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The UN calls for the elimination of child labour by 2030, and its ‘worst forms’ by 2025. Implicit in this mandate is the assumption that children’s work is harmful, yet no coherent theory of harm exists within the child labour field. Moreover, evidence suggests that simply removing children from supposedly harmful work is often damaging. This paper explores how harm may be understood and identified in the context of children’s work. It reviews and synthesises literature from multiple disciplines, pointing towards a more situated and nuanced approach to harm that incorporates both ‘subjective’ and ‘objective’ dimensions.

The article aims to produce a new class of composite material having a high strength-to-weight ratio using Al–Si alloy and SiC particles. Explicitly, the key objective of this study is associated with multi-objective modelling and optimization of a novel composite material for automobile sectors. The study is based on a structured multi-disciplinary approach by involving the principles and techniques of mechanical engineering, materials engineering, and inferential statistics. More specifically, the mixture design technique from the design of experiment toolbox is employed to ensure multi-objective optimization of the mixture components, namely, Al–Si alloy and SiC particles. The composite material is prepared using the stir casting technique with varying weight percentages of the reinforcing particles. The mechanical properties such as hardness, tensile strength, density, and impact strength of the novel composite material are studied and considered for modelling and optimization. The study assisted in developing an optimal combination of component mixtures and a predictive model to produce a composite material having higher strength through structured engineering and robust statistical methodology. The researchers can follow the modelling and optimization approach adopted in the article as a template for robust composite material development.

Nutrition status plays a critical role in pressure injury (PI) healing and yet the available literature, especially in pediatric patients, is limited. Critically ill pediatric patients are at an increased risk of skin integrity compromise and PI development. Adequate nutritional intake can often be challenging to achieve in this population and immobility and illness present additional obstacles to maintaining skin integrity in this vulnerable population. Despite the unique nutritional challenges and needs of this group, there is no standardized approach to macro- and micronutrient management and monitoring. Here, several key vitamins and minerals believed to play a role in PI healing are discussed and an approach to nutritional management and monitoring for PI healing in pediatric patients is proposed. Registered dietitians (RD) are essential to assess individual patient macro and micronutrient requirements, to identify gaps and make recommendations to optimize nutritional therapy that may exist and impact wound healing. We used a scoping review to focus on the interplay of nutrition and PI healing and inform a multidisciplinary approach to PI identification and management. Through this review, we propose a strategy for the nutritional management of pediatric patients

Even before the onslaught of COVID-19 pandemic could settle, the unprecedented rise in cases with COVID-19 associated mucormycosis pushed the medical health to the fringe. Hyperglycaemia and corticosteroids appear to be the most consistent associations leading to the commonest manifestation of mucormycosis, Rhino-Orbito-Cerebral Mucormycosis. To address challenges right from categorisation and staging of the disease to the management of relentless progression, a multi-disciplinary expert committee was formed to handle the task in an evidence-based format to enforce best practices. The report of the committee on one hand attempts to succinctly present the currently available evidence while at the other also attempts to bridge the evidence-deficient gaps with the specialty-specific virtuosity of experts.

This study proposes a framework for designing/optimizing a Lunar rover for an early-phase mission concept trade-off. The proposed framework (1) develops models for major rover subsystems and lunar environment, (2) generates the rover’s operational schedule using the models, and (3) yields a set of attractive design solutions. The framework adopts a Pareto search algorithm to find the Pareto-optimal solutions for the multi-objective optimization problem considering multiple system-level metrics (i.e., cost, exploration range, scientific value). A case study on the design optimization of a realistic Lunar rover demonstrates the effectiveness of the proposed framework.

Purpose A biopsychosocial case formulation is an important tool for understanding complexity and guiding treatment for people with intellectual disabilities. It has been suggested that formulation meetings develop staff understanding of individuals they support. This study aims to explore the change processes that occur as a result of professional team formulation meetings, and the mechanisms that facilitate and hinder these events. Design/methodology/approach Eight clinicians who took part in multi-disciplinary team-based formulations in an inpatient mental health service for adults with intellectual disabilities were interviewed. Interviews were examined using thematic analysis. Findings The key themes identified were: “gaining information”, “altered thoughts” and “focused goals”. These themes were supported by “collaborative working” and “time for reflection” and were hindered by “poor communication and interaction” and inconsistent “staff attendance”. Originality/value Multi-disciplinary team formulation meetings may have a number of change processes that affect staff knowledge and perception of the people that they support. The facilitation of these processes should be a focus for further development.

Purpose This study aims to assess a novel clinic whereby new patients were discussed in a multi-agency, multi-disciplinary panel and given feedback on the same day. The objectives were to determine the impacts on time to commencing treatment, need for further assessment, discharges and staff and patient experiences. Design/methodology/approach Outcomes from the new assessment clinic were compared to previous individual assessments. Feedback questionnaires were given to patients, while a focus group was conducted with staff. Findings There was a significant reduction in the time to agreeing a treatment plan (34 days to Practical implications The model of a multi-agency, multi-disciplinary clinic could be used for assessing new referrals to community mental health teams. Originality/value The use of a multi-agency, multi-disciplinary clinic is a novel approach within community mental health teams which led to improvements in efficiency, while demonstrating positive patient and clinician feedback.

The Yamuna-Sutlej interfluve area has been important because of the presence of several palaeochannels that are hypothesized to be linked to Rigvedic river Saraswati that is now lost in time and space. Using satellite data, followed by field studies, the palaeo-course of a major river system in parts of the foothills of Himalaya, piedmont zone and plains of Himachal Pradesh, Punjab, Haryana and Rajasthan has been delineated. The palaeocourse of this major river system originating from south of Ropar, flowing southwards, combined with its tributaries including Ghaggar near Shutrana in Punjab flowed further south-west in parts of India and Pakistan culminating at Kutch. Along the length of interpreted palaeochannel, numerous Indus valley civilization sites are present. The field investigations with systematic sampling for geochronological analysis using thermo luminescence/optically stimulated luminescence (TL/OSL) technique, petro-mineraosedimentological studies have substantiated the existence of palaeochannels on the ground. Comprehensive remote-sensing investigations backed by geochronological input reveals that Sutlej palaeochannel was the main contributor of perennial water source at around 12±1 ka before shifting its course to present state and the palaeochannels between Yamuna-Sutlej interfluve were its tributaries, the most important being Ghaggar. The Sutlej palaeochannel was active till 12 ka and was receiving Himalayan sediments before the advent of aeolian episodes at around 12 ka and 7.4±0.4 ka. However, sediments from the river bed of the present Ghaggar river near Anupgarh indicates that the palaeochannel was receiving water supply till 5.2 ka having sufficient energy to deposit fine sand.

Chronic disorders of consciousness (DOC) develop after severe traumatic and non-traumatic brain damage and are characterized by the restoration of wakefulness in a patient after a coma without the recovery of consciousness. To optimize the diagnosis and treatment of patients with chronic DOC, a Russian working group on the problems of chronic DOC was organized, which included specialists in various areas, primarily anesthesiologists, critical care physicians and neurologists. While discussing the terminology of chronic DOC, the group identified that currently there is no definition for the state that falls into the period from the recovery of wakefulness and until 28 days after the brain damage when vegetative state/unresponsive wakefulness syndrome (VS/UWS) or minimally conscious state (MCS) may be diagnosed. In the intensive care unit (ICU) setting, there is often no consultant to provide critical care physicians with the correct diagnosis of the latter clinical syndromes, and neurophysiological tests are not feasible either. Therefore, there is a need to create a set of simple, understandable and easily reproducible strategies for managing this category of patients in the ICU. Thus, the working group proposed the term “prolonged disorders of consciousness” to be used for the patients with the signs of VS/UWS or MCS syndromes during their stay in the ICU until 28 days after initial brain damage and/or until the correct differential diagnosis of a type of chronic DOC is made. With the introduction of prolonged disorders of consciousness definition, the regular ICU staff will better understand how to provide an optimal set of supportive therapy and early rehabilitation activities in the lack of specific diagnostics techniques and dedicated specialists. Allocation of this category of patients allows us to create an algorithm for their better diagnosis and management and ensures consistent and effective interdisciplinary care at various levels. On the one hand, this approach will help us allow to free up ICU beds that are in high demand, while on the other, it will maximize the opportunity to realize the rehabilitation potential of DOC patients due to timely transfer to specialized centers. Conclusion. If the term “prolonged disorder of consciousness” is accepted by professional communities of specialists (critical care physicians, neurologists, neurosurgeons, etc.), it will be used in guidelines for the management of DOC patients.

PurposeThis study examines the impact of participation in a STEM Enrichment Summer Bridge Program, funded by the NSF Houston-Louis Stokes Alliance for Minority Participation, on undergraduate student success outcomes, particularly for under-represented students.Design/methodology/approachThe study uses propensity score matching and logistic regression analysis to examine the effects of participation in the STEM enrichment program on graduation and retention in STEM after matching on baseline socio-demographic and pre-college characteristics.FindingsThe analysis found that program participation had a significant effect on increasing both the graduation rates and retention of under-represented minority students in STEM fields. In addition, results indicated that program participation had a particularly strong impact for Pell-eligible students in terms of course grades.Research limitations/implicationsData obtained for this study were limited to a single Hispanic-serving/Asian-serving institution, and therefore are not necessarily representative of the graduation and retention trends of the larger population of underrepresented minority (URM) students across the nation.Originality/valueThis study uniquely adds to the existing body of literature surrounding the retention of URM students in STEM fields by accounting for baseline variables, such as pre-college academic achievement and socio-demographic characteristics, that could lead to bias in estimating results. Specifically, this study addresses limitations of previous studies by comparing participants and non-participants of the STEM enrichment program who are matched on a selection of baseline characteristics.

The coupling between different disciplines for multi-disciplinary optimization greatly increases the complexity of a computational framework, while at the same time increasing CPU time and memory usage. To overcome these difficulties, first, proper orthogonal decomposition and radial basis function were used to generate a reduced-order model from the initial experimental points. Second, analysis results for additional experimental points were predicted using the reduced-order model. Third, using automated machine learning, surrogate models for the objective and constraint functions were obtained from the analysis results at the initial and additional experimental points. Last, optimization was performed using the surrogate models for the objective and constraint functions. As an example, the multi-disciplinary optimization problem of determining the thicknesses of the composite lamina and sandwich core when the composite sandwich structure was used as an aircraft wing skin material was analyzed.

Resources are vital for older worker effectiveness and well-being, yet limited attention has been paid to the antecedents of resources. Drawing together the rich cross-disciplinary literature on resources, and through the lens of cumulative disadvantage and resource passageways, we review the individual, organizational, and institutional factors that influence the resources available to people in late working life. The review provides a more nuanced perspective on older workers as agentic actors. We highlight how agency can be constrained via a person’s resources, which are shaped by structural influences. Knowledge of structural influences on resources is important for understanding the experiences of older workers and their continued effectiveness in the work domain. We outline avenues for future research on resources and aging at work that incorporates these multi-level influences.

Summary: Background: Peripheral artery disease presents an increasing healthcare burden worldwide. Day-case angioplasty in a secondary care setting can be a safe and effective means of meeting the growing demand for lower limb revascularisation. We evaluated the safety and efficacy of a day-case-based angioplasty service in a UK district general hospital. Patients and methods: Consecutive patients undergoing endovascular revascularisation between August 2018–February 2020 were analysed retrospectively. All patients were discussed at a multi-disciplinary (diabetic foot) team meeting following a day case algorithm. Patient and procedural characteristics, technical success, peri-procedural complications, and 30-day outcome of day-case angioplasties were compared with those requiring overnight stay or were hospitalized. Results: Fifty-seven percent of 138 patients were diabetic, mean age 75 ± 12 years, 95% had critical limb ischaemia (Fontaine III 12%, IV 83%), and baseline ankle brachial pressure index [ABPI] 0.40 ± 0.30. Sixty-three patients (45%) were treated as planned day cases, 21 (15%) required overnight admission for social indications. Fifteen (11%) were planned admissions with the need for sequential debridement procedures, and 39 (28%) were already hospitalised at the time of referral to the vascular service. The overall technical success was 92% and not successful procedures mainly occurred in patients > 80 years. The ABPI increased at the initial follow-up to 0.84 ± 0.18. Fifty-three percent required treatment of > 1 level, 80% included recanalisations of chronic total occlusions, and average total lesion length was 133 ± 90 mm. Closure devices were employed in all cases. There were no major peri-procedural complications. A single minor access-site related bleeding episode (0.8%) occurred, requiring 24 h observation in hospital. While significantly more wounds had closed in out-patients, the mortality, major amputation and target lesion revascularization did not differ between groups. Conclusions: Safe and effective day-case-based angioplasty can be provided in a secondary care setting for patients with critical limb ischaemia needing complex multi-level procedures.

Events such as Facebook-Cambridge Analytica scandal and data aggregation efforts by technology providers have illustrated how fragile modern society is to privacy violations. Internationally recognized entities such as the National Science Foundation (NSF) have indicated that Artificial Intelligence (AI)-enabled models, artifacts, and systems can efficiently and effectively sift through large quantities of data from legal documents, social media, Dark Web sites, and other sources to curb privacy violations. Yet considerable efforts are still required for understanding prevailing data sources, systematically developing AI-enabled privacy analytics to tackle emerging challenges, and deploying systems to address critical privacy needs. To this end, we provide an overview of prevailing data sources that can support AI-enabled privacy analytics; a multi-disciplinary research framework that connects data, algorithms, and systems to tackle emerging AI-enabled privacy analytics challenges such as entity resolution, privacy assistance systems, privacy risk modeling, and more; a summary of selected funding sources to support high-impact privacy analytics research; and an overview of prevailing conference and journal venues that can be leveraged to share and archive privacy analytics research. We conclude this paper with an introduction of the papers included in this special issue.

Aim To identify multi-disciplinary paediatric weight management services currently available in Australia and determine gaps in service provision for children and adolescents with obesity. Methods Surveys were distributed to 17 identified Australian multi-disciplinary paediatric weight management services. A representative from each service was asked to complete an online survey regarding service and patient characteristics, assessment and management practices, and professional development approaches. Results Representatives from 16 multi-disciplinary paediatric weight management services completed the survey. Fourteen services were based in major metropolitan cities and two in regional areas. Fourteen services provided care to pre-school aged children (0-4 years old), 15 to primary school aged children (5-12 years old) and 13 to high school aged children (13-18 years old). The number of patients seen per year per service ranged from 20 to 250 and duration of waiting lists ranged from 2 months to more than 12 months. Conclusions The current availability and accessibility of multi-disciplinary paediatric weight management services is inadequate to service Australian children and adolescents with obesity, particularly those with severe obesity and those in rural and remote communities. To better address the issue of paediatric obesity, establishment of additional multi-disciplinary services, training for health-care professionals and monitoring of the provision of evidence-based care is urgently needed.

Introduction: The comprehensive assessment of elderly people who requires health and social care is becoming of increasing importance. The study was conducted to detect various morbidities in elderly people based on their physical, psychological, and socio-environmental assessment. Material & Methods: history of any underlying disease of each subject was obtained. General physical examination and wherever required, relevant laboratory investigations were performed, followed by comprehensive geriatric assessment (CGA) which consisted of three components namely physical, psychological and socio environmental assessment. Results: Among 150 subjects, 37% had suspected respiratory, 33% musculo-skeletal and 27% gastrointestinal system diseases. Symptoms were less prevalent among those subjects who had regular health checkups. Depression was noted in 43% and impaired memory in 12%. Socio environment impairments that were present were unsafe homes (13%), absence of social support (6%) and lonely living (7%). Conclusion: The family physician should always perform careful CGA along with required laboratory diagnosis which can help in proper rehabilitation of the patient and unnecessary sufferings can be avoided.

Background Successful trauma resuscitation relies on multi-disciplinary collaboration. In most academic programs, general surgery (GS) and emergency medicine (EM) residents rarely train together before functioning as a team. Methods In our Multi-Disciplinary Trauma Evaluation and Management Simulation (MD-TEAMS), EM and GS residents completed manikin-based trauma scenarios and were evaluated on resuscitation and communication skills. Residents were surveyed on confidence surrounding training objectives. Results Residents showed improved confidence running trauma scenarios in multi-disciplinary teams. Residents received lower communication scores from same-discipline vs cross-discipline faculty. EM residents scored higher in evaluation and planning domains; GS residents scored higher in action processes; groups scored equally in team management. Strong correlation existed between team leader communication and resuscitative skill completion. Conclusion MD-TEAMS demonstrated correlation between communication and resuscitation checklist item completion and communication differences by resident specialty. In the future, we plan to evaluate training-related resident behavior changes and specialty-specific communication differences by residents.

Objective: To explore the prokinetic effect of Ranitidine, to compare it with the prokinetic effect of Neostigmineand to observe the potentiating prokinetic effect of Ranitidine and Neostigmine in combination. Study Design: Randomised controlled trial (experimental study). Place and Duration of Study: Multi disciplinary centre, Army Medical College, Rawalpindi, from Jan to Dec 2015. Methodology: Experiments were performed on three groups of rabbits (n=6) and Cumulative dose responsecurves were plotted using isolated duodenal tissue on power lab (USA). In the first two groups of experiments,cumulative concentrations of Neostigmine and Ranitidine were studied separately with neostigmine acting as acontrol and in the third group the potentiating effect of a fixed dose of ranitidine on neostigmine was evaluated. Results: Neostigmine’s response was taken as 100 percent and Ranitidine’s response when compared to it came out to be 197 percent. The dose response curve of Neostigmine was shifted to the left and upwards in the presence of Ranitidine. The percent response with Neostigmine alone was taken as 100 percent and increased to 212 percent when the tissue was pre-treated with Ranitidine. Conclusion: Our study has indicated that Ranitidine has marked prokinetic effect which is found to be greaterthan Neostigmine. It is also inferred that Ranitidine can potentiate the prokinetic effect of Neostigmine.

Clustering is a commonly used method for exploring and analysing data where the primary objective is to categorise observations into similar clusters. In recent decades, several algorithms and methods have been developed for analysing clustered data. We notice that most of these techniques deterministically define a cluster based on the value of the attributes, distance, and density of homogenous and single-featured datasets. However, these definitions are not successful in adding clear semantic meaning to the clusters produced. Evolutionary operators and statistical and multi-disciplinary techniques may help in generating meaningful clusters. Based on this premise, we propose a new evolutionary clustering algorithm (ECAStar) based on social class ranking and meta-heuristic algorithms for stochastically analysing heterogeneous and multiple-featured datasets. The ECAStar is integrated with recombinational evolutionary operators, Levy flight optimisation, and some statistical techniques, such as quartiles and percentiles, as well as the Euclidean distance of the K-means algorithm. Experiments are conducted to evaluate the ECAStar against five conventional approaches: K-means (KM), K-meansPlusPlus (KMPlusPlus), expectation maximisation (EM), learning vector quantisation (LVQ), and the genetic algorithm for clusteringPlusPlus (GENCLUSTPlusPlus)., 30 pages

Introduction : Despite the high prevalence of mental health issues for young people with intellectual disability (ID), young people with ID can struggle to receive the mental health support they ne...

Aim. Optimization of the tactics of management of patients with liver cirrhosis who underwent Transjugular Intrahepatic Portosystemic Shunt – TIPS based on own experience and literature data. Materials and methods. From 2014 to 2019 years 51 Transjugular Intrahepatic Portosystemic Shunt procedures were performed. Results. The indications for Transjugular Intrahepatic Portosystemic Shunt procedure were detailed. The tactics of treatment in post-operative period was assessed. Shot-term and long-term results of the treatment were discussed. Especial attention was put to persons who included in patient list of liver transplantation. Conclusion. Transjugular Intrahepatic Portosystemic Shunt allows obtaining stable decompression in portal system that reduces frequency of bleeding relapse from gastric and esophageal veins. The mortality was decreased, and patients can wait till liver transplantation.

Cybersecurity has rapidly emerged as a grand societal challenge of the 21st century. Innovative solutions to proactively tackle emerging cybersecurity challenges are essential to ensuring a safe and secure society. Artificial Intelligence (AI) has rapidly emerged as a viable approach for sifting through terabytes of heterogeneous cybersecurity data to execute fundamental cybersecurity tasks, such as asset prioritization, control allocation, vulnerability management, and threat detection, with unprecedented efficiency and effectiveness. Despite its initial promise, AI and cybersecurity have been traditionally siloed disciplines that relied on disparate knowledge and methodologies. Consequently, the AI for Cybersecurity discipline is in its nascency. In this article, we aim to provide an important step to progress the AI for Cybersecurity discipline. We first provide an overview of prevailing cybersecurity data, summarize extant AI for Cybersecurity application areas, and identify key limitations in the prevailing landscape. Based on these key issues, we offer a multi-disciplinary AI for Cybersecurity roadmap that centers on major themes such as cybersecurity applications and data, advanced AI methodologies for cybersecurity, and AI-enabled decision making. To help scholars and practitioners make significant headway in tackling these grand AI for Cybersecurity issues, we summarize promising funding mechanisms from the National Science Foundation (NSF) that can support long-term, systematic research programs. We conclude this article with an introduction of the articles included in this special issue.

The COVID-19 pandemic pushed dental health officials around the world to reassess and adjust their existing healthcare practices. As studies on controlled COVID-19 transmission remain challenging, this review focuses on particles that can carry the virus and relevant approaches to mitigate the risk of pathogen transmission in dental offices. This review gives an overview of particles generated in clinical settings and how size influences their distribution, concentration, and generation route. A wide array of pertinent particle characterization and counting methods are reviewed, along with their working range, reliability, and limitations. This is followed by a focus on the effectiveness of personal protective equipment (PPE) and face shields in protecting patients and dentists from aerosols. Direct studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are still limited, but the literature supports the use of masks as an important and effective non-pharmaceutical preventive measure that could reduce the risk of contracting a respiratory infection by up to 20%. In addition to discussing about PPE used by most dental care professionals, this review describes other ways by which dental offices can protect patients and dental office personnel, which includes modification of the existing room design, dental equipment, and heating, ventilation, and air conditioning (HVAC) system. More affordable modifications include positioning a high-efficiency particulate air (HEPA) unit within proximity of the patient's chair or using ultraviolet germicidal irradiation in conjunction with ventilation. Additionally, portable fans could be used to direct airflow in one direction, first through the staff working areas and then through the patient treatment areas, which could decrease the number of airborne particles in dental offices. This review concludes that there is a need for greater awareness amongst dental practitioners about the relationship between particle dynamics and clinical dentistry, and additional research is needed to fill the broad gaps of knowledge in this field.

Parkinson being an progressive disorder has drew many challenges in physical therapy management, and having wide variety of signs and symptoms it has always proven as challenging to the therapists, however in last five years there was extremely good progress in management of Parkinson disease. But due to its heterogeneity signs from individual to individual, hardly literature has been proven useful for practice. In multidisciplinary team approach exercise therapy has drastically proven to support and maintain quality of life in daily activities. This review provides the importance of exercise therapy in Parkinson in multi disciplinary approach. Keywords: Excercise therapy, Parkinson, Multidisciplinary.

OBJECTIVE To implement and evaluate outcomes from a comprehensive, multi-disciplinary debulking program in the United States. SUMMARY BACKGROUND DATA Interest in and access to surgical treatment for chronic lymphedema (LE) in the United States have increased in recent years, yet there remains little attention on liposuction, or debulking, as an effective treatment option. In some other countries, debulking is a common procedure for the surgical treatment of LE, is covered by insurance, and has demonstrated excellent, reproducible outcomes. In this study we describe our experience implementing a debulking technique from Sweden in the United States. METHODS Patients who presented with chronic lymphedema followed a systematic multi-disciplinary work-up. For debulking with power assisted liposuction, the surgical protocol was modeled after that developed by Hakan Brorson. A retrospective review of consecutive patients who underwent debulking at our institution was conducted. RESULTS Between December 2017 and January 2020, 39 patients underwent 41 debulking procedures with power assisted liposuction, including 23 upper and 18 lower extremities. Mean patient age was 58 years and 85% of patients had LE secondary to cancer, the majority of which (64%) was breast cancer. Patients experienced excess volume reductions of 111% and 115% in the upper and lower extremities, respectively, at one year post-operatively. Overall quality of life (LYMQOL) improved by a mean of 33%. Finally, patients reported a decreased incidence of cellulitis and decreased reliance on conservative therapy modalities post-operatively. CONCLUSIONS Debulking with power assisted liposuction is an effective treatment for patients with chronic extremity lymphedema. The operation addresses patient goals and improves quality of life, and additionally reduces extremity volumes, infection rates and reliance on outpatient therapy. A comprehensive, multi-disciplinary debulking program can be successfully implemented in the United States healthcare system.

This paper returns to the question of whether business schools alone can meet the challenges of enhancing creativity and innovation in entrepreneurial education. Policy makers have side-stepped definitional argumentation in order to embrace a more nuanced potential for entrepreneurial competency development, using multidisciplinary practice in learning and assessment that can be found beyond business and management discourse. Insights from other disciplines can be missed as different terminologies and definitions apply. Design education is inherently multidisciplinary and has been instrumental in facilitating significant policy-level changes. To delve more deeply into this phenomenon, the authors illustrate what actually happens in a classroom in which business and design intersect. Neuroscience research into the learning brain informs learning, teaching and assessment related to creativity, visioning and dealing with ambiguity – through the progressive development of flexibility and adaptability. The authors introduce the Crit, a common feature of Art and Design courses, as a tool of assessment, concluding that, before we dig deeper into business and management discourses, sideways glances into design education will continue to offer benefits.

Sound mathematical knowledge is an essential ingredient for student success in many disciplines, and quality mathematics support is crucial to that success. How that support is delivered is often t...

Taxanes represented by paclitaxel and targeted therapy including trastuzumab are two common agents for human epidermal growth factor receptor-2 (HER-2)-positive breast cancer patients. Effectiveness, however, usually comes at the cost of many side effects, some of which are even fatal. Drug-induced interstitial lung diseases (DILDs) comprise a group of drug-induced pulmonary injuries usually caused by using these medications. For DILDs, systemic therapy can be harmful to lung tissues and rapidly threaten the lives of some breast cancer patients. Through the cases from our hospital and related studies in medical databases, we hope readers can learn a lesson from an angle of multi-disciplinary integration based on clinical practice and pharmacological mechanisms to make anti-cancer agents less harmful and reduce the incidence of DILD in breast cancer patients during systemic therapy.

Taxa relegated to synonymy with other superficially similar taxa based on herbarium-based taxonomy may be distinct species that are only ‘rediscovered’ on the collection of new, multi-disciplinary evidence. Here we investigate the case of Satyrium jacottetiae that has been included in the concept of S. membranaceum (Orchidaceae). The two taxa share similarities in some conspicuous traits, such as the dry and membranous floral bracts, light pink labellum and laceration of the petals, but a quantitative morphometric analysis based on 23 floral traits showed that the two taxa differentiate in ordination space. We found that the taxa can be distinguished by features of the rostellum (short and broad in S. jacottetiae and elongate and notched in S. membranaceum), which are not readily apparent from examination of herbarium specimens. A phylogenetic analysis of nuclear ribosomal DNA sequences further revealed that accessions of S. jacottetiae belong to a clade that contains two other Satyrium spp. but not S. membranaceum. The two taxa have largely non-overlapping distributions on slightly different soil types, but they also maintain their integrity in the few zones of overlap despite evidence indicating that both are primarily pollinated by nocturnal moths. Coexistence in these cases of sympatry appears to be facilitated by a sequential difference in flowering times. We conclude that S. jacottetiae and S. membranaceum are morphologically, phylogenetically, geographically and ecologically distinct and should therefore be recognized as separate species. This study highlights the importance of multi-disciplinary taxonomic effort to avoid under-assessment of biodiversity.

Introduction Necrotizing neutrophilic dermatoses can clinically resemble necrotizing fasciitis and therefore pose a diagnostic and therapeutic challenge. Given their similar presentations, misdiagnosis and inappropriate or delayed treatments are possible. Presentation of case We discuss the case of a woman with acute myeloid leukemia who presented with fevers, chills, cough, and a leg wound. She underwent amputation of her lower extremity after she was presumed to have necrotizing fasciitis; however, symptoms persisted. She was ultimately diagnosed with and treated for necrotizing Sweet's syndrome with notable clinical improvement. Discussion Both, necrotizing neutrophilic dermatoses and necrotizing fasciitis, grossly affect the skin and are associated with rapidly progressing systemic features including fevers, chills, leukocytosis, and elevated inflammatory markers. Recent literature in dermatology addresses these similarities and the appropriate approach to management; however, it is critical that medical and surgical subspecialties have an understanding of necrotizing neutrophilic dermatoses and their clinical presentations, diagnostic approaches, as well as therapeutic interventions. Familiarity with this entity can mitigate the risk of misdiagnosis, morbidity, and mortality. Conclusion With this report, we seek to review the features that are suggestive of and aid in the diagnosis of necrotizing neutrophilic dermatoses to help prevent significant and avoidable morbidity., Highlights • Necrotizing neutrophilic dermatoses are a rare skin condition that can easily be misdiagnosed as necrotizing fasciitis. • Providers from specialties like internal medicine, oncology, and surgery may encounter necrotizing neutrophilic dermatosis. • Familiarity with the management of necrotizing neutrophilic dermatoses can reduce avoidable morbidity.

Cancer is a serious threat to human life and health. It has become the leading cause of death worldwide. According to the National Cancer Center 2019 National Cancer Report, there were about 4 million new cases of cancer in China in 2015, and 8 people were diagnosed with cancer and 5 people died of cancer every minute. Currently, cancer remains a major threat to human health in China and is associated with a high mortality rate. While great efforts have been devoted to the development of cancer therapies, including surgery, radiotherapy, chemotherapy, traditional Chinese medicine, targeted therapy, and immunotherapy, most cancer therapies fail to achieve satisfactory efficacy, which is closely related to the lack of understanding of tumors in modern science, absence of major breakthroughs in the field of cancer research using key cutting-edge technologies, and limited translation and application of the achievements of basic research findings. Cancer represents a collection of multi-origin and multi-step systemic chronic diseases with various outcomes. The high heterogeneity of cancer poses a challenge for traditional therapeutic approaches to treat one type of tumor with the same method but provides opportunities to promote personalized therapies, including immunotherapy and targeted therapy. To promote original and innovative cancer research in China, it is essential to take advantage of modern genetic technology, stem cell technology, molecular imaging technology, molecular diagnosis, bioinformatics, innovative drug development, physical and chemical research methods, and alternative cutting-edge technologies, combined with extensive clinical data and patient population in China. For these reasons, the National Natural Science Foundation of China organized the 223rd Shuangqing Forum titled “Cancer Research Driven by Cutting-edge Multi-disciplinary Technologies”. Forty-five scholars from more than 30 universities and research institutes in China were invited to participate in this forum, and summarized the current status and trend in cancer research, especially the role of cutting-edge technologies in promoting cancer research, the key future research directions, and key scientific challenges. Based on the discussion of forum participants, this review highlights the current status, progress, challenges, and opportunities of cancer research in China, and presents the achievement and importance of multi-disciplinary technologies in driving cancer research and developing cancer therapy and diagnostics. It also summarizes the key scientific questions in the cancer research field for the next 5 to 10 years, and proposes strategies to fund cutting-edge technologies in exploring cancer research in China.

Now a days, prosthetic rehabilitation of partially edentulous arches through dental implant placements is becoming the most sought and accepted treatment modality among the patients and is gradually replacing the conventional treatment approaches comprising of removable partial dentures (RPDs) and tooth-supported fixed partial dentures (FPDs). However, patients often present with complex cases of partial edentulism where the arches may exhibit mal-alignment problems requiring orthodontic treatment and situations of bone inadequacy demanding bone graft procedures before implant placement. A multi-disciplinary approach could be the best way to manage such challenging cases. This article describes a similar case that was managed efficiently and systematically by adopting a multidisciplinary approach comprising of multiple dental specialities.

Background After years of decline, the rate of amputations was reported to increase by 50% in the U.S. population between 2009 and 2015. Few studies have examined the most recent trends in hospitalized diabetic foot ulcer (DFU) in Asian patients. This study aimed to examine recent trends and outcomes in hospitalized DFU at a tertiary diabetes center in Bangkok. Methods We conducted a retrospective study from consecutive hospitalized DFU admissions from 2014 to 2018 at Theptarin Hospital, a multi-disciplinary diabetes center, led by diabetologists. Results During the study period, 290 patients (male 57.4%, age 65.5 ± 13.3 years, T2DM 99.4%, DM duration 18.8 ± 11.5 years, A1C 8.6 ± 2.3%) with 350 admissions were included. DFU were classified into neuropathic wounds (38.0%), ischemic wounds (2.6%), and mixed-type wounds (59.4%). The median length of stay was 8 days. Severe DFU (Wagner grade 3–5) composed 68.3% of all DFU and one-third of patients had prior history of amputations. Complete healing was achieved in 73.5% of the patients. Major amputation was performed in 16 (4.6%) and minor amputation was performed in 78 (22.3%) of all DFU. The mortality rate at 1 year after discharge was 12.0%. Advanced diseases with higher co-morbidities were associated with worse outcomes. When compared with our previous published data from 2009 to 2013, the annual rate of ischemic wounds from peripheral arterial diseases (PAD) and severity of DFU were increased in this study period. The major amputation rate slightly decreased from 6.0 to 4.6% but the minor amputation rate increased from 18.7 to 22.3%. Conclusion The changing trend of DFU provides an excellent outlook into the inadequacies of our current diabetes care systems and global trend of aging population. After considerable successes in reducing major amputations over the past decade, the current analysis revealed a discouraging change in the healing rate of DFU and a stable pattern of major amputation. The prevalence of PAD among Thai patients with DFU increased significantly and affected the results of DFU treatments. Redefined organization of care with multidisciplinary team approach and coordination with referral centers are urgently required to improve outcomes of DFU.

“Coccydynia” unresponsive to a trial of conservative treatment should be evaluated promptly. Otherwise we may be fraught with the danger of serious complications. Sacral tumors are often quiescent to start with. They may achieve enormous size before they become symptomatic. Here is a case report and literature review of such a case in a 63 year old male, which was initially treated as coccydynia, till he became severely symptomatic. Chordomas are the most common primary tumor of the sacrum in adults. They are locally aggressive with immense potential for local recurrence and metastasis to lungs and other bones. If they get to the right hands at the right time, they are mostly curable. Total sacrectomy (Enbloc resection) is the treatment of choice for sacral chordomas. In early stages, a low sacral resection all from behind is possible. Lesions extending higher than S3 requires high sacrectomy and lumbopelvic fixation depending on the integrity of the sacroiliac joints. High sacrectomy has high morbidity of permanent colostomy and bladder catheterization.A 63 year old man presented with coccydynia of long duration and was diagnosed as chordoma of the sacrum upon imaging and image guided biopsy. He was treated with anterior, posterior and anterior surgeries in a single sitting, through a multi disciplinary approach.

Background: Guidelines to support accessible goal setting with stroke survivors with aphasia are lacking.Aims: This review aimed to (i) determine the communication barriers and facilitators relevan...