produced from air in the presence of the ultra violet radiation and photo catalyst. In this process, the free radicals outbreaks the bio aerosols like bacteria, fungus and volatile organic compounds (VOCs) and destroy them. The proposed system is relies on the fast operation of PCS which operates under sub-threshold conditions and reduced computation time. The properties of common source amplifier like very high voltage gain and input output resistance increased the sensitivity as well as stability of the circuit. The system is more user friendly and the outcomes of simulation are fairly in agreement with the theoretical estimation. Keywords: bio aerosol, Photo Catalytic Oxidation (PCO), hydroxyl, hydrogen peroxide, SPICE, surface sanitizer.

There is growing recognition in research and policy of a mental health crisis among Canada’s paramedics but despite this, epidemiological surveillance of the problem is in its infancy. Just weeks before the emergence of the COVID-19 pandemic, we surveyed paramedics from a single, large, urban paramedic service in Ontario, Canada to assess for symptom clusters consistent with Post-Traumatic Stress Disorder (PTSD), major depressive disorder, and generalized anxiety disorder and to identify potential risk factors for each. In total, we received 589 completed surveys (a 97% completion rate) and found that 11% screened positive for PTSD, 15% for depression, and 15% for anxiety, with 1 in 4 active-duty paramedics screening positive for any of the three as recently as February 2020. In adjusted analyses, the risk of a positive screen varied as a function of employment classification, gender, self-reported resilience, and previous experience as a member of the service’s peer support team. Our findings support the position that paramedics screen positive for mental disorders at high rates – a problem likely to have worsened since the onset of the COVID-19 pandemic. We echo the calls of researchers and policymakers for urgent action to support paramedic mental health in Canada.

Briquetting of biomass is an ideal technique for improvising both its volumetric and net energy density; besides, serving as an effective means for reducing pollution. In general, numerous biomass and organic by-products are discarded as wastes, citing their non-edibility, composition of chemical compounds present in their raw form, in addition to their zero usage value. Yet, these biomass wastes hold significant heating values, which promote them into promising solid biofuels, either in their existing or pre-treated form. Accordingly, this review article discusses about the various biomasses used as raw feedstock for briquetting, besides summarising the works carried out in relevance to their respective briquettes. In addition, proximate and lignocellulosic composition of these biomasses, and their pre-treatment techniques followed to prepare them for briquetting, have also been discussed. This study suggested that the heating value of biomasses ranged between 10-20 MJ/kg, whilst, their briquettes reported between 15 and 25 MJ/kg; thereby citing their potential as viable replacement for existing fossil coals. Besides, factors affecting different thermal and physicochemical properties of these briquettes have also been studied and concluded that these properties play a crucial role in deciding the overall quality of the briquettes. Ultimately, this study proposed that any biomass with good calorific value and lignin content can be processed into briquettes with good strength and durability; however, the choice of biomass will also be accounted for by its availability, geographical distribution, and handleability.

Machine learning (ML) is penetrating in all walks of life and is one of the major driving forces behind the fourth industrial revolution, typically known as Industry 4.0. The purpose of the present study is to review the state-of-the-art ML applications in the biofuels' life cycle stages, i.e., soil, feedstock, production, consumption, and emissions. A keyword search is performed to retrieve relevant articles from the databases of the Web of Science and Google Scholar. ML applications in the soil stage were mostly based on the use of satellite images of land for estimation of biofuels yield or suitability analysis of agricultural land. In the second stage of the life cycle, assessment of rheological properties of the feedstocks and their effect on the quality of biofuels were dominant studies reported in the literature. The production stage included estimation and optimization of quality, quantity, and process conditions. The fuel consumption and emissions stage included analysis of engine performance and estimation of emissions temperature and composition, such as NOx CO, and CO2. This study identified the following trends: dominant ML method, the stage of life cycle getting more usage of ML, the type of data used for the development of the ML-based models, and the stage-wise frequently used input and output variables. The findings of this article are beneficial for academia and industry-related people involved in model development in different stages of biofuel’s life cycle.

Microbe laden air particles, known as bio-aerosols, are routinely generated, in clinical dentistry due to the operative instrumentation within a milieu rich in salivary organisms. As the major mode of transmission of SARS-CoV-2 appears to be airborne aerosols and droplets, there has been an intense focus on such aerosol generating procedures (AGP). As there has been no systematic reviews on the efficacy of bio-aerosol reducing measure in dentistry, the objective of this systematic review was to evaluate the literature on three major AGPs, rubber dam application, pre-procedural oral rinse, and high-volume evacuation (HVE) aimed at reducing dental bio-aerosols. Method: PubMed via Ovid MEDLINE, EBSCO host, Cochrane Library, and Web of Science databases between January 01, 1985, and April 30, 2020, were searched.Results: A total of 156 records in the English language literature were identified, of which 17 clinical studies with 724 patients were included in the final analyses. The eligible reviewed articles revealed the inadequacy of the afore mentioned three principal AGPs used in contemporary dental practice to minimise bio-aerosols. HVE appears to be the most efficacious method, although no single approach provides total elimination of bio-aerosols. Conclusion:This, the first systematic review on methods of controlling bio-aerosols in dental operatory settings, indicates that employing combination strategies of rubber dam, with a pre-procedural antimicrobial oral rinse, and HVE can significantly minimize bio-aerosols. As the quality of the currently available data on dental bio-aerosols are rather poor, further, controlled, multi-centre studies are essential to address this critical issue.

Surface Plasmon Resonance (SPR) is an attracting property of certain transition metals when they are synthesized in nano-range giving rise to promising optical applications. However, most SPR and associated applications are limited to the noble metal nanoparticles, which limits their potential due to high production cost. We report surface plasmon resonance in copper-copper oxide core-shell quantum dots synthesized via chemical route studied by using UV-Visible spectrophotometry. Tuning of the plasmonic resonance with respect to the particle diameter is achieved by an inexpensive all chemical route. Photoluminescence measurements also support the data. This size reduction leads to remarkable changes in its optical response as compared to the bulk metal. The results point towards applications of these materials in tunable SPR based biosensors.

This paper presents a new optical, multi-functional, high-resolution 3-axis sensor which serves to navigate and can, for example, replace standard joysticks in medical devices such as electric wheelchairs, surgical robots or medical diagnosis devices. A light source, e.g. a laser diode is affixed to a movable axis and projects a random geometric shape on an image sensor (CMOS or CCD). The software in the downstream microcontroller identifies the geometric shape’s center, distortion and size, then calculates X, Y, and Z coordinates. These coordinates can then be processed in attached devices. The 3-axis sensor is characterized by its very high resolution, precise reproducibility and plausibility of the coordinates produced. In addition, optical processing of the signal provides a high level of safety against electromagnetic and radio frequency interference. The sensor presented here is adaptive and can be adjusted to fit a user’s range of motion (stroke and force). This recommendation aims to optimize sensor systems such as joysticks in medical devices in terms of safety, ease of use, and adaptability.

When phenomena in quantum mechanics are interpreted from the perspective of bio-psychology, wave function collapse from several to a single eigenstate must be plausibly explained. Quantum mechanics requires a context, yet the context of an observer is rarely considered. On the other hand, in bio-psychology, the observer context is examined to explain superposition and collapse by different mental functions used in everyday life. Three mental functions are described, one of which is responsible for observation, and the others for conservation and treatment of information in mental representation. Whereas observation produces information with certainty, the subsequent processes result in uncertain potentiality. In order to encompass uncertainty, multiple possibilities are simultaneously considered in mental superposition, one of which should represent the unknown future outcome. During observation, all suggested potentialities necessarily collapse to one real outcome. The collapse of superposition does not occur in observable physical reality, but in its mental representation. Some physical principles—such as superposition, infinity and nothingness before the Big Bang—are pure phenomena of mental representation, which will always remain unverifiable by observation. This argument proves that mental representation brought about by the observer context participates in the production of mental models for the best approximation of physical reality.

Dermal interstitial fluid (ISF) is a novel source of biomarkers that can be considered as an alternative to blood sampling for disease diagnosis and treatment. Nevertheless, in vivo extraction and analysis of ISF are challenging. On the other hand, microneedle (MN) technology can address most of the challenges associated with dermal ISF extraction and is well-suited for long-term, continuous ISF monitoring as well as in situ detection. In this review, we first briefly summarise the different dermal ISF collection methods and compare them with MN methods. Next, we elaborate on the design considerations and biocompatibility of MNs. Subsequently, the fabrication technologies of various MNs used for dermal ISF extraction, including solid MNs, hollow MNs, porous MNs and hydrogel MNs, are thoroughly explained. In addition, different sensing mechanisms of ISF detection will be discussed in detail. Subsequently, we identify the challenges and propose the possible solutions associated with ISF extraction. A detailed investigation is provided for the transport and sampling mechanism of ISF in vivo. Also, the current in vitro skin model integrated with the MN arrays will be discussed. Finally, future directions to develop a point-of-care (POC) device to sample ISF are proposed.

This paper reports 2 × 4 hybrid Mach-zehnder interferometer (MZI) - multi-mode interferometers (MMI) based compact thermo-optical switch consisting of slab waveguides on silicon-on-insulator, SOI, platform. The device consists of two identical MMIs, each of 6 μm wide and 140 μm long connected with two phase shifters MMIs each with 2 μm wide and 8 μm long and linear tappers each 4 μm long, connected at both ends of the MMIs to minimize the power coupling loss. The loss for linear taper is found to be below 0.02dB. The footprint of the whole device is six 6 μm × 324 μm. This structure is based on unique multimode region shape, which leads optical switch to have less coupling loss and reduced cross-talk. The average thermo-optical switching power consumption is 1.4 mW, the excess losses are 0.8 dB, and the imbalances are 0.1 dB. Aluminum is used as a heating pad, and a trench is created around this pad to prevent from spreading of heat and reduce power loss almost by a factor of 2 to the adjacent phase shifter. Our new heating method has advantages of compact size and ease of fabrication with the current CMOS technology.

Software-based ultrasound imaging systems provide high flexibility that allows easy and fast adoption of newly developed algorithms. However, the extremely high data rate required for data transfer from sensors (e.g., transducers) to the ultrasound imaging systems is a major bottleneck in the software-based architecture, especially in the context of real-time imaging. To overcome this limitation, in this paper, we present a Binary cLuster (BL) code, which yields an improved compression ratio compared to the exponential Golomb code. Owing to the real-time encoding/decoding features without overheads, the universal code is a good solution to reduce the data transfer rate for software-based ultrasound imaging. The performance of the proposed method was evaluated using in vitro and in vivo data sets. It was demonstrated that the BL-beta code has a good stable lossless compression performance of 20 ~ 30% while requiring no auxiliary memory or storage.

Developments in technology have enabled envisioning the derivation of materials and products from renewable biomass, as an alternative to finite fossil-based resource consumption. Therefore, bioeconomy is regarded as an opportunity for sustainable economic growth. Countries are formulating strategies in accordance with their goals to attain from bioeconomy. Proper measurement, monitoring and reporting of the outcomes of these strategies is crucial for long-term success. This study aims to critically evaluate the national methods used for the measurement, monitoring and reporting of bioeconomy contribution to the total economy. For this purpose, research and surveys have been conducted on selected countries (Argentina, Germany, Malaysia, the Netherlands, South Africa and the United States). The results reveal that the bioeconomy targets set up in the strategies often reflect country’s priorities and comparative advantages. However, comprehensive approaches to measure and monitor bioeconomy progress are frequently lacking. Most countries only measure the contribution to gross domestic product (GDP), turnover and employment of the sectors included in their bioeconomy definition, which may provide an incomplete picture. In addition, this study identifies the mismatch between the targets and measurement methods, as the environmental and social impacts of bioeconomy are often foreseen, but not measured. It is concluded that existing global efforts towards a sustainable bioeconomy monitoring can be strengthened and leveraged to measure progress towards sustainable goals.

After conducting a detailed survey among the villagers of Pallissery and Karukutty, it was observed that in most of the villages the native people have to travel long distances for their basic health needs. Also most of the villagers lack knowledge regarding live health updates. At times, these problems have even resulted in death of many people including pregnant women and children. The objective of our research is to propose an integrated and easy to use Medical Kiosk that can be installed at various locations in rural areas. The Kiosk will provide an integrated environment for all medical related activities and would perform numerous functions like sending notifications regarding medical camps, mobile medical help, important dates for vaccinations, child care, insurance policies and provide other live medical updates to the villagers. It would also support the basic facilities for measurement of body parameters like height, weight, BMI, blood pressure, and heartbeat and also facilitate live consultation facilities with specialized doctors through video and voice chats.

Background: Handover is a critical process for ensuring quality and safety in healthcare. Considerable research suggests that poor handover results in significant morbidity, mortality, dissatisfaction, and excess financial costs. Despite this, little formal attention, education, and evaluation has been given to handover. There is also paucity of data on the opinions of practitioners on the safety of handover.Objectives: The aim of this study was to measure the perceived risk, degree of patient harm and the systems used to support handover, and to understand how this varied by care setting, type of clinical practice, location, or level of experience. Methods: An open, anonymous and confidential online questionnaire covering: (a) respondent characteristics; (b) peer-to-peer handover; (c) internal referrals; (d) discharges and transfers between organisations; and (e) leading and improving handover was conducted with healthcare practitioners and managers from various settings. Results: We gathered a total of 432 completed responses from 26 countries. The average reported performance of handover was rated as 3.9 out of 5.For each type of handover, 12 - 14% reported errors occurring more than weekly. Of those that knew the outcome of such errors, between 29% and 34% reported that they had witnessed moderate or severe harm. 12% and 17% of respondents believed that handover was high or very high risk (See table 4). These respondents were more likely to have witnessed moderate or severe harm, or to be more senior.A wide combination of handover systems was utilised by respondents. 28% - 32% relied exclusively on EPRs (with or without face-to-face contact). 21% used Office documents such as Word and Excel for peer-to-peer handover, and over 30% used hand-written or manual systems. Conclusions: This study suggests the need to do more — and go further — to improve communication and reduce risk during all types of handovers. Clinical leaders should find ways to train and support handover with effective systems, with less experienced staff being the primary focus. More research is needed to demonstrate the interventions that improve the safety of handover.

This work addresses the problem of the application of artificial intelligence to the creation and maintenance of medical documentation and the use of big data in medicine to support efficient patient diagnosis and treatment. This study covers the latest advances in AI and big data, based on literature reviews and interviews with leading experts in these fields. The following conclusions were obtained: (1) Based on the needs of patients and providers of medical services, and given the latest technological advances, all medical documentation should be digital and the processes of its creation, access, sharing, and consistency checking should by supported by suitably designed AI systems. (2) The knowledge contained in medical documentation constitutes a resource of strategic importance for humanity, with almost unlimited potential. (3) All medical documentation should be anonymised and should be made widely available, just like data and research results in the field of experimental physics. (4) This will accelerate development of new treatments, best practice and help to identify new medical emergencies, such as Covid-19. In practice today, unfortunately, the design of medical record systems is fragmented between institutions and countries, often focusing discussions on narrow technical details, and forcing clinicians to waste time on filling up multiple pages of illness history. This leads to many inefficiencies and lost opportunities and necessitates a fundamentally new approach.

COVID-19 is a severe global problem, and AI can play a significant role in preventing losses by monitoring and detecting infected persons in early-stage. This paper aims to propose a high-speed and accurate fully-automated method to detect COVID-19 from the patient's CT scan images. We introduce a new dataset that contains 48260 CT scan images from 282 normal persons and 15589 images from 95 patients with COVID-19 infections. At the first stage, this system runs our proposed image processing algorithm to discard those CT images that inside the lung is not properly visible in them. This action helps to reduce the processing time and false detections. At the next stage, we introduce a novel method for increasing the classification accuracy of convolutional networks. We implemented our method using the ResNet50V2 network and a modified feature pyramid network alongside our designed architecture for classifying the selected CT images into COVID-19 or normal with higher accuracy than other models. After running these two phases, the system determines the condition of the patient using a selected threshold. We are the first to evaluate our system in two different ways. In the single image classification stage, our model achieved 98.49% accuracy on more than 7996 test images. At the patient identification phase, the system correctly identified almost 234 of 245 patients with high speed. We also investigate the classified images with the Grad-CAM algorithm to indicate the area of infections in images and evaluate our model classification correctness.

While referral-level medicine is important in the veterinary curriculum, students also need a solid base knowledge of clinically relevant routine surgery and diagnostic skills. Veterinary hospitals must maintain a steady caseload that provides wellness cases and commonly encountered conditions. Shelter Medicine programs can create the opportunities to meet these challenges. Students can gain quantifiable surgical experience in spay/neuter with measured growth in surgical efficiency and competency while providing needed community service for animal shelters. Students can directly interact with shelter animals by performing examinations, diagnostic testing, and development of treatment protocols and recommendations for commonly encountered problems. Furthermore, students can obtain a working knowledge of biosecurity on a population level to minimize risk of infectious diseases spreading to healthy populations.

COVID-19 greatly challenges human beings in the health sector and leaves behind a large amount of medical waste that poses many potential threats to the environment. In this paper, we compiled relevant data released by official agencies and the media, and conducted data supplementation based on previous studies to calculate the net value of medical waste production in Hubei Province during COVID-19 with the help of a neural network model. Then, we reviewed the data related to the environmental impact of medical waste per unit and designed four scenarios to estimate the environmental impact of new medical waste generated during the epidemic. The results showed that at a medical waste generation rate of\ 0.\ 5\ kg/(\ bed\ \cdot\ d) COVID-19 resulted in a net increase in medical waste volume of about 3366.99 tons in Hubei Province. In the four scenario assumptions, if the medical waste brought by COVID-19 is completely incinerated, it will have a large impact on the air quality. If it is disposed by distillation sterilization, it will produce a large amount of wastewater and waste residue. Based on the results of the study, three policy recommendations are proposed in this paper: strict control of medical wastewater discharge, reduction and transformation of the emitted acidic gases, and attention to the emission of metallic nickel in exhaust gas and chloride in soil. These policy recommendations provide a scientific basis for controlling medical waste pollution.

Multidisciplinary neurotechnology holds the promise of understanding and non-invasively treating neurodegenerative diseases. In this preclinical trial on Parkinson's disease (PD), we combined neuroscience together with the nascent field of medical virtual reality and generated several important observations. First, we established the Oculus Rift virtual reality system as a potent measurement device for parkinsonian involuntary hand tremors (IHT). Interestingly, we determined changes in rotation were the most sensitive marker of PD IHT. Secondly, we determined parkinsonian tremors can be abolished in VR with algorithms that remove tremors from patients' digital hands. We also found that PD patients were interested in and were readily able to use VR hardware and software. Together these data suggest PD patients can enter VR and be asymptotic of PD IHT. Importantly, VR is an open-medium where patients can perform actions, activities, and functions that positively impact their real lives - for instance, one can sign tax return documents in VR and have them printed on real paper or directly e-sign via internet to government tax agencies. Lastly, we generated a technical framework wherein movements in the real world can be measured side-by-side with those in virtual reality. With this framework, we observed anecdotal evidence of parkinsonian tremors being reduced in real life when our algorithms abolished digital hand tremors in VR.

This study describes the development of an automated bag valve mask (BVM) compression system, which, during acute shortages and supply chain disruptions can serve as a temporary emergency ventilator. The resuscitation system is based on the Arduino controller with a real-time operating system installed on a largely RepRap 3-D printable parametric component-based structure. The cost of the system is under $170, which makes it affordable for replication by makers around the world. The device provides a controlled breathing mode with tidal volumes from 100 to 800 milliliters, breathing rates from 5 to 40 breaths/minute, and inspiratory-to-expiratory ratio from 1:1 to 1:4. The system is designed for reliability and scalability of measurement circuits through the use of the serial peripheral interface and has the ability to connect additional hardware due to the object-oriented algorithmic approach. Experimental results demonstrate repeatability and accuracy exceeding human capabilities in BVM-based manual ventilation. Future work is necessary to further develop and test the system to make it acceptable for deployment outside of emergencies in clinical environments, however, the nature of the design is such that desired features are relatively easy to add with the test using protocols and parametric design files provided.

Access to nasopharyngeal swabs for sampling remain a bottleneck in some regions for COVID-19 testing. This study develops a distributed manufacturing solution using only an open source manufacturing tool chain consisting of two types of open source 3-D printing and batch UV curing, and provides a parametric fully free design of a nasopharyngeal swab. The swab was designed using parametric OpenSCAD in two components (a head with engineered break point and various handles), which has several advantages: i) minimizing print time on relatively slow SLA printers, ii) enabling the use of smaller print volume open source SLA printers, iii) reducing the amount of relatively expensive UV resin, and iv) enabling production of handle on more accessible material extrusion 3-D printers. A modular open source UV LED box was designed, fabricated for $45 and tested for batch curing. Swabs can be fabricated for $0.06-$0.12/swab. The results of the mechanical validation tests showed that the swabs could withstand greater forces than would be expected in normal clinical use. The swabs were also able to absorb a significant amounts of synthetic mucus materials and passed abrasion and handling tests. The results show the open source swab are promising candidates for clinical trials.

This study evaluates the production of biohydrogen from agro industrial waste. The worldwide energy demand is increasing exponentially and the reserves of fossil fuels are depleting, the combustion of fossil fuels has the effect on environment because of CO2 emission. Hydrogen generation market size is forecast to cross 180 billion by 2024, according to a new research report by global market. For the production of biohydrogen. we had chosen groundnut shell as our source, using Tween80 as a surfactant we had undergone pre-treatment studies for (10min,20min,30min,40min,50min) we had estimated the content of cellulose, protein, carbohydrates at (1%,2%,3%,4%,5%) and obtained the optimum value in the form of graph. The production of hydrogen is done by using the rumen fluid of the cow and the quantity of the hydrogen produced by this process is identified by using the analytical instrument Gas Chromatography.

A quantum hybrid (QH) intelligent approach that blends the adaptive search capability of the quantum-behaved particle swarm optimisation (QPSO) method with the intuitionistic rationality of traditional fuzzy k-nearest neighbours (Fuzzy k-NN) algorithm (known simply as the Q-Fuzzy approach) is proposed for efficient feature selection and classification of cells in cervical smeared (CS) images. From an initial multitude of seventeen (17) features describing the geometry, colour, and texture of the CS images, the QPSO stage of our proposed technique is used to select the best subset features (i.e. global best particles) that represent a pruned down collection of seven (7) features. Using a dataset of almost 1000 images, performance evaluation of our proposed Q-Fuzzy approach assesses the impact of our feature selection on classification accuracy by way of three experimental scenarios that are compared alongside two other approaches: The All-features (i.e. classification without prior feature selection) and another hybrid technique combining the standard PSO algorithm with the Fuzzy k-NN technique (P-Fuzzy approach). In the first and second scenarios, we further divided the assessment criteria in terms of classification accuracy based on the choice of best features and those in terms of the different categories of the cervical cells. In the third scenario, we introduced new QH hybrid techniques, i.e. QPSO combined with other supervised learning methods, and compared the classification accuracy alongside our proposed Q-Fuzzy approach. Furthermore, we employed statistical approaches to establish qualitative agreement with regards to the feature selection in scenarios 1 and 3. The synergy between the QPSO and Fuzzy k-NN in the proposed Q-Fuzzy approach marginally improves classification accuracy as manifest in the reduction in number cell features, which is crucial for effective cervical cancer detection and diagnosis.

This paper investigates the effects of Inter-generational co-residence on health care market, and labor market outcomes, to see whether or not living under the same roof with at least one parent matters in health care market, and labor market behaviors in post-Affordable-Care Act (ACA) USA. The adopted analytical strategy involves not only looking at the gender differences in co-residence, and its effects on outcomes in the two markets, but also accounting for co-residence endogeneity following the recent literature. Unlike the recent literature that relies on instrumental variables methods, this study adopts a switching regression approach, defining inter-generational co-residence as an endogenous selection process using a binary probit equation, and modeled jointly with the extensive margins and intensive margins in the two markets. This novel approach results in a recursive trivariate probit model for each market, and estimated using penalized maximum likelihood methods. The results suggest that ACA by reorganizing the US health care market, seems to have reduced significantly disparities in health care access among males and females based on race, region of residence, place of birth, and citizenship. However not only do we observe significant differences in inter-generational co-residence status between males and females, we also find significant inequalities in the effects of co-residence on health care market, and labor market outcomes. In fact, co-residence is found to increase health care expenditure by 56.7% among females, while this figure increases to 74.2% among males. In addition co-residing individuals, while spending 69.7% more on health care annually are 1.22 times more likely to access health care, but 31% less likely to use health care intensively during the year. In the labor market, co-residence is found to reduce significantly hours of weekly labor supplied by 41% for females, and 55.6% for males. Furthermore co-residing individuals, while not significantly different in their likelihood of labor force participation, are 1.52 times less likely to work full time once they decide to participate, and also spend about 55.4% less time working in the labor market in post-ACA USA.

Cheating during examination is now day serious problem spatially in Ethiopia where many students sit in one class to exam. When cheating occurs in medical schools, it has serious consequences for human life, social values, and the economy. Even though, cheating on exams has existed in any department, with unknown reason, prevalence of cheater among 2^nd year laboratory students were high. So that assessing factors and improving cheating behavior of the students are mandatory to create competitive graduated students. To identify factors and to improve cheating behavior action research study design was conducted among 2^nd year medical laboratory student. Criterion sampling technique was used to selects sixteen cheater students among 2^nd year laboratory students. To gather necessary data, we used focus group discussions, individual interview, open-ended questionnaire and observation and collected information by using hand writing notes. During exam different cheating methods used by students like using a system of signals, writing on hands, desks and copy the other students answer. While the compelling reasons for cheating were like hard courses, hard exams, time pressure and fear of failure. To improve cheating behavior of the student’s different action strategies were taken like prepared exam by using code, arrangement sitting style during exam and sit with brainy students during class, reading and discussion. Most students were trying to done exam by themselves but their results are not good as previously. So that, we need more future action plan to avoid cheating behavior of the students. During, the next action plan we will be taken the remaining main action strategies and action evaluation we will be expected 50% of participants will be avoided their cheater behavior and done exam independently without forced by the environment.

Nutraceuticals are combination of nutrients and pharmaceuticals and these are derived from various plants, microbes and animals too. The food products that are considered as nutraceuticals are categorised based on the availability in the market. It is a medical approach to improve health and remedy for illness. Nowadays there is an increase in shift towards use of nutraceuticals as its usage provides preventive therapies to various chronic diseases. Various natural nutraceuticals are based on extracts from Ginger, turmeric, garlic, amla, cinnamon, aloe vera etc. A wide variety of therapeutic values are provided by them such as anti-inflammatory, antibacterial, antifungal properties, allergy relief, antidiabetic and cardiovascular problems. India is in its infancy stage but have many emerging companies that are trying to meet the demand of growing population. Overall ‘Nutraceuticals’ has been known as a new era of well being, in which the food industry has become a main player.

The theatre has a tremendous ability to influence public discourse and shape societal opinions. And medical conditions can provide writers with a rich scope for plot development and characters with challenges to overcome. In particular, the neurological condition epilepsy has many possibilities with historical beliefs that people were possessed by gods and devils and the sudden, disabling seizures characteristic of the condition. But used unsympathetically, it can promote misunderstanding within audiences, resulting in discrimination for people with the condition. This review looks back at how epilepsy has been portrayed throughout history. How the Greeks portrayed epilepsy as a punishment from the gods. Then later, how Shakespeare utilised epilepsy to suggest characters as uncontrollable. However, we finish on a message of hope as modern writers look to collaboration to ensure accurate and honest portrayals of epilepsy, improving public understanding and removing many of the stigmas that have dogged the condition.

This paper presents novel feature descriptors and classification algorithms for automated scoring of HER2 in Whole Slide Images (WSI) of breast cancer histology slides. Since a large amount of processing is involved in analyzing WSI images, the primary design goal has been to keep the computational complexity to the minimum possible level and to use simple, yet robust feature descriptors that can provide accurate classification of the slides. We propose two types of feature descriptors that encode important information about staining patterns and the percentage of staining present in ImmunoHistoChemistry (IHC) stained slides. The first descriptor is called a characteristic curve which is a smooth non-increasing curve that represents the variation of percentage of staining with saturation levels. The second new descriptor introduced in this paper is an LBP feature curve which is also a non-increasing smooth curve that represents the local texture of the staining patterns. Both descriptors show excellent interclass variance and intraclass correlation, and are suitable for the design of automatic HER2 classification algorithms. This paper gives the detailed theoretical aspects of the feature descriptors and also provides experimental results and comparative analysis.

Green synthesis offers a superior alternative to traditional methods for producing metal and metal oxide nanoparticles. This approach is not only benign and safe but also cost-effective, scalable, and straightforward, operating under ambient conditions. Notable metals and metal oxide nanoparticles, such as manganese oxides, iron oxides, silver, and gold, have been produced using various bio-reductants derived from plant extracts. These biological agents not only expedite the reduction process but also stabilize the nanoparticles, serving dual roles as reducing and capping agents. This review presents the green synthesis of nanoparticles (NPs) obtained from biogenic wastes and plant extracts. The green-synthesized nanostructured MnO2 are evaluated as a potential photocatalyst for water treatment and as an electrode material in lithium-ion batteries and supercapacitors. The green-derived iron oxide nanoparticles are examined as promising antioxidant, anti-inflammatory, and anti-diabetic agents. Additionally, this review discusses the green synthesis of precious metal nanoparticles, specifically silver (Ag NPs) and gold (Au NPs), highlighting their potential medical applications in areas like antiviral treatments and cancer therapy.

Background: Simulations have historically aided training programs by providing a realistic and holistic replication of professional scenarios and procedures. Simulations have developed over the past 40 years to include varying fidelities and modalities of simulation. Learning in a simulation-centered environment has benefits, ranging from improved patient care to specific skills acquisition while catering to students’ numerous and varied learning approaches. Simulation is a multifaceted field that benefits all parties, the teachers, the learners, and the patients. The application of simulation to medical education and its amalgamation with other modes and substitutes allows for a more integrated learning and testing curriculum that advances the current trajectory of medical education. Such developments, however, are limited to resource rich areas, leaving behind low-middle income countries to use traditional, less evolved methodologies and practices. This review aimed to explore different aspects of simulation and focus specifically on low-cost task trainers and their accessibility. Method: The purpose of the study was to assess the accessibility of low-cost task trainers in terms of cost-effectiveness, distribution, validation, and frequency within specific specialties. To do so, 84 PubMed publications have been screened, and 39 filtered research studies have collected the necessary data. After analyzing the papers, we classified the following information – process, specialization, validation (y/n), costs, development location, and year of publication. Results: After carefully analyzing the accumulated data from the selected 39 publications, we found that most studies (i.e., 6 out of 39) were published in 2020. Emergency Medicine was the most common specialty for which low-cost trainers were developed (9 out of 39 procedural simulators); Otolaryngology followed this with 8 out of 39 trainers and general surgery with 7/39 of the task-trainers. The price ranges fluctuated and fell within the price bracket of USD 0 to USD 400 collectively. Our review also uncovered the concentration of development of such innovations solely in high income countries (HICs). Conclusion: Simulation is an invaluable tool applicable to a diverse range of phases of medical education. Future conjunction of simulation with low-cost substitutes along with increased encouragement and enthusiasm towards developing cost effective simulation-based learning environments (SBLEs) with the reserves and requirements of these areas in mind may prove to be a reliable option for low and middle resource settings

High-quality chromosome-scale haplotype sequences— of diploid genomes, polyploid genomes and metagenomes — provide important insights into genetic variation associated with disease and biodiversity. However, whole-genome short read sequencing does not yield haplotype information that spans whole chromosomes directly. Computational assembly of shorter haplotype fragments is required for haplotype reconstruction, which can be challenging owing to limited fragment lengths and high haplotype and repeat variability across genomes. Recent advancements in long-read and chromosome-scale sequencing technologies, alongside computational innovations, are improving the reconstruction of haplotypes at the level of whole chromosomes. Here, we review recent methodological progress in these areas and discuss perspectives that could enable routine high-quality haplotype reconstruction in clinical and evolutionary studies.

Currently, energy security and environmental degradation are the two biggest challenges before humanity that can be surmounted with the use of green and sustainable biofuels produced from lignocellulosic crops. In the future, to ensure adequate and cost-effective supply of biofuels, it requires a sufficient amount of amenable and quality lignocellulosic feedstocks. Therefore, agricultural yields of lignocellulosic biomass crops should be substantially increased by intense genetic maneuvering of key gene regulatory mechanisms and signaling pathways that control plant biomass yield. Recently, numerous miRNAs families are identified, characterized, and validated across the plant kingdom. Plant microRNAs (miRNAs) are 21 to 24 nucleotides long, non-coding small RNAs, act as regulators of their target genes via inducing modifications in transcription, translation, and epigenome. MiRNAs represent many hallmark characteristics like sequence-specific regulation, tissue, and species-specific expression, evolutionary conservation, and functional diversity. They coordinate well physiological and life cycle processes in plants under adverse environmental conditions. Hence, miRNAs offer accurate, precise, and efficient regulatory switches in the miRNA-targeted genetic networks. It is evident from the study of the miR156 family and its target SQUAMOSA PROMOTER BINDING PROTEIN-LIKE (SPL) genes network that controls highly significant agronomic traits in crop plants. The miR156/SPL module acts as a master circuit that synchronizes many intricate complex biological functions such as growth and development, and metabolic processes by sensing internal and external environmental signals in plants. Therefore, miR156 can prove a potential target for miRNAs based plant biotechnology to harmonize complex biofuel traits and improve biomass yield in lignocellulosic biomass crops.

Polymeric wet-strength agents are important additives used in the paper industry to improve the mechanical properties of paper products, especially when they come in contact with water. These agents play a crucial role in enhancing the durability, strength, and dimensional stability of paper products. The aim of this review is to provide an overview of the different types of wet-strength agents available and their mechanisms of action. We will also discuss the challenges associated with the use of wet-strength agents and the recent advances in the development of more sustainable and environmentally friendly agents. As the demand for more sustainable and durable paper products continues to grow, the use of wet strength agents is expected to increase in the coming years.

As part of the efforts to reduce the environmental impacts caused by the aviation sector, the use of bio-based instead of fossil-based materials has been assessed as a possible mitigation option. Natural Fibre Polymer Composites have proven to have a higher environmental performance in the automotive sector and are emerging as an option for weight reduction in aircraft. This study quantifies, though Life Cycle Assessment, the environmental performance of specific flax-based composite panels intended for aircrafts as interior fitting elements (i.e. partition panels, tray tables, baggage compartments) compared to a glass fibre/epoxy composite with a honeycomb core. Through system expansion, the fate of co-products issued from the production of the flax fibre technical textile used as reinforcement in the biocomposite material were considered in the assessment. Results showed that for an application in the aeronautics sector, the weight of the panels is the upmost critical parameter shaping the overall environmental performance of panels. Focusing on the panel production only, the biocomposite panel showed a higher environmental performance in the categories of climate change and marine eutrophication compared to the conventional panel, and the fire suppressant agent was identified as the main contributor to the environmental impacts of the bio-based panel. Yet these gains were negligible when considering the full life cycle of the panels, due to the higher weight (14%) of the bio-based panels; which is linked to the bio-based panel being at a prototype stage.In order to improve the environmental performance of the biocomposite panel and thus reduce its weight, it was shown relevant to optimize geometry of the panel itself, especially its core, so less resin could be used.

Objectives: To determine the effects of caffeine consumption on the sleep habits and lifestyle of medical students. Methods: A cross-sectional study was conducted at Jinnah Sindh Medical University (JSMU) and Hamdard College of Medicine. On 422 undergraduate students aged 18-25 years, through random sampling. The duration of the study was from January 2019 to June 2019. The data was collected through self-administered questionnaire which included data regarding sleep habits and lifestyle of medical students. Results: Majority (81.6%) of the students consumed caffeine while only (18.4%) did not. One third of the participants (31.8%) reported caffeine consumption increased their academic performance and (57.3%) reported that it does not. More than half of the participants (63.3%) who consumed caffeine slept during class, whereas (47.2%) never had difficulty in falling asleep during the night. Conclusion: This research concluded that caffeine does have some role on sleep habits of medical students as they tend to have less sleep hours, experience day time dysfunction, average quality of sleep, and falling asleep during class. It has been concluded that caffeine has no effect on eating habits of medical students however, it does increase the screening time, keeping them active.

Background: Serious games are conceptualized as a broad topic and overlap segments of more modern forms of education: e-learning, edutainment, game-based learning, and digital game-based learning. Serious Games aligns with digitalization and the modern era and creates novel opportunities for learning and assessment in medical education. Escape rooms, a type of serious games, merge mental and physical aspects to reinforce critical skills useful in daily life. It challenges logic and reasoning and demands careful analysis of situations to correlate and solve different stages of the escape room under pressurized, timed conditions. Furthermore, it serves as an adequate environment to build problem-solving skills, communication skills, and leadership skills through the collaboration of people to achieve a common goal. The aim of this study was to investigate the applications of escape rooms in Medical Education. Method: This study investigated the applications of escape rooms in medical education. Serious games are expanding in education and have attained great relevance due to their intriguing and intrinsically motivating attributes. Within serious games, we focused on escape rooms in which participants are locked in a room, faced with puzzles that must be solved to ‘escape the room’. Compiling the data from the first 100 hits of medical application of escape rooms, we found 72 cases and categorized them by year, specialty, participants structure, simulation experience, and design. Results: We reported on escape rooms in medical education by the year in which they were reported, the medical specialty, the participant structure, grouped or individual, the experience design; real, hybrid, or digital, and the modality of the delivery. 72% of the escape rooms focused on four main areas: nursing education (25.0%), emergency medicine (22.2%), pharmacy (12.5%), and interprofessional education (12.5%). Most of the escape rooms had a group-based physical design and little attention was given to provide a detailed description of the design considerations, such as the pathway type (linear, semi-linear, open). Conclusion: Escape rooms are applied in a wide range of medical education areas. In Medical Education, group-based on-site escape rooms with a focus on nursing, emergency medicine, pharmacy and interprofessional education dominates the implementation landscape. To further advance the field, stronger emphasis on making explicit the design considerations will advance the research and inform implementations.

In this study we investigated the potential of two non-edible oil extracts from seeds of Colliguaya Integerrima (CIO) and Colliguaja Salicifolia (CSO) to use as a renewable source for polyols and eventually polyurethane foams or biodiesel. For this purpose, two novel polyols from the aforementioned oils were obtained in a one-single step reaction using a mixture of hydrogen peroxide and acetic acid. The polyol derivatives obtained from the two studied oils were characterized by spectral (FT-IR, ¹H NMR and ¹³C NMR), physico-chemical (e.g. chromatographic analysis, acid value, oxidizability values, iodine value, peroxide value, saponification number, kinematic viscosity, theorical molecular weights, density, hydroxyl number and hydroxyl functionality) and thermal (TGA) analyses according to standard methods. Physico-chemical results revealed that all parameters, with the exception of the iodine value, were higher for bio-polyols (CSP and CIP polyols) compared to the starting oils. The NMR, TGA and FT-IR analyses demonstrated the formation of polyols. Finally, the OH functionality values for CIP and CSP polyols were 4.50 and 5.00, respectively. This result indicated the possible used of CIP and CSP polyols as a raw material for the preparation of polyurethane rigid foams.

A significant attention has been made to the accurate detection of diabetes which is a big challenge for the research community to develop a diagnosis system to detect diabetes in a successful way in the IoT e-healthcare environment. Internet of Things (IOT) has emerging role in healthcare services which delivers a system to analyze the medical data for diagnosis of diseases applied data mining methods. The existing diagnosis systems have some drawbacks, such as high computation time, and low prediction accuracy. To handle these issues, we have proposed a IOT based diagnosis system using machine learning methods, such as preprocessing of data, feature selection, and classification for the detection of diabetes disease in e- healthcare environment. Model validation and performance evaluation metrics have been used to check the validity of the proposed system. We have proposed a filter method based on the Decision Tree (Iterative Dichotomiser 3) algorithm for highly important feature selection. Two ensemble learning Decision Tree algorithms, such as Ada Boost and Random Forest are also used for feature selection and compared the classifier performance with wrapper based feature selection algorithms also. Machine learning classifier Decision Tree has been used for the classification of healthy and diabetic subjects. The experimental results show that the Decision Tree algorithm based on selected features improves the classification performance of the predictive model and achieved optimal accuracy. Additionally, the proposed system performance is high as compared to the previous state-of-the-art methods. High performance of the proposed method is due to the different combinations of selected features set and GL, DPF, and BMI are more significantly important features in the dataset for prediction of diabetes disease. Furthermore, the experimental results statistical analysis demonstrated that the proposed method would be effectively detected diabetes disease and can easily be deployed in IOT wireless sensor technologies based e-healthcare environment.

We present a generalized state-space model formulation particularly motivated by an online scheduling perspective. Through these proposed generalizations, we enable a natural way to handle routinely encountered disturbances and a rich set of corresponding counter-decisions. Thereby, greatly simplifying and extending the possible application of mathematical programming based online scheduling solutions to diverse application settings.

Promoter is a small region of DNA sequence in response to various transcription factors, which initiates a particular gene expression. The promoter-engineered bio-sensor can activate or repress gene expression through transcription factor recognizing specific molecules, such as polyamine, sugars, lactams, amino acids, organic acids or redox molecule, however, the reported applications of promoter enhanced bio-sensor are not too much. This review paper highlights the strategies of construction of promoter-gene engineered bio-sensor with human and bacteria’s genetic promoter array for high-throughput screening (HTS) molecular drugs, study of membrane protein’s localization and nucleocytoplasmic shuttling mechanism of regulating factor, enzyme activity, detection of the toxicity of intermediate chemicals, and probing bacteria density to improve value-added product titer. These bio-sensors’s sensitivity and specificity can be further improved by proposed approaches of Mn²⁺ and Mg²⁺ added random Error-prone PCR and site-directed mutagenesis which is applied for construction of bacteria’s “mutant library”. It is expected to establish flexible HTS platform (Bio-sensor array) to large-scale screen transcription factor-acting drugs, reducing the toxicity of intermediate compounds, and constructing gene dynamic regulatory system in “push and pull” mode to effectively regulate the valuable medicinal product production. This proposed novel promoter-engineered biosensors aided synthetic genetic circuit construction will maximize the efficiency of bio-synthesis of medicinal compound, which will greatly promote the development of microbial metabolic engineering and biomedical science.

The bio-oil obtained by pyrolysis of Açaí (Euterpe oleracea Mart.) seeds at 450 ºC, 1.0 atmosphere, in technical scale, submitted to fractional distillation to produce biofuels-like fractions. The distillation of bio-oil carried out in a laboratory distillation column (Vigreux) of 30 cm. The physical-chemistry properties (density, kinematic viscosity, acid value and refractive index) determined by official methods. The chemical functions present in distillation fractions determined by FT-IR and the chemical composition by GC-MS. The distillation of bio-oil yielded gasoline, light kerosene, and kerosene-like fuel fractions of 16.16, 19.56, and 41.89% (wt.), respectively. All the physical-chemistry properties (density, kinematic viscosity, acid value and refractive index) increase with boiling temperature. The gasoline-like fraction is composed by 64.0% (area.) hydrocarbons and 36.0% (area.) oxygenates, while light kerosene-like fraction by 66.67% (area.) hydrocarbons and 33.33% (area.) oxygenates, and kerosene-like fraction by 19.87% (area.) hydrocarbons and 81.13% (area.) oxygenates.

High density polyethylene (HDPE) and poly(lactic) acid (PLA) blends with different ratios of both polymers, namely 30:70, 50:50 and 70:30, were produced. Polyethylene grafted maleic anhydride and a random copolymer of ethylene and glycidyl methacrylate, were also proposed as compatibilizers to modify HDPE-PLA optimal blends and were added in the amounts of 1, 3 and 5 wt.%. Blends properties have been evaluated through different aspects by performing tensile tests, scanning electron microscopy to analyze blend morphology and interfaces, and thermomechanical analysis through differential scanning calorimetry, thermo-gravimetric analyses and infrared spectroscopy. The second blend, the one with equal amounts of HDPE and PLA seems to represent a good balance between high amount of bio-derived charge and acceptable mechanical properties. This suggests a good potential of these blends, which would be a good starting point for the production of composites with lingo-cellulosic fillers.

The Smart Angel connected medical device allows ambulatory surgery patients to monitor their health by taking their own blood pressure and oxygen levels and by answering a health questionnaire from home. This preventive device must necessarily be "usable" by patients with different profiles. The objective of this article is, therefore, to better understand the links between certain characteristics of potential patients and usability. We conducted an experimental study involving thirty-six participants, investigating the effects of four patient characteristics (i.e. age, education, technophilia and health literacy) on usability measured in terms of effectiveness, efficiency, and satisfaction. The results show a moderate correlation between age, health literacy and usability. However, there is a weak correlation between technophilia and usability and no relationship between the level of education and usability. This study provides theoretical insights into the effects of user characteristics by means of personas in usability (ISO 9241-11).

Machine learning (ML) is penetrating in all walks of life and is one of the major driving forces behind the fourth industrial revolution, typically known as Industry 4.0. This study reviews the state-of-the-art ML applications in the biofuels’ life cycle stages, i.e., soil, feedstock, production, consumption, and emissions. A keyword search is performed to retrieve relevant articles from the databases of the Web of Science and Google Scholar. ML applications in the soil stage were mostly based on the use of satellite images of land for estimation of biofuels yield or suitability analysis of agricultural land. In the second stage of the life cycle, assessment of rheological properties of the feedstocks and their effect on the quality of biofuels were dominant studies reported in the literature. The production stage included estimation and optimization of quality, quantity, and process conditions. The fuel consumption and emissions stage included analysis of engine performance and estimation of emissions temperature and composition, such as NOx, CO, and CO2. This study identified the following trends: dominant ML method, the stage of life cycle getting more usage of ML, the type of data used for the development of the ML-based models, and the stage-wise frequently used input and output variables. The findings of this article are beneficial for academia and industry-related people involved in model development in different stages of biofuel’s life cycle.

This topical review describes the results of recent research into and development of silicon nitride, a ceramic material with unique properties. The outcome of this ongoing research strongly encourages the use of monolithic silicon nitride and coatings as contemporary and future biomaterial for a variety of medical applications. Crystallographic structure, synthesis and processing of monolithic structures and coatings, and examples of their medical applications are covered that relate to spinal, orthopedic and dental implants, bone grafts and scaffolds, platforms for intelligent synthetic neural circuits, antibacterial and antiviral particles and coatings, optical biosensors, and nano-photonic waveguides for sophisticated medical diagnostic devices. The examples provided show convincingly that silicon nitride is destined to become a leader to replace titanium and other entrenched biomaterials in many fields of medicine.

Abstract: The promotion of sustainable packaging is part of the European Green Deal and plays a key role in the EU’s social and political strategy. One option is the use of renewable resources and biomass waste as raw materials for polymer production. Lignocellulose biomass from annual and perennial industrial crops and agricultural residues are a major source of polysaccharides, proteins, and lignin, and can also be used to obtain plant-based extracts and essential oils. Therefore, these biomasses are considered as potential substitute for fossil-based resources. Here, the status quo of bio-based polymers is discussed and evaluated in terms of properties related to packaging applications such as gas and water vapor permeability as well as mechanical properties. So far, their practical use is still restricted due to lower performance in fundamental packaging functions that directly influence food quality and safety, the length of shelf life and thus the amount of food waste. Besides bio-based polymers, this review focuses on plant extracts as active packaging agents. Incorporating extracts of herbs, flowers, trees, and their fruits is inevitable to achieve desired material properties that are capable to prolong the food shelf life. Finally, the adoption potential of packaging based on polymers from renewable resources is discussed from a bioeconomy perspective.

Background: Role-playing is often used as a pedagogical method for learning communication in medical education. Therefore, medical play using the Teddy Bear Hospital (TBH) is a concept that can quickly familiarize children with health care and help them develop positive experiences in these areas. This review aims to assess the strengths of TBH, as a form of directed medical role play, in improving health outcomes and well-being in children, along with implanting an awareness of preventive health care in young children.Methods: For this scoping review, we examined the list of recommendations, including 11 studies from two databases, PubMed and Google Scholar. We incorporated pre/post quasi-experimental studies, ANOVA, qualitative research studies, systematic reviews, and control group studies that deliberately utilize the teddy bear hospital as an intervention.Results: The results of individual studies were further categorized into three sections. The first being upon the analysis of 11 studies, the Teddy Bear Hospital was mainly conducted in Europe and Asia. It is evident that regardless of the different approaches and strategies used to implement the Teddy Bear Hospital, they all ultimately share the same intent: to raise health care awareness and alleviate young children's anxiety over medical treatment while focusing on the promotion of positive healthy lifestyle. All studies portray the teddy bear hospital as an intervention of medical roleplay which analyzed the children's feelings, behaviors, and health awareness after visiting the Teddy Bear Hospital.Conclusion: The application of the teddy bear hospital has overwhelmingly positive results, with lower levels of anxiety and improved health knowledge. Its reported efficacy calls for future studies on aspects that lead to its efficacy and potential effectiveness.

This work deals with the numerical investigation of the delivery of potential therapeutic agents through dentinal discs (i.e. a cylindrical segment of the dentinal tissue) towards the dentin-pulp junction. The aim is to assess the main key features (i.e. molecular size, initial concentration, consumption rate, disc porosity and thickness) that affect the delivery of therapeutic substances to the dental pulp and consequently to define the necessary quantitative and qualitative issues related to a specific agent before its potential application in clinical practice. The CFD code used for the computational study is validated with relevant experimental data obtained using micro Laser Induced Fluorescence (μ-LIF) a non-intrusive optical measuring technique. As the phenomenon is diffusion dominated and strongly dependent on the molecular size, the time needed for the concentration of released molecules to attain a required value can be controlled by their initial concentration. Finally, a model is proposed which, given the maximum acceptable time for the drug concentration to attain a required value at the pulpal side of the tissue along with the aforementioned key design parameters, is able to estimate the initial concentration to be imposed and vice versa.

Disrupted nutrient recycling is a significant problem for Europe, while phosphorus and nitrogen are wasted instead of being used for plant nutrition. Mineral phosphate is critical raw material, which contains environmentally hazardous elements such as cadmium and uranium. Therefore, phosphorus recovery from agricultural by-product streams is critically important key priority. Phosphorus recovery from food grade animal bone by-products have been applied researched since 2002 with objective driven evolution progress towards specialized pyrolysis processing technology and animal bone char product (ABC) developments in economical industrial scale. Different animal bone by-products tested under different conditions at 400 kg/h throughput capacity in the continuously operated 3R zero emission autothermal carbonization system. The different material core treatment temperatures (between >300°C and <850°C) were combined with different residence times under industrial productive processing conditions. It has been industrial demonstrated that material core treatment temperature <850°C with 20 minutes residence time is necessary to achieve high quality ABC with useful agronomic value. The output ABC product having concentrated >30% phosphorus pentoxide (P2O5) and specific quality innovative fertilizer for agronomical efficient organic and low input farming applications as functional organic fertilizer, soil improver, growing medium and/or fertilizing product blend with high mineral phosphate fertiliser replacement value.

ABSTRACT:This paper presents arguments for why it is important to include disability in the undergraduate medical curriculum. I, the first author am currently involved with my doctoral thesis proposal titled "Proposing clinician competency guidelines for the inclusion of disability in the undergraduate medical curriculum of South Africa. An exploratory study.” As part of my research, I conducted a literature search and developed arguments to strengthen the reasons why the research I propose in my thesis is necessary. It is important that I position myself in this research. I am a South African, Caucasian, female medical doctor, with an interest in physical rehabilitation medicine and I am a person with a physical disability. Although this research study will be conducted in South Africa, I am hopeful that the findings will be transferable to medical schools across the world.

Though innovations for sustainable management of natural resources have emerged over time, the rising demand for nature based health solutions and integration of endemic flora into global value chains could have adverse impacts on ecosystems. The ecological risks in the exploitation of wild medicinal plant resources are exacerbated by a myriad of agrotechnological risks and challenges that highly constrain their domestication. Successful exploitation and commercialization of medicinal plants thus require a clear understanding of their demand and production systems or value chain analysis. Accordingly there is need for innovative approaches towards their integration into global value chains. Since quality and safety, traceability, certification, as well as, consumer tastes and preferences are critical drivers in purchasing decisions by global consumers, they are inadvertently exploited to weaken Indigenous knowledge (IK), undermine common property rights and entrench value chains that favour a few elite buyers. This tend to create pervasive incentives for overexploitation of medicinal plant resources and environmental degradation. Potential solution lies in the recognition of drivers of vulnerability to environmental degradation and the innovative use of policy bricolage, feedback loops and interactions between knowledge, power and agency on one hand, and collective action and property rights institutions on the other hand. We conceptualise a framework that can mediate a transformational agenda and enhance systematic understanding of sustainability lenses in endemic medicinal plant resources value chains. This could in turn strengthen IK, enhance collective action and promote participation of local actors with positive impact on the utilisation and integration of endemic medicinal plant resources into global value chains.

A Wireless Body Area Sensor Network (WBASN) is combination of numerous sense nodes, positioned onto/close or inside a person body. Wireless Body Area Sensor Networks (WBASN) is a developing automation trend that exploits wireless sensor nodes to put instantaneous wearable well-being of ill person to improve individual’s existence. The sensor nodes might be used outwardly to observe abundant health parameters (like heart activity, blood pressure and cholesterol) of an ill person at a vital site within hospital. Hence the goal of WBASN is much crucial, enhancing the lifetime of nodes is compulsory to sustain many issues such as utility and efficiency. It is essential to evaluate time that when the first node will die it we want to refresh or change the battery reason is that loss of crucial information is not tolerable. The lifetime is termed as the time interval when a first node dies out due to battery exhaustion. In our proposed protocol life time of a network is the main concern as well other protocol related issues such as throughput, path loss, and residual energy. Bio-sensors are used for deployment on human body. Poisson distribution and equilibrium model techniques have been used for attaining the required results. Multi-hop network topology and random network node deployment used to achieve minimum energy consumption and longer network lifetime.

Ultrafast laser 3D lithography based on non-linear light-matter interactions, widely known as multi-photon lithography (MPL), offers unrivaled precision rapid prototyping and flexible additive manufacturing options. 3D printing equipment based on MPL are already commercially available, yet there is still no comprehensive understanding of factors determining spatial resolution, accuracy, fabrication throughput, repeatability, and standardized metrology methods for the accurate characterization of the produced 3D objects and their functionalities. The photoexcitation mechanisms, spatial-control or photo-modified volumes, and the variety of processable materials are topics actively investigated. The complexity of the research field is underlined by limited understanding and fragmented knowledge of light-excitation and material response. Research to date has only provided case-specific findings on photoexcitation, chemical modification, and material characterization of the experimental data. In this review, we aim to provide a consistent and comprehensive summary of the existing literature on photopolymerization mechanisms under highly confined spatial and temporal conditions, where, besides the excitation and cross-linking, parameters such as diffusion, temperature accumulation, and the finite amount of monomer molecules start to become of critical importance. Key parameters such as, photoexcitation, polymerization kinetics, and the properties of the additively manufactured materials at the nanoscale in 3D are examined, whereas, the perspectives for future research and as well as emerging applications are outlined.

Background: Health policy is a set of comprehensive principles and legislations that guide how healthcare should be effectively delivered in the community. Medical schools should prepare students to undertake managerial responsibilities by incorporating health policy in the curriculum to deal with the intricacies of healthcare systems and their clinical roles in their future professional careers. Objective: To examine medical students' perception at a Public University in Malaysia regarding teaching health policy and their participation in health policy roles. Material and Methods: A cross-sectional study using universal sampling was carried out among the medical students using a paper-based questionnaire to collect the data. Results: Most respondents opined their willingness to learn health policy (80.9%) and that teaching health policy (83.6%) should be compulsory for medical students. The respondents thought health policy should be introduced earlier in Year 1 or 2. The student scores on their knowledge regarding health policy and year of study were significantly associated with their involvement in the health policy roles in both the simple and multiple logistic regression. Both statistical tests reported higher participation in health policy roles with the higher year of study, though only Year 4 and 5 were significant in the simple logistic regression and only Year 5 in the multiple logistic regression compared to Year 1. On the other hand, age and type of admission show significant results only in the simple logistic regression, while the race was only significant at the multivariate level. Conclusion: This study demonstrated that most respondents showed their willingness to learn health policy, participate in the health policy programs, and recommend that health policy be considered an essential topic in the medical curriculum, which should be taught right from the first year of medical school. We recommend encouraging students’ participation in health policy activities.

Novel bio-inspired materials have gained recently great attention, especially in medical applications. Applying sophisticated design and engineering methods, various polymer-polymer hybrid systems with outstanding performance have been developed in last decades. Hybrid systems composed of bioelastomers and hydrogels are very attractive due to their high biocompatibility and elastic nature for advanced biomaterials used in various medical applications such as drug delivery systems and scaffolds for tissue engineering. Herein, we describe the advances in current state-of-the-art design, properties and applications of polymer-polymer hybrid systems in medical applications. Bio-inspired functionalities, including bioadhesiveness, injectability, antibacterial properties and degradability applicable to advanced drug delivery systems and medical devices will be discussed in a context of future efforts towards development of bioinspired materials.

Inequality of health service for different specialty categories not only occurs in different areas inequality of health service for different specialty categories in the world, but also happens in the online service platform. In the online health community (OHC), health service was often of inequality for different specialty categories, including both online views and medical consultation for offline registered service. Moreover, how the factor city-level impacts the inequality of health service in OHC is still unknown. We designed a causal inference study with data on distributions of serviced patients and online views in over 100 distinct specialty categories on one largest OHC in China. To derive the causal effect of the city-levels (two levels inducing 1 and 0) on the Gini coefficient, we matched the focus cases in cities of rich healthcare resources with the potential control cities. For the Gini coefficient of serviced patients in over 100 specialty categories, the average treatment effect of level-1 cities is 0.470, which is 0.029 higher than that of the matched group. Similarly, for the Gini coefficient of online views, the average treatment effect of Level-1 cities is 0.573, which is 0.016 higher than that of the matched group. For each of the specialty categories, we also estimated the average treatment effect the specialty category’s Gini coefficient ( ) with the balanced covariates. The results support the argument that the total Gini coefficient of all the doctors in OHC shows that the inequality of health service is still very serious. This study contributes to the development of the theoretically grounded understanding of the causal effect of city-level on the inequality of health service in an online to offline healthcare service setting.

Application of native PGPR as bio inoculant is an alternative sustainable agricultural practice to enhance crop productivity, grain quality, and soil fertility. In this view, a study was to examine the effect of either individual or consortium PGPR inoculation on growth, yield, and grain nutrient uptake of two teff varieties. The pot experiment was carried out in (CRD) three replication and 10 treatments. The PGPR inoculants used in this study were Pseudomonas fluorescens biotype G, Enterobacter cloacae ss disolvens, and Serratia marcescens ss marcescen and their consortium. Dukem and Magna varieties were used in this study. The results of the analysis of variance showed significant differences (P ≤ 0.001) among the treatment and most of the agronomic traits except number of fertile tillers and also significant different (P ≤ 0.01) for grain P and N uptake. The variety was significantly affected grain Mg, Zn and Fe uptake at 5 % probability level and did not significantly influence all agronomic traits of the two varieties. Furthermore, interaction effects of two factors (TM*VT) were significant differences (P ≤ 0.05) for plant height and panicle length. Individual treatments mean comparison results showed that inoculation of native PGPR consortium significantly affected most of the PGP traits at (P ≤ 0.05). The maximum traits like plant height (189cm), panicle length (66.7cm), shoot dry biomass (9.98g), root dry biomass (2.90g) and grain yield per plant (4.55g) were observed from Dz-01-196. It could be concluded that the consortium of native PGPR inoculants for plant growth, yield and grain nutrient uptake improvement performed better than their individual strain.

The characteristics of biogenic aerosols in urban area were explored by determining the composition, temporal distribution of saccharides in PM_2.5 in Shanghai. The total saccharides showed a wide range of 15.2 ng/m³ to 1752.8 ng/m³, with the averaged concentrations were 169.8 ng/m³，300.5 ng/m³，288.4 ng/m³，688 ng/m³ in spring, summer, autumn, and winter, respectively. The concerned saccharides include anhydrosaccharides (levoglucosan and mannosan), which were higher in cold seasons due to the increased biomass burning, saccharide alcohols (mannitol, arabitol, sorbitol) and monosaccharides (fructose, glucose), which showed more abundant in warm seasons attributed to the biological emissions. By PMF analysis, four emission sources of saccharides were demonstrated, including biomass burning, fungal spores, soil suspension and plant pollens. Resolution of backward trajectory and fire points showed a process of high concentrations of levoglucosan. We found that concentrations of anhydrosaccharides showed relatively stable under different pollution levels while saccharide alcohols exhibited an obvious decrease, indicated that biomass burning was not the core reason of the heavy haze pollution, however, and high level PM_2.5 pollution might inhibit effects of biological activities.

Background: Simulation plays a crucial role in health studies, as it helps medical students apply their theoretical knowledge in real-life situations. Moulage is one of the techniques that helps in making simulation more realistic or high-fidelity. It uses special effects to emulate wounds for a better understanding of what the wound is like visually. Still, moulage is expensive, time-consuming, resource-intensive, and requires the training of staff, which is why we need to find low-cost substitutes for moulage materials. Method: When searching the database “PubMed” for the terms “Low-cost and Medical moulage”, we retrieved 222 studies, out of which when excluding results not related to low-cost, we obtained 62 studies, from which when removing studies that do not contain information regarding moulage, we found two papers, after referring to citations and cited articles of those papers, we ended up with six studies. Based on the selected articles and additional articles sourced from their reference list, a total of 11 studies were included in the review. Results: We understand that moulage is a technique that helps make simulations come alive, but the resources required to use it are at times, expensive, which is why we need to find methods to do low-cost moulage, and many studies address that it can be as simple as using homemade ingredients. Students from a previous study have talked about their opinions regarding the realistic component of moulage and whether if it is any different from other moulages. Most of the students agreed that the moulage ranked well in face and content validity. However, further innovations must be introduced in the field to be widely spread and lead to newer opportunities. Conclusion: Although the research done under moulage is limited, it is accepted that moulage is helpful for simulation-based studies and that low-cost moulage can help make medical studies a better experience for students studying it. Students have a favorable opinion on the realistic aspect of the low-cost moulage applied to them. Newer methods can be introduced to moulage, and it can be implemented in low-income countries.

Activated carbons can be produced from biomass in a thermal process either in a direct carbonization-activation process or by first carbonizing the biomass and later on activating the biochars into activated carbons. The properties of the ACs are dependent on the type of process used for production. In this study, the properties of activated carbons produced in a one-stage and a two-stage process are considered. Activated carbons were produced by physical activation of two types of starting materials, bio chars produced from spruce and birch chips in a commercial carbonization plant and from the corresponding raw chips. The activated carbons produced were characterized regarding specific surfaces, pore volumes and pore size distributions. The un-activated bio chars had some degree of surface area 190 and 140 m²g^-1 for spruce and birch and pore volumes of 0.067 and 0.092 cm³g^-1. According to the results obtained, two slightly different types of activated carbons are produced depending if a one-stage or a two-stage carbonization and activation process is used. The ACs produced in the one-stage process had higher specific surface areas compared to the ones produced in a two-stage process (761-940 m²g^-1 vs. 540-650 m²g^-1) . In addition, total pore volumes were higher in one-stage process but development of micropores is greater compared to two-stage process. There was no significant difference in total carbon content between one-stage and two-stage process.

Motorcycles can be considered a new form of smart vehicle when taking into account their small and modern structure and due to the fact that nowadays they are used in the new role of ambu-lance to rapidly reach emergency patients in large cities with traffic congestion. However, there is no study regarding the measuring of access time for motorcycle ambulances in large cities of Thailand. Therefore, this study aims to compare access times to patients between motorcycle ambulances and conventional ambulances, including analysis of the use of AED installed on motorcycle ambulances to contribute to the sustainable development of public health policies. In two hundred and seventy-one operations, it was found that the times from dispatch to vehicle (ambulance and motorlance) being en route and times from the 1669 center (center for com-mand-and-control EMS in Thailand) call receipt to arrival on scene (response time) of motorcycle ambulances was shorter than that of a conventional ambulance and the use of AED on a motor-cycle ambulance can increase the chances of survival for patients with cardiac arrest outside the hospital in public places where AEDs are not available and in all cases where access to an AED was less than eight minutes.

Students’ anxiety due to the COVID-19 pandemic was expressed by some medical students in the form of anger and mistrust. This study aims to explore the reasons for mistrust between students and faculty among medical schools in Egypt that have flared during the COVID-19 pandemic. This is a three-phase exploratory qualitative study depending on thematic emergence from appreciative interviews (AI) sessions. Students are revealed to be very well-educated regarding contemporary medical education concepts. The most important factors from the student perspective were the presence of a well-designed assessment system aligned with the learning outcomes and teaching methodologies and the presence of extracurricular activities and soft skills, respectively. A balanced student life respecting their mental health was found important to increase trust. A roadmap to breaking the mistrust must be planned on several pivots: curriculum structure, extracurricular life, communication strategies, and identifying student roles in their learning and in decision making.

Coronavirus (COVID19) appears to be an inflection point that is forcing a disruption in medical education. However, it is not clear what the responses of the institutions are to this pandemic and how the adaptation of new methods may impact medical education in the post COVID-19 era. Objective: The study aims to explore how medical schools in Egypt responded to COVID-19 pandemic regarding the teaching and learning/assessment for undergraduate students. Design: A mixed method exploratory two-phase study was conducted. A survey was prepared and disseminated to a convenient non-probability sample of the medical school faculty through various social platforms. Then, a focus group guide was conducted to explore in more depth the findings. Results: The staff level of preparedness for that unexpected shift was evaluated by 55.1% of the survey participants as optimum to high and a good leadership support was reported by 70 % of them. They reported conflicting views about the proper role of medical education units but reinforced the idea of Egyptian Knowledge Bank’s crucial role in this transition. Additionally, there is a communication problem with the students that leads to their detachment. Subsequently, 84.6 % of the participants reported that their schools used alternative teaching methods for small groups, large groups, pre-clinical and clinical clerkships. However, 64.1 % of the participants identified a clinical skills teaching challenge. Although, 68.4% reported that alternative methods were used for formative assessment but absence of alternative methods for summative assessment was declared by 76.3%. Conclusions: Individuals moved faster than bodies and relied on support existing outside the universities when catastrophe happened. However, institutes which have experience in adapting modern engaging learning methods should organize a better response for crisis. Online learning should be integrated in the curriculum with a fair percentage especially in the early years of medical study.

Centrifuges are commonly required devices in medical diagnostics facilities as well as scientific laboratories. Although there are commercial and open source centrifuges, costs of the former and required electricity to operate the latter, limit accessibility in resource-constrained settings. There is a need for low-cost, human-powered, verified and reliable lab-scale centrifuge. This study provides the designs for a low-cost 100% 3-D printed centrifuge, which can be fabricated on any low-cost RepRap-class fused filament fabrication (FFF) or fused particle fabrication (FPF)-based 3-D printer. In addition, validation procedures are provided using a web camera and free and open source software. This paper provides the complete open source plans including instructions for fabrication and operation for a hand-powered centrifuge. This study successfully tested and validated the instrument, which can be operated anywhere in the world with no electricity inputs obtaining a radial velocity of over 1750rpm and over 50N of relative centrifugal force. Using commercial filament the instrument costs about US$25, which is less than half of all commercially available systems; however, the costs can be dropped further using recycled plastics on open source systems for over 99% savings. The results are discussed in the contexts of resource-constrained medical and scientific facilities.

Introduction Color vision deficiency (CVD) constitutes one of the frequently observed eye disorders in all human populations. Color is a prominent sign utilized in the medical profession to study and identify histopathological specimens, lab instruments, and patient examination. Color deficiency affects the medical skills of students resulting in poor clinical examination and color appreciation. There is no effective screening of CVD at any level of the medical profession. Hence, this study was aimed to determine the prevalence of CVD among medical students. Materials and methods This was a cross-sectional study conducted from September 2019 to February 2020 over a period of six months in Karachi, Pakistan. All medical students aged 18-21 years of either gender enrolled in the first and second years of medical college were included in this study. The examination was performed during daylight. Ishihara plates were placed at a distance of 75 cm from the subject and tilted so that the plane of the paper lies perpendicular to the line of vision. Students were given five seconds to read the plate and one examiner was instructed to mark the checklist. A score of less than 12 out of 14 red/green test plates (not including the demonstration plate) was considered as a CVD. All statistical analysis was performed using Statistical Package for Social Sciences version 20.0 (Armonk, NY: IBM Corp). Results The mean age of the medical students was 19.61± 1.22 years. There were (n=123) 53.0% females and (n=111) 47.0% males. Most of the medical students (n=131, 56.0%) belonged to the upper-middle-class socioeconomic group. CVD was observed in (n=13) 6.0%of medical students. Age (p=0.001) and socioeconomic status (p=0.001) were the only demographic factors significantly associated with color deficiency. Conclusions Color deficiency, although an unnoticed concern, is fairly common among medical students. Medical students must be screened for CVD as this will enable them to be aware of their limitations in their future observational skills as a doctor and devise ways of overcoming them in clinical practice.

Artificial reefs have been deployed in multiple regions of the world for different purposes including habitat restoration and protection, biodiversity and fish stock enhancement, fisheries management and recreation. Artificial reefs can be a valuable tool for ecosystem protection and rehabilitation, helping mitigate the effects of anthropogenic impacts that we face today. However, knowledge on artificial reefs is unevenly distributed worldwide, with some regions having much more quality information available and published (e.g. European Mediterranean Sea area), while others, for instance the North-East Atlantic area, do not. Here, we provide a characterization of purposely built artificial reefs in North-East Atlantic area based on all available literature (i.e. research papers and reports), highlighting the needs and gaps that are vital for establishing future perspectives for artificial reef deployment and research. In the North-East Atlantic area, sixty-one purposely built artificial reefs have been deployed since 1970, mostly between the years 1990-2009, with Spain being the country with the highest number of artificial reefs. The most reported purpose for their deployment is fisheries productivity and habitat/species protection, although, most artificial reefs are multipurpose in order to maximise the benefits of a given financial investment. The majority of artificial reefs were submerged at < 50 m, mainly between 10-20 m of depth. The most used designs were cubic blocks and complex designs made by an array of combined shapes, which mostly consist of concrete (79%). From all the analysed data on artificial reefs, 67% of the cases reported surveys to assess biodiversity after the deployment. However, in 26% of those cases, data was not available. When data was available, only 31% of cases reported long-term biomonitoring surveys (3 years or more). Based upon these findings, we noticed a general lack of scientifically robust data, including records of species and abundance of both fish and invertebrates, as well as macroalgae. Preventing an adequate determination of the best balance between shape, construction material and bio-colonization. Critiques and suggestions are discussed in the light of current available data in order to perform more efficient research, evaluation and functioning of future artificial reefs.

The green biomass of horticultural plants contains valuable secondary metabolites (SM) which can potentially be extracted and sold. When exposed to stress, plants accumulate higher amounts of these SMs, making the extraction and commercialization even more attractive. We evaluated the potential for accumulating of the flavones cynaroside and graveobioside A in leaves of two bell pepper cultivars (Mavras and Stayer) when exposed to salt stress (100 mM NaCl), UVA/B excitation (UVA 4-5 W/m²; UVB 10-14 W/m² for 3 hours per day) or a combination of both stressors. HPLC analyses proved the enhanced accumulation of both metabolites under stress conditions. Cynaroside accumulation is effectively triggered by high-UV stress, whereas graveobioside A contents increase under salt stress. Highest contents were observed in plants exposed to combined stress. Effects of stress on overall plant performance differed significantly between treatments, with least negative impact on aboveground biomass found for high-UV stressed plants. The usage of two non-destructive instruments (Dualex and Multiplex) allowed us to gain insights in ontogenetical effects at the leaf level and temporal development of SM contents over time. Indices provided by those devices correlate fairly with amounts detected via HPLC (Cynaroside: R2 = 0.46 – 0.66; Graveobioside A: R2 = 0.51 – 0.71). The concentrations of both metabolites tend to decrease at leaf level during the ontogenetical development even under stress conditions. High-UV stress is a promising tool for enriching plant leaves with valuable SM without major effects on plant biomass. All data is available online [1].