Hope for Haiti: Enriching Relationships With Design Thinking

Hope for Haiti is a non-profit organization dedicated to improving the quality of life for the Haitian people, mainly children. Their activities and services are all funded by key donors and philanthropic partners and investors. The organization aims is to create sustainable communities that catalyze generational and transformative change by focusing on five core areas within the Greater South of Haiti. These core areas are education, economy, health care & nutrition, infrastructure, and clean water. Our project aims to empower the Haitian people and attract key donors to support Hope for Haiti. We achieved this by applying the design thinking process

Retardadores de crescimento no desenvolvimento e na qualidade ornamental de Zinnia elegans Jacq. 'Lilliput' envasada

As zínias têm grande potencial como plantas floríferas envasadas e representam rápida fonte de novidade para a floricultura com o auxílio de retardadores de crescimento. Avaliaram-se os efeitos de retardadores de crescimento no desenvolvimento e na produção de plantas envasadas de porte baixo, compactas e atrativas de 'Lilliput' Zinnia elegans, cultivar altamente ornamental, com sementes de baixo custo. O delineamento experimental foi em blocos casualizados, com dez tratamentos (controle e três concentrações de cada retardador: daminozide, paclobutrazol e chlormequat) e quatro repetições (dois vasos por unidade experimental, com uma planta por vaso de 0,6 L). Paclobutrazol (0,5; 0,75 e 1,0 mg i.a. por vaso) e chlormequat (1,0; 2,0 e 3,0 g L-1) foram aplicados ao substrato (40 mL por vaso), enquanto o daminozide (2,5; 3,75 e 5,0 g L-1) foi aplicado através de pulverização foliar (10 mL por vaso), no estádio de gema floral apical visível. Daminozide (2,5 e 3,75 g L-1), paclobutrazol (0,5; 0,75 e 1,0 mg i.a. por vaso) e 1,0 g L-1 de chlormequat reduziram significativamente a altura das plantas e o comprimento dos ramos laterais, sem afetar o diâmetro dos capítulos, atrasar o ciclo de produção e causar fitotoxicidade. Entretanto, as plantas não se apresentaram suficientemente baixas e compactas para atender às exigências de qualidade do mercado. Chlormequat (2,0 e 3,0 g L-1) causou fitotoxicidade e daminozide (5,0 g L-1) aumentou o ciclo de produção.Zinnias have good potential to be used as flowering, potted plants, being a quick source of novelty for the floriculture industry with the aid of growth retardants. This study evaluated the effect of growth retardants on development and production of short, compact and attractive plants of potted 'Lilliput' Zinnia elegans, a highly ornamental zinnia with low cost seeds. Trials were set up in randomized blocks, with ten treatments (control and three treatments of each retardant: daminozide, paclobutrazol and chlormequat) and four replications (two pots per experimental unit, with one plant per 0.6-L pot). Paclobutrazol (0.5, 0.75 and 1.0 mg a.i. per pot) and chlormequat (1.0, 2.0 and 3.0 g L-1) were applied as a single drench (40 mL per pot), and daminozide (2.5, 3.75 and 5.0 g L-1) as a single foliar spray to runoff (10 mL per pot), at apical flower bud stage. Daminozide (2.5 and 3.75 g L-1), paclobutrazol (0.5, 0.75 and 1.0 mg a.i. per pot) and chlormequat at 1.0 g L-1 significantly reduced plant height and side branches length, without affecting flower diameter, delaying production cycle and causing phytotoxicity symptoms. However, plants were not short and compact enough to meet market quality demand. Chlormequat (2.0 and 3.0 g L-1) caused phytotoxicity symptoms and daminozide (5.0 g L-1) delayed production cycle

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Kubtec Medical Imaging

Kubtec is a leading digital X-ray company based in Stratford, Connecticut. Kubtec offers the most innovative tools in digital x-ray equipment for specimen radiography, low-dose imaging, and forensic analysis. We will show the benefits of applying design thinking to Kubtec’s business problems. The company has three different types of end users. The main challenges for the company are how to communicate more effectively with each end users that includes buyers, X-ray technicians and patients. We also take consideration for utilizing the space. These challenges have become the research questions for this project

Digitizing radiographic films: a simple way to evaluate indirect digital images

OBJECTIVES: This study applied a simple method to evaluate the performance of three digital devices (two scanners and one digital camera) using the reproducibility of pixel values attributed to the same radiographic image. METHODS: Using the same capture parameters, a radiographic image was repeatedly digitized in order to determine the variability of pixel values given to the image throughout the digitization process. One coefficient value was obtained and was called pixel value reproducibility. RESULTS: A significant difference in pixel values was observed among the three devices for the digitized images (ANOVA, p<0.00001). There was significant pixel value variability at the same digitization conditions for one scanner and the digital camera. CONCLUSIONS: Digital devices may assign pixel values differently in consecutive digitization depending on the optical density of the radiographic image and the equipment. The pixel value reproducibility was not satisfactory as tested for two devices. It is maybe advisable knowing the digitization variations regarding pixel values whenever using digital radiography images in longitudinal clinical examinations

Bacterial Sphingolipids Exacerbate Colitis by Inhibiting ILC3-derived IL-22 ProductionSummary

Background &amp; Aims: Gut bacterial sphingolipids, primarily produced by Bacteroidetes, have dual roles as bacterial virulence factors and regulators of the host mucosal immune system, including regulatory T cells and invariant natural killer T cells. Patients with inflammatory bowel disease display altered sphingolipids profiles in fecal samples. However, how bacterial sphingolipids modulate mucosal homeostasis and regulate intestinal inflammation remains unclear. Methods: We used dextran sodium sulfate (DSS)-induced colitis in mice monocolonized with Bacteroides fragilis strains expressing or lacking sphingolipids to assess the influence of bacterial sphingolipids on intestinal inflammation using transcriptional, protein, and cellular analyses. Colonic explant and organoid were used to study the function of bacterial sphingolipids. Host mucosal immune cells and cytokines were profiled and characterized using flow cytometry, enzyme-linked immunosorbent assay, and Western blot, and cytokine function in vivo was investigated by monoclonal antibody injection. Results: B fragilis sphingolipids exacerbated intestinal inflammation. Mice monocolonized with B fragilis lacking sphingolipids exhibited less severe DSS-induced colitis. This amelioration of colitis was associated with increased production of interleukin (IL)-22 by ILC3. Mice colonized with B fragilis lacking sphingolipids following DSS treatment showed enhanced epithelial STAT3 activity, intestinal cell proliferation, and antimicrobial peptide production. Protection against DSS colitis associated with B fragilis lacking sphingolipids was reversed on IL22 blockade. Furthermore, bacterial sphingolipids restricted epithelial IL18 production following DSS treatment and interfered with IL22 production by a subset of ILC3 cells expressing both IL18R and major histocompatibility complex class II. Conclusions: B fragilis–derived sphingolipids exacerbate mucosal inflammation by impeding epithelial IL18 expression and concomitantly suppressing the production of IL22 by ILC3 cells