Implementation of a quality improvement project on smoking cessation reduces smoking in a high risk trauma patient population.

BackgroundCigarette smoking causes about one of every five deaths in the U.S. each year. In 2013 the prevalence of smoking in our institution's trauma population was 26.7 %, well above the national adult average of 18.1 % according to the CDC website. As a quality improvement project we implemented a multimodality smoking cessation program in a high-risk trauma population.MethodsAll smokers with independent mental capacity admitted to our level I trauma center from 6/1/2014 until 3/31/2015 were counseled by a physician on the benefits of smoking cessation. Those who wished to quit smoking were given further counseling by a pulmonary rehabilitation nurse and offered nicotine replacement therapy (e.g. nicotine patch). A planned 30 day or later follow-up was performed to ascertain the primary endpoint of the total number of patients who quit smoking, with a secondary endpoint of reduction in the frequency of smoking, defined as at least a half pack per day reduction from their pre-intervention state.ResultsDuring the 9 month study period, 1066 trauma patients were admitted with 241 (22.6 %) identified as smokers. A total of 31 patients with a mean Injury Severity Score (ISS) of 14.2 (range 1-38), mean age of 47.6 (21-71) and mean years of smoking of 27.1 (2-55), wished to stop smoking. Seven of the 31 patients, (22.5 %, 95 % confidence interval [CI] of 10-41 %) achieved self-reported smoking cessation at or beyond 30 days post discharge. An additional eight patients (25.8 %, 95 % CI 12-45 %) reported significant reduction in smoking.ConclusionsTrauma patients represent a high risk smoking population. The implementation of a smoking cessation program led to a smoking cessation rate of 22.5 % and smoking reduction in 25.8 % of all identified smokers who participated in the program. This is a relatively simple, inexpensive intervention with potentially far reaching and beneficial long-term health implications. A larger, multi-center prospective study appears warranted.Level of evidenceTherapeutic Study, Level V evidence

Using Photoactive Nanoparticles as Photodynamic Antimicrobial Chemotherapeutic (PACT) Agent to Treat Chronic Wounds

The purpose of this study is to use photoactive vitamin nanoparticles as photodynamic antimicrobial chemotherapeutic agent to treat patients with chronic wounds. Chronic wounds are considered as a pandemic health problem which affects millions of people and increases ~10 % annually. According to the American Academy of Dermatology, the expense of treating chronic wounds constitutes over half of the total cost for all skin diseases. The main cause of chronic wounds is due to the existence of biofilms. Biofilms are complex microbial communities containing and are reported to be major factor contributing to multiple chronic inflammatory diseases. Owing to bacterial species with in biofilms being exceptionally resisted to many traditional therapies, Photodynamic Antimicrobial Chemotherapy (PACT) can provide an effective alternative antimicrobial, antifungal, and antiviral treatment for drug-resistant microorganism. PDT uses both light and nontoxic vitamin photosensitizers to destroy specific targeted cells. The main advantage of PACT would be that it is very unlikely for bacteria to develop resistance to reactive oxygen species. However, the main limitation of this technique would be the uptake kinetics of the photo sensitizers in microorganisms. We have developed a unique nano-emulsion to increase the solubility of these otherwise hard to dissolve, hydrophobic vitamins for faster, more effective delivery to the targeted cells. This provides a photodynamic chemotherapeutic regime for the treatment of chronic wound ulcers caused by microbial biofilms

The Effect of Noise-reducing Acoustic Panels on the Noise Levels and Overall Safety of Infant Sleep Machines

Infant sleep machines (ISMs) are devices used to help infants fall asleep faster and stay asleep for longer amounts of time, yet they can often be too loud for infantile ears, which could potentially be dangerous. This research aimed to minimize the risks of infant sleep machines without reducing the effectiveness of the infant sleep machines themselves through the use of acoustic panels. Based on previous studies, it was hypothesized that the acoustic panels would reduce the noise levels of the ISM to less than recommended limits of 50 dB-A. A specific corner of a designated room was prepared with a crib with a sound level meter placed inside and a table housing the ISM all to simulate a sleeping infant being exposed to the white noise from the ISM. After 30 trials were conducted without any soundproofing, another 30 trials were conducted after acoustic panels were placed on the walls behind the crib in order to reduce the noise levels of the ISM. Significant differences were found between the two groups, with the t-statistic of 30.9688 being much higher than the critical value of 1.697, and the p-value being less than 0.001, all with an alpha of 0.05. Finally, it was found that acoustic panels did reduce the noise levels to below less than 50 dB-A, which means the hypothesis was supported. This shows that acoustic panels have a significant effect on noise reduction for infants and are a safe, inexpensive option for parents

Influence of Diet on Population Growth and Allergen Production in Cultured House Dust Mites - \u3cem\u3edermatophagoides Farinae\u3c/em\u3e and \u3cem\u3edermatophagoides Pteronyssinus\u3c/em\u3e

Dermatophagoides farinae and Dermatophagoides pteronyssinus culture extracts are used for skin testing, immunotherapy and research studies. There is a need to develop an effective culture method so that standardized extracts and allergens can be produced. The purpose of this study was to examine if different diets effect mite population growth and the amount of allergen produced in cultures. Dermatophagoides farinae and Dermatophagoides pteronyssinus were cultured on diets A and B. The density of mites, life stage composition and allergen concentration was determined at two week intervals. Enzyme-linked immune sorbent assays (ELISA) were used to assess group 1 and group 2 allergen concentrations. This study showed that diet is an important factor for culturing of mites. Diet B was found to be better suited to culture Dermatophagoides farinae whereas diet A was better for culturing of Dermatophagoides pteronyssinus. Diet A cultures of Dermatophagoides pteronyssinus produced greater concentrations of group 2 allergen than diet B

Kilpailija-analyysi Motonetin verkkosivuston kehittämiseksi

Työssä tavoitteena oli tehdä kilpailija-analyysi Motonet Oy:n verkkosivustosta ja tarjota kehitysehdotuksia yrityksen kilpailukyvyn vahvistamiseksi. Analyysissä verrattiin Motonetin verkkosivustoa kuuden keskeisen kilpailijan verkkosivustoihin. Vertailun tarkastelukriteereiksi valittiin verkkosivustojen käyttäjäkokemukset, visuaalisuus, sisältö, hakukoneoptimointi ja toiminnallisuudet. Työn tavoitteena oli tunnistaa Motonetin vahvuudet ja kehityskohteet sekä luoda selkeitä konkreettisia suosituksia verkkosivuston parantamiseksi. Tutkimus osoitti, että Motonetin verkkosivusto on kilpailukykyinen erityisesti navigoinnin selkeydessä ja kattavissa tuotetiedoissa. Kehityskohteiksi havaittiin mobiilikäytettävyyden parantaminen, hakukoneoptimoinnin tekninen kehittäminen sekä visuaalisuuden modernisointi. Tutkimuksen tulokset luovat arvokkaan perustan Motonetin verkkosivuston kehittämiselle ja voivat toimia esimerkkinä myös muille samankaltaisille projekteille.Opinnäytetyö toteutetaan Motonetille, joka pyrkii vahvistamaan asemaansa kuluttajatuotemarkkinoilla digitaalisen markkinoinnin avulla. Työn tavoitteena on tarjota arvokasta tietoa Motonetin kilpailijoista ja näiden digitaalisen markkinoinnin strategioista, jotta yritys voi hyödyntää analyysia oman markkinointinsa kehittämisessä. Kilpailija-analyysi auttaa tunnistamaan kilpailijoiden vahvuuksia ja heikkouksia sekä arvioimaan Motonetin markkinoinnin tehokkuutta suhteessa kilpailijoihin

Valtion erityisavustus ja oppilaanohjauksen kehittämishankkeet hallinnan teknologiana

Tässä tutkielmassa käsittelen valtion erityisavustusta perusopetuksen oppilaanohjaukseen kohdistuvana hallinnan teknologiana. Tutkielma laajentaa käsitystä koulutuspoliittisten kehittämishankkeiden vaikutuksista ja tarjoaa näkökulmia siihen, miten yhteiskunnalliset rakenteet ja virkakielen diskurssit muokkaavat koulutuksen ja ohjauksen käytäntöjä. Opinto-ohjauksen rahoitusinstrumenttien diskursiivisuutta ei juurikaan ole tutkittu, sillä useimmat hankerahoitukseen liittyvät tutkimukset keskittyvät koulutuksen ja ohjauksen eriarvoisuuteen tai hankerahoituksiin muilla aloilla. Viime vuosien koulutuspoliittiset muutokset, koulutuksen eriarvoisuus ja yhä nuorempiin oppilaisiin kohdistuvat jatko-opinto paineet tekevät tutkimuksesta tärkeän ja ajankohtaisen. Tutkielmani on kriittinen diskurssianalyysi, jonka aineistona on valtion erityisavustushakemuksen ilmoitusteksti sekä 22 avustushakemusta. Avustus myönnettiin perusopetuksen oppilaanohjauksen alueellisiin kehittämishankkeisiin vuosille 2021–2022. Tutkimani erityisavustus kytkeytyy useisiin koulutuspoliittisiin ohjelmiin ja muutoksiin, kuten 1.8.2021 alkaen voimaan tulleeseen oppivelvollisuusiän nostoon sekä tehostettuun henkilökohtaiseen oppilaanohjaukseen. Erityisavustuksella pyrittiin julkilausutusti tukemaan oppilaanohjauksen kehittämistä erityisesti näihin muutoksiin liittyen. Tutkielmassani esitän, että oppilaanohjauksen kehittäminen on koulutuspoliittisen hallinnan teknologia, jonka avulla pyritään takaamaan sujuvat siirtymät peruskoulusta toiselle asteelle ja välttämään keskeytyksiä jatko-opinnoissa. Sosiaalisen konstruktionismin viitekehyksessä valtion erityisavustuksen hakuilmoitus ja avustushakemukset voidaan tunnistaa kielellisinä tekoina, jotka merkityksellistävät käsitystä oppilaanohjauksesta ja ihanteellisesta opiskelijasubjektista. Analysoin valtion erityisavustusta anonyyminä hallintana, joka ohjaa yksilöiden koulutusvalintoja ja elämänkulkua. Tutkielman teoreettinen pohja rakentuu Michel Foucault’n vallan sekä Peter Millerin ja Nikolas Rosen hallinnan käsitteille. Tutkimuskysymykseni ovat: 1. Millaisia diskursseja valtion erityisavustuksen hakuilmoituksen ja avustushakemusten kehittämistavoitteista voidaan tunnistaa ja 2. Miten oppilaanohjausta kehittämällä pyritään ohjaamaan ja hallitsemaan yksilöiden elämänpolkuja? Aineistosta tunnistamani tehostetun tuen, tehokkuuden ja työelämän diskurssit ovat osin limittäisiä ja legitimoivat erilaisia poliittisia tavoitteita. Oppilaanohjauksen kehittämispuheen diskursiivisuus pohjautuu tutkielmani mukaan laajempaan talousdiskurssiin ja uusliberalistisen koulutuspolitiikan ideologiaan. Tutkielmani tarkoitus ei ole kritisoida valtion erityisavustusta tai oppilaanohjauksen kehittämistä sinänsä, vaan pyrkiä tuomaan näkyväksi valtion erityisavustuksen kielellisten tekojen ja tekstien merkitystä uusliberalistisen hegemonian uusintamisessa. Tutkielmassa kiinnitän huomiota siihen, miten oppilaanohjausta merkityksellistetään, millaisia subjektipositioita oppilaanohjaajille ja oppilaille diskursseissa tarjoutuu ja millaisia näkökulmia oppilaanohjauksen kehittämisen diskurssit saattavat ohittaa. Esitän tutkielmassani, että oppilaanohjauksen kehittämistarpeet, tavoitteet ja problematisoinnit kuvataan uusliberalistisen koulutuspolitiikan ehdoilla. Hallinnan teknologiana valtion erityisavustus ja sillä rahoitetut hankkeet ovat käytännön toimenpide, jolla poliittisten ohjelmien kieli konkretisoituu oppilaanohjauksen ja normatiivisten elämänpolkujen merkitystä rakentaviksi käytännöiksi

Reliable Fault Tolerance System for Service Composition in Mobile Ad Hoc Network

A Due to the rapid development of smart processing mobile devices, Mobile applications are exploring the use of web services in MANETs to satisfy the user needs. Complex user needs are satisfied by the service composition where a complex service is created by combining one or more atomic services. Service composition has a significant challenge in MANETs due to its limited bandwidth, constrained energy sources, dynamic node movement and often suffers from node failures. These constraints increase the failure rate of service composition. To overcome these, we propose Reliable Fault Tolerant System for Service Composition in MANETs (RFTSC) which makes use of the checkpointing technique for service composition in MANETs. We propose fault policies for each fault in service composition when the faults occur. Failure of services in the service composition process is recovered locally by making use of Checkpointing system and by using discovered services which satisfies the QoS constraints. A Multi-Service Tree (MST) is proposed to recover failed services with O(1) time complexity. Simulation result shows that the proposed approach is efficient when compared to existing approaches

Role of STAT3/IFNg axis in promoting cancer stem cells (CSC)

Interferon-gamma (IFNγ) has emerged as a significant player in cancer biology, influencing stem-like cell populations in various cancer contexts. While IFNγ is used as a treatment option for cancer patients based on its anti-tumorigenic effects it is seen to have off target effects where it promotes tumorigenesis paradoxically. It has been shown that IFNg exposure increases the expression of certain cancer stem cell (CSC) markers. However, the mechanism of this is not yet understood. This study addresses this critical gap in being able to understand the role of IFNg experience in the regulation of cancer. It is hypothesized that IFNg treatment of breast cancer and sarcoma cells would induce stem-like phenotypes, but the efficiency depends on whether STAT3 is activated by IFNg. So, if cells lacked STAT1, then IFNg should activate STAT3, and this could promote stemness, among other characteristics. This research has two areas of focus: in vitro and in vivo models of fibrosarcoma cell lines lacking or constituted with STAT1 and the effect of fludarabine (STAT1 inhibitor) on breast cancer cell lines. It is shown that IFNg exposure increases sphere formation and Sca1+/CD90- stem cell like marker expression in fibrosarcoma cells lacking STAT1 thereby potentially indicating that it is STAT3 behind these findings. In breast cancer models it was observed that fludarabine alone increase stem cell marker population as well as increases it even more synergistically with IFNg. These findings advance our understanding of the complex interplay of IFNg on the STAT1/STAT3 axis thereby effecting cancer stem cells in tumor biology

Fuzzy Based Optimal QoS Constraint Services Composition in Mobile Ad Hoc Networks

In recent years, computational capability of mobile devices such as Laptops, mobile phones, PDAs, etc., are greatly improved. Implementation of SOA ("Service Oriented Architectures") in mobile ad hoc networks increases the flexibility of using mobile devices. On composing different available services to satisfy end user requirement is a critical challenge in MANETs ("Mobile Ad Hoc Network") due to dynamic topology, Resource heterogeneity, Band width constraint and highly distributed service providers. Existing composition services approaches are not suitable for MANETs due to lack of constraints consideration while choosing services. In this paper, we proposed Fuzzy based optimal QoS constrained Service Composition in MANETs. We consider Energy constraint, hop count, Response time & service throughput as QoS Constraints composing optimal services. We proposed fuzzy logic based system to provide rating to the services for optimal selection of services. We also considered that each node can provide one or more services. The service composition failure rate will be reduced by selecting optimal services in available services. The simulation result demonstrates that the proposed method outperformed than the traditional AODV in terms of average packet delay, energy constraint, throughput and turnaround time

The Cell Surface Estrogen Receptor, G Protein- Coupled Receptor 30 (GPR30), is Markedly Down Regulated During Breast Tumorigenesis

Background: GPR30 is a cell surface estrogen receptor that has been shown to mediate a number of non-genomic rapid effects of estrogen and appear to balance the signaling of estrogen and growth factors. In addition, progestins appear to use GPR30 for their actions. Therefore, GPR30 could play a critical role in hormonal regulation of breast epithelial cell integrity. Deregulation of the events mediated by GPR30 could contribute to tumorigenesis.Methods: To understand the role of GPR30 in the deregulation of estrogen signaling processes during breast carcinogenesis, we have undertaken this study to investigate its expression at mRNA levels in tumor tissues and their matched normal tissues. We compared its expression at mRNA levels by RT quantitative real-time PCR relative to GAPDH in ERα”—positive (n = 54) and ERα”—negative (n = 45) breast cancer tissues to their matched normal tissues.Results: We report here, for the first time, that GPR30 mRNA levels were significantly down-regulated in cancer tissues in comparison with their matched normal tissues (p 0.0001 by two sided paired t-test). The GPR30 expression levels were significantly lower in tumor tissues from patients (n = 29) who had lymph node metastasis in comparison with tumors from patients (n = 53) who were negative for lymph node metastasis (two sample t-test, p 0.02), but no association was found with ERα, PR and other tumor characteristics.Conclusions: Down-regulation of GPR30 could contribute to breast tumorigenesis and lymph node metastasis