eLearning

During the pandemic season, learning and teaching through offline is getting difficult for both teachers and students. Keeping this in mind, we want to design a web application which will be providing the services for both teachers and learners. If the services of E-learning want to be used by the students and trainers, then they need to register with the application. Every user will be having their own dash boards to do the operations. Learner will be having the courses, he can be able to select the courses, he can select the schedule i.e., live or self-pacing etc., he can be able to communicate with the teacher if he is having any doubts etc. Students can create their profile at the time of the registration, he will be having the edit facilities to his/her profile. Similarly, teachers can register with the application. They will be having the dashboards with the operations like creating the course, communicating with the students, scheduling the class, teaching the class etc. Main objective of the application is to provide the teaching and learning with enhanced features in the application. It should meet the expectations of the teachers and learners; it should provide user accessibility to learn and to teach. This application will be replacing the existing system and provides the better services to all the users. As the application needs 3 months of time to complete it and will be released by the end of November 2021. To implement the above application, we have selected the software as HTML, CSS, Bootstrap, JavaScript, jQuery as front end and the database we are going to use is SQL Server Management studio. IDE (Integrated development environment) we are using is Visual studio community 2019

Navigating a Multi-Billion Dollar Industry: Protecting Drug-Related Inventions to Further Research and Development

Even with advancements in science and technology, pharmaceuticals continue to find themselves tethered to patent protection guidelines that once ensured revenue would continue to flow and provide funding for the next blockbuster drug or antibodies. However, as the Federal Circuit appears to inch towards unpredictability in the realm of patent validity, challenges involving patenting are imminent. In fact, gaps are forming in the ability of pharmaceuticals to further research and develop drugs. This Note proposes a solution that encapsulates a more precise standard supported by economic and policy rationales to determine patent validity. It begins with the general requirements of patenting and reasons why trade secrecy may be more effective as investments in research and development increase. Next, policy rationales of patent protection versus trade secrecy will be explained using the Juno case. Lastly, a solution will be proposed for how courts may consider patent validity cases to protect innovation. Overall, this Note aims to highlight the difficulties between choosing patent protection versus trade secrecy and how investment incentives may contribute to the decision, leaning towards the trade secrecy route

The identification and interpretation of pathogenic non-coding mutations in pancreatic ductal adenocarcinoma.

PhD Theses MedicalPancreatic ductal adenocarcinoma (PDAC) remains one of the most aggressive and lethal malignancies. Despite significant advances in medicine and surgery, pancreatic cancer still has a dismal 5-year survival rate below 8%. Much emphasis to date has been directed into identifying somatic mutations in the coding regions of the genome, identifying several known drivers including KRAS, TP53, CDNK2A, AIRD1A, and SMAD4. However, the coding regions comprise only 2% of the human genome. The other 98% comprises non-coding DNA, where somatic non-coding mutations (NCMs) are becoming increasingly associated with pathogenic roles in cancer. To date, little is known regarding somatic NCMs and their regulatory affects in PDAC. We integrate publicly available ChIP-Seq data for the enrichment of active promoter and enhancer regions, RNA-seq data for gene expression analysis and whole genome sequencing data produced by the International Cancer Genome Consortium (659 PDAC patients). Using our analytic pipeline of two independent approaches, we identify 14 regulatory regions harbouring putative functional somatic mutations or recurrent variants, arising proximal to PDAC relevant genes including an enhancer within the intron of the transcription factor FOXP1 and the promoter of the oncogenic long non-coding RNA (lncRNA), HOTAIR. Furthermore, pathway analysis identified NCMs in close proximity to genes involved in transcriptional regulation and biological processes such as cell adhesion. Using a combination of luciferase reporter and high-throughput STARR-seq assays, we assess the regulatory activity of 587 somatic NCMs with putative transcriptional factor motif gain or loss of function capabilities. Our results show 43 NCMs with significant gene reporter expression alterations. Interestingly, we identify NCMs located in a 2kb region within the intron of the cancer associated polycistronic lncRNA MIR100HG, which demonstrates an up-regulation in gene reporter activity. This site is also located proximal to the oncogenic mir-125b-1. CRISPR-Cas9 mediated deletion of this 2kb element demonstrated phenotypic alterations in PDAC cell lines, with a reduced capacity in cell migration and clonogenicity. We also observe evidence of differential expression of nearby TAD associated genes, suggesting important regulatory roles of this 2kb intronic element. This study represents a step towards unravelling the non-coding regions of the genome and to the identification of novel biomarkers and therapeutic targets in this deadly disease

Streptococcus viridans osteomyelitis and endocarditis following dental treatment: a case report

Vertebral osteomyelitis is an uncommon complication of infective endocarditis with the organism Streptococcus viridans being a rare cause of the condition. This case highlights an unusual presentation of Streptococcus viridans associated with infective endocarditis and pyogenic osteomyelitis in a patient following a dental procedure

Examination from the Patient Perspective of Factors and Influences of Cost of Care-Related Communication between Physicians and African American Women with Asthma.

Asthma is a prevalent chronic condition where associated costs to patients are high and perceptions of financial burden may be evident. Communication between clinician and patient (cost of care-related communication) may mitigate perceptions and improve disease management. Through mixed methods approaches, this dissertation examined 1) economic factors that mediate patient characteristics and perception of financial burden and preferences for cost of care-related communication, 2) associations between cost of care-related communication and asthma self-management behaviors, and 3) clinical factors that mediate communication and asthma-related urgent care use. Baseline data were collected from 343 African American women seeking services for asthma in Southeast Michigan. Additional qualitative data were collected from sub-samples via two focus groups (n=14) and in-depth interviews (n=25). Mediation was assessed with structural equation modeling. In the first and second study, associations between perceptions of financial burden, preferences for cost of care-related communication, and patient characteristics were examined through hypothesized mediators (household income, health insurance, out-of-pocket expenses). In the third study, the relationship between cost of care-related communication and self-management behaviors and urgent care use was assessed with linear regression models, and structural equation models. Coded transcripts from the qualitative data were analyzed for themes to provide supporting information. More than half of women with asthma reported perceptions of financial burden. Three-fourths reported a preference to discuss cost with their clinician; however, less than half reported such discussions actually occurring. Household income, health insurance, and out-of-pocket expenses accounted for the relationships between patients’ characteristics and their perceptions of burden and preferences for communication. No associations between cost of care-related communication, self-management behaviors and asthma-related urgent care use were found. Many people perceive financial burden and would like to discuss cost with their clinician, but these discussions occur infrequently, and are often initiated by patients. Burden may be present despite having economic resources. Given the high percentage of women desiring cost-of-care discussions, more research is needed in order to strengthen capacity of care teams and patients in order to integrate financial concerns with disease management into routine care.PHDHealth Behavior & Health EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/97902/1/minalrp_1.pd

What other STI testing should we do for a patient with chlamydia?

Testing for gonorrhea is recommended for a patient with genital chlamydia; also test for gonorrhea and chlamydia in their sexual partner because of the high prevalence of coinfection, particularly among younger patients (strength of recommendation [SOR]: C, based on expert opinion and observational studies). Testing for syphilis and HIV is also recommended for the patient and their partner (SOR: C, based on expert opinion)

Management Strategies in Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronic, proximal and distal, asymmetrical or symmetrical, motor and sensory demyelinating polyneuropathy with a progressive course for at least 2 months. The accurate diagnosis is crucial as CIDP is amenable to treatment. Recent advances have provided new strategies and options for management of this syndrome. In this article, we review the clinical and diagnostic features as well as discuss recent insights and treatment strategies along with our experience in the management of patients with CIDP

DIFFERENT ASPECTS INVOLVED IN PROCESS VALIDATION

ABSTRACT Validation refers to establishing documented evidence that a process or system, when operated within established parameters, can perform effectively and reproducibly to produce a medicinal product meeting its pre-determined specifications and quality attributes. Validation of the individualsteps of the processes is called the process validation. Process validation involves the collection and evaluation of data, from the process design stage throughout production, that establish scientific evidence that a process is capable of consistently delivering a quality drug substance. It is internationally recognized that validation is necessary in analyticallaboratories. The use of validated methods is important for an analyticallaboratory to show its qualification and competency.This new approach to process validation encompasses equipmentand utility qualification and is fully science and risk-based. Itprovides the pharmaceutical industry with the opportunity tore-think the whole concept of validation and ensure that theseactivities add real value to our businesses and to patients.It involves prospective validation, retrospective validation and concurrent validation.A life-cycle approach should be applied linking product and process development, validation of the commercial manufacturing process and maintenance of the process in a state of control during routine commercial production. KEYWORDS:Validation, prospective validation, concurrent validation, retrospective  validation, quality by desig

A qualitative study of physician perspectives of cost-related communication and patients’ financial burden with managing chronic disease

Abstract Background Patient financial burden with chronic disease poses significant health risks, yet it remains outside the scope of clinical visits. Little is known about how physicians perceive their patients’ health-related financial burden in the context of primary care. The purpose of this study was to describe physician experiences with patients’ financial burden while managing chronic disease and the communication of these issues. Methods In November 2013, four focus groups were conducted in an academic medical center. A convenience sample of 29 internal and family medicine resident physicians was used in this study. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding physicians’ experiences with identifying, managing, and communicating financial burden with their patients in the context of primary care. Results Major themes identified were 1) patient financial burden with chronic care is visible to physicians, 2) patient’s financial burden with chronic care and discussing these issues is important to physicians, 3) ability to identify patients who perceive financial burden is imperfect, 4) communication of financial burden with patients is complex and difficult to navigate, 5) strategies utilized to address concerns are not always generalizable, and 6) physicians have ideas for widespread change to make these conversations easier for them. Conclusion Awareness of physician perspectives in identifying and addressing their patients’ disease-related financial burden may better equip researchers and medical educators to develop interventions that aid care teams in better understanding these patient concerns to promote compliance with treatment recommendations.http://deepblue.lib.umich.edu/bitstream/2027.42/116043/1/12913_2015_Article_1189.pd

Maternal outcome in pregnancy with sickle cell trait haemoglobinopathie

Background: Sickle cell trait, the heterozygous state for sickle cell disorders (SCD), which is associated with various obstetrical and non- obstetrical complication. Our objective was to study the pregnancy outcome in women with sickle cell trait.Methods: A prospective observational study was conducted collecting data from medical records of around 40 consecutive consenting subjects admitted in a tertiary health care center of south Gujarat over a period of May 2020 to April 2021 after Human Research Ethics Committee (HREC) approval.Results: In our study majority of the subjects (52.5%) belonged to age group of 18-25 years, majority (62.5%) of subjects were belonged to tribal population. Majority (92.5%) of subjects in our study diagnosed as sickle cell trait post -conceptional. 67% of subjects had various antenatal maternal morbidity among them anemia (45%); preterm labour (12.5%); hypertensive disorder (7.5%) and respiratory failure (2.5%). 65% of our subjects were delivered vaginaly. 5% of subjects had post- partum complication.Conclusions: Though sickle cell trait is considered as a low risk factor during pregnancy, expansion of SCT screening and educational efforts, the availability of reproductive technologies, and the increasing research on clinical complications of SCT have important implications for reproductive and genetic counselling guidelines