Impact of educational intervention on the awareness of undergraduate medical students towards teratogenicity: an observational study

Background: The term teratogenicity is defined as any morphological, behavioral or biochemical effect induced during embryonic life or fetal life detected at birth or later. the factors that lead to teratogenicity include both non-genetic and genetic factors. The objective of the present study was to assess the impact of educational interventions on the awareness of undergraduate medical students towards teratogenicityMethods: The present study was a questionnaire-based comparative observational study carried out at Department of Pharmacology and Therapeutics, Government Medical College, Jammu (J&K) for a period of three months from 1st November 2017 to 31st January 2018. The questionnaire was designed and validated by conducting pilot study on a sample of ten students. The questionnaire comprised of two main parts. The first part comprised of questions pertaining to the demographic profile of the students and second part consisted of questions assessing the students’ knowledge and awareness towards teratogenicity. The scoring of the assessment of the performance of the students regarding knowledge of various aspects of teratogenicity was done before and after the educational intervention and was compared using paired t-test.Results: A total of 134 second year MBBS undergraduate students participated in the study. Mean age of students was 19.32±0.82 years. In the present study it was found that before the educational intervention about 98.5% of the students and after the intervention all the students were aware of the term teratogenicity. About 69.4% of students knew about all the causes that lead to teratogenicity but after the intervention about 76.1% of the students knew about it. Also, the percentage of students who knew about the name of two teratogenic drugs and two teratogenic defects associated with drugs were only 31.3% and 22.3% respectively. After the educational intervention it increased to 61.9% and 52.2% respectively.Conclusions: In the present study, it was found that after the educational intervention, there was a significant improvement in the mean knowledge score of the students. This reflects the need of early exposure of students to this important issue of teratogenicity

A Comparative Study and Kinetics for the Removal of Hexavalent Chromium from Aqueous Solution by Agricultural, Timber and Fruit Wastes

The removal of hexavalent chromium from aqueous solutions using low cost agricultural, timber and fruits wastes is studied. The adsorbents selected were rice husk in ash and dried form, sawdust, orange peels and sugarcane bagasse. Batch mode experiments were conducted at room temperature to study the effect of pH, agitation time, initial metal ion concentration, and adsorbent dose. Equilibrium adsorption isotherms and kinetics were investigated. The adsorption isotherm data were fitted to Langmuir isotherm and the monolayer adsorption capacity has been observed to follow the order dried rice husk (16.94 mg/g) > orange peels (12.65 mg/g) > rice husk ash (11.11 mg/g) > sugarcane bagasse (5.12 mg/g) > sawdust (4.56 mg/g) at room temperature. It was found that the maximum amount absorbed metal (qmax) value is significantly influenced by liquid/solid ratio and by the pH values of the metal solutions. The kinetic data obtained at different concentrations have been analyzed using a pseudo-first-order, pseudo-second order and intraparticle diffusion equation. The experimental data fitted very well the pseudo-second-order kinetic model. On the basis of present studies, it can be concluded that dried rice husk, has a higher chromium adsorption capacities compared to other adsorbents. Keywords: Adsorption, Hexavalent chromium, Cr (VI), non-conventional adsorbent, isotherms, heavy metal, kinetics, adsorption isotherm

Management Strategies for Oral Cancer Subsites

Oral cancers are the most common cancers in India, especially in males. This can be attributed primarily to consumption of tobacco and areca related products. Surgery is the mainstay of treatment for oral cancers with subtle subsite-specific nuances. The oral cavity starts at the mucocutaneous junction of the lips (the vermilion border) extending posteriorly to the junction of the hard and soft palate superiorly, anterior fauces laterally and the junction of the anterior two-thirds and posterior third of the tongue inferiorly. The oral cavity is lined by stratified squamous epithelium of varying degrees of keratinization. Primary tumors of the oral cavity may be derived from the mucosa, salivary glands, neurovascular tissues, bone or dental tissues. Over 90% of malignant tumors of the oral cavity are squamous cell carcinomas. There are certain basic principles of oncology, those hold true, despite the disease subsite and pathology. Stage I and II disease should be dealt with single modality treatment, whereas Stage III and IV warrant combined modality approach. Choice of modality (surgical versus non-surgical), depends on intent of treatment, chances of cure, accessibility and resectability of disease, impact on quality of life and patient’s general health profile

Developing a BIM-based methodology to support renewable energy assessment of buildings

Realising the benefits of implementing Building Information Modelling (BIM) tools and processes on projects worldwide, the architecture, engineering and construction (AEC) industry is rapidly moving towards BIM adoption. This calls for higher levels of interoperability amongst existing design and analysis tools used by various project team members. An approach to achieving higher levels of BIM maturity and interoperability is to adopt open, non-proprietary data exchange standards such as the Industry Foundation Classes (IFC). Efforts are currently underway to establish IFC-compliance in analysis tools. Establishing interoperability between architectural BIM models and energy analysis tools has been a challenging effort. With the industry chasing renewable energy targets for existing and new building stock, it becomes imperative to incorporate analysis tools for renewable energy systems (RES) in this effort. A plethora of tools are used by the project team to assess the performance of various RES in existing buildings or in post-design stages of new buildings. A holistic RES simulation tool is required that can assess various RES and their impact on the building’s energy consumption, carbon emissions and operational costs. Developing this tool’s interoperability with architectural BIM models would lead to higher adoption. The aim of this thesis is to develop a methodology to support renewable energy simulation by using architectural BIM models based on open data exchange standards thereby enhancing their interoperability. The research process involved a literature review of the existing RES analysis methods and approaches of developing IFC-compliant analysis tools. A methodology was developed that involved a standardised conceptual framework that can be used to establish compliance in RES analysis tools with open-data exchange schemas. The conceptual framework was implemented in a solar PV simulation model by means of a prototype. The prototype was validated against existing PV analysis tools and presented to industry experts to gain their feedback. It was concluded that the tool supported RES assessment of buildings in early design stages and could be widely adopted as a BIM tool by the AEC industry

Multi-center implementation of rapid whole genome sequencing provides additional evidence of its utility in the pediatric inpatient setting

ObjectiveMulti-center implementation of rapid whole genome sequencing with assessment of the clinical utility of rapid whole genome sequencing (rWGS), including positive, negative and uncertain results, in admitted infants with a suspected genetic disease.Study designrWGS tests were ordered at eight hospitals between November 2017 and April 2020. Investigators completed a survey of demographic data, Human Phenotype Ontology (HPO) terms, test results and impacts of results on clinical care.ResultsA total of 188 patients, on general hospital floors and intensive care unit (ICU) settings, underwent rWGS testing. Racial and ethnic characteristics of the tested infants were broadly representative of births in the country at large. 35% of infants received a diagnostic result in a median of 6 days. The most common HPO terms for tested infants indicated an abnormality of the nervous system, followed by the cardiovascular system, the digestive system, the respiratory system and the head and neck. Providers indicated a major change in clinical management because of rWGS for 32% of infants tested overall and 70% of those with a diagnostic result. Also, 7% of infants with a negative rWGS result and 23% with a variant of unknown significance (VUS) had a major change in management due to testing.ConclusionsOur study demonstrates that the implementation of rWGS is feasible across diverse institutions, and provides additional evidence to support the clinical utility of rWGS in a demographically representative sample of admitted infants and includes assessment of the clinical impact of uncertain rWGS results in addition to both positive and negative results

Prescribing Prevalence of Medications With Potential Genotype-Guided Dosing in Pediatric Patients

Importance: Genotype-guided prescribing in pediatrics could prevent adverse drug reactions and improve therapeutic response. Clinical pharmacogenetic implementation guidelines are available for many medications commonly prescribed to children. Frequencies of medication prescription and actionable genotypes (genotypes where a prescribing change may be indicated) inform the potential value of pharmacogenetic implementation. Objective: To assess potential opportunities for genotype-guided prescribing in pediatric populations among multiple health systems by examining the prevalence of prescriptions for each drug with the highest level of evidence (Clinical Pharmacogenetics Implementation Consortium level A) and estimating the prevalence of potential actionable prescribing decisions. Design, setting, and participants: This serial cross-sectional study of prescribing prevalences in 16 health systems included electronic health records data from pediatric inpatient and outpatient encounters from January 1, 2011, to December 31, 2017. The health systems included academic medical centers with free-standing children's hospitals and community hospitals that were part of an adult health care system. Participants included approximately 2.9 million patients younger than 21 years observed per year. Data were analyzed from June 5, 2018, to April 14, 2020. Exposures: Prescription of 38 level A medications based on electronic health records. Main outcomes and measures: Annual prevalence of level A medication prescribing and estimated actionable exposures, calculated by combining estimated site-year prevalences across sites with each site weighted equally. Results: Data from approximately 2.9 million pediatric patients (median age, 8 [interquartile range, 2-16] years; 50.7% female, 62.3% White) were analyzed for a typical calendar year. The annual prescribing prevalence of at least 1 level A drug ranged from 7987 to 10 629 per 100 000 patients with increasing trends from 2011 to 2014. The most prescribed level A drug was the antiemetic ondansetron (annual prevalence of exposure, 8107 [95% CI, 8077-8137] per 100 000 children). Among commonly prescribed opioids, annual prevalence per 100 000 patients was 295 (95% CI, 273-317) for tramadol, 571 (95% CI, 557-586) for codeine, and 2116 (95% CI, 2097-2135) for oxycodone. The antidepressants citalopram, escitalopram, and amitriptyline were also commonly prescribed (annual prevalence, approximately 250 per 100 000 patients for each). Estimated prevalences of actionable exposures were highest for oxycodone and ondansetron (>300 per 100 000 patients annually). CYP2D6 and CYP2C19 substrates were more frequently prescribed than medications influenced by other genes. Conclusions and relevance: These findings suggest that opportunities for pharmacogenetic implementation among pediatric patients in the US are abundant. As expected, the greatest opportunity exists with implementing CYP2D6 and CYP2C19 pharmacogenetic guidance for commonly prescribed antiemetics, analgesics, and antidepressants

Energy Demand Forecasting

Energy load forecasting is a major business problem in the electric power industry. A lot of effort is put in this field by the researchers and industry experts to estimate load. In the recent times, technological development, renewable integration requirements and aging infrastructure has made the energy forecasting more and more important to energy system operations and its planning [1] This project is based on participation in worldwide energy forecasting competition GEFCom for 2017. With the growing need of load forecasting, this competition is an effort to bring together the very advanced and sophisticated techniques and methodologies to predict the demand of energy using hierarchical probabilistic energy forecasting and has participants from various countries. This report explains the learning process and the entire journey of participation in this competition

The Effects of Trust on Behavioral Intention and Use Behavior Within E-Government Contexts

As electronic transactions between governments and users become increasingly common, the role of users’ trust in e-government assumes considerable importance. While prior models of technology acceptance have identified several factors that influence behavioral intention and use behavior, trust has largely been missing in such models. This study incorporates e-government trust into the unified theory of acceptance and use of technology (UTAUT) model and conducts an empirical analysis using meta-analytic structural equation modeling (MASEM) methods on findings gathered from 90 prior studies on e-government. Results show that trust plays a central role in users’ intention to use and use of e-government systems. Specifically, in e-government contexts, trust is impacted by performance expectancy, effort expectancy, social influence, and facilitating conditions; has a direct effect on system use; and an indirect effect on system use through behavioral intention. Practitioners should strive to leverage users’ trust to leverage the full potential of e-government systems

Clarifying the Role of E-Government Trust in E-Government Success Models: A Meta-analytic Structural Equation Modeling Approach

E-government implementation success is of critical importance for nations. Prior information systems (IS) success models emphasize the effects of information quality, service quality, system quality, and user satisfaction but do not consider e-government trust. This study incorporates e-government trust into the IS success model and empirically tests the model on empirical findings reported in 67 prior studies using meta-analysis methods and structural equation modeling. Our analysis shows that: a) information quality, service quality, system quality, and user satisfaction influence e-government trust, and b) system use mediates the effect of e-government trust on intention to use e-government systems in the future

Go2Go Expansion in Hillsboro, OR

Go2Go is a car sharing service, which operates in major cities of the United States of America. In Oregon, there are 500 Go2Go vehicles spread across the Portland Metro Area. With the population growth in Oregon, the demand of car sharing services also increases. Since increase in its success and demand, Go2Go is looking into expanding into another populated city, such as Hillsboro, Oregon. Hillsboro is the fifth largest city in the state of Oregon and hosts many big technology companies, such as Intel, Nike and Tektronix. This project proposal is backed by Go2Go Sales and Marketing team, which had conducted an in depth Market Research on the expansion