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(Wolverhampton Intellectual Repository and E-Theses)
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Evaluation of challenges for successful adoption of smart healthcare strategiesSmart healthcare strategies have been identified as a potential solution to address the growing challenges faced by the healthcare sector. The ability of smart healthcare strategies to improve efficiency, patient’s outcomes and delivery of quality healthcare has motivated and committed governments and policy makers to invest in this innovation. However, uptake and usage of smart healthcare strategies has not been successful as anticipated, and this is due to a number of challenges faced by different stakeholders during the adoption of these strategies. The objective of this paper is to systematically check published literature to identify and compile a comprehensive list of challenges of adopting smart healthcare strategies. Knowledge of these potential challenges gives stakeholders awareness and better prospects of dealing with the challenges of adopting smart healthcare strategies. A systematic literature review was conducted. EBSCOhost, PubMed, Scopus and Science Direct were searched for full text, peer reviewed, English language articles that reported the challenges for successful adoption of smart healthcare management strategies. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to select eligible articles. After the full screening, 26 articles that met the criteria were analysed and reported. Three main themes of challenges that affect the adoption of smart healthcare strategies have been identified based on technology-organisation-environment (TOE) framework. The findings of this study demonstrate that different TOE challenges affect smart health strategies adoption by healthcare sector. This study, therefore, proposes a differentiated approach to policies and practices to effectively scale up adoption of smart health and reduce failure rates of smart health projects. It is concluded that future research is needed in identifying key change management strategies to successfully manage the identified challenges to improve the prospects of successful adoption of smart healthcare strategies.
Direct thermal management of windings enabled by additive manufacturingThe electrification and hybridization of ground- and air-transport, in pursuit of Carbon Net Zero targets, is driving demand for high power-density electrical machines. The power-density and reliability of electrical machines is ultimately limited by their ability to dissipate internally generated losses within the temperature constraints of the electrical insulation system. As the electrical windings are typically the dominant source of loss, their enhanced design is in the critical path to improvements in power-density. Application of metal additive manufacturing has the potential to disrupt conventional winding design by removing restrictions on conductor profiles, topologies and embedded thermal management. In this paper, a modular end-winding heat exchanger concept is presented, which enables effective direct cooling without occupying valuable stator slot cross-section. In addition, this arrangement eliminates the need for a good stator-winding thermal interface, thereby allowing mechanical or other less permanent winding retention methods to be used, facilitating non-destructive disassembly and repair. A prototype winding is fabricated and experimentally tested to demonstrate the feasibility of the concept, yielding promising results.
RNA-seq analysis reveals key genes associated with seed germination of Fritillaria taipaiensis P.Y.Li by cold stratificationSeed dormancy is an adaptive strategy for environmental evolution. However, the molecular mechanism of the breaking of seed dormancy at cold temperatures is still unclear, and the genetic regulation of germination initiated by exposure to cold temperature requires further investigation. In the initial phase of the current study, the seed coat characteristics and embryo development of Fritillaria taipaiensis P.Y.Li at different temperatures (0°C, 4°C, 10°C & 25°C) was recorded. The results obtained demonstrated that embryo elongation and the dormancy-breaking was most significantly affected at 4°C. Subsequently, transcriptome analyses of seeds in different states of dormancy, at two stratification temperatures (4°C and 25°C) was performed, combined with weighted gene coexpression network analysis (WGCNA) and metabolomics, to explore the transcriptional regulation of seed germination in F. taipaiensis at the two selected stratification temperatures. The results showed that stratification at the colder temperature (4°C) induced an up-regulation of gene expression involved in gibberellic acid (GA) and auxin biosynthesis and the down-regulation of genes related to the abscisic acid (ABA) biosynthetic pathway. Thereby promoting embryo development and the stimulation of seed germination. Collectively, these data constitute a significant advance in our understanding of the role of cold temperatures in the regulation of seed germination in F. taipaiensis and also provide valuable transcriptomic data for seed dormancy for other non-model plant species.
Investigation of the effect of disulfiram on the chemoresistance and invasiveness in pancreatic cancer cellsPancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers worldwide with a mortality to incidence ratio of 94%. It is the 10th most common cancer in the UK with a 5-year survival less than 7%. In contrast to the improved therapeutic outcomes in many other cancers, the prognosis of PDAC remains dismal. One reason for this is because most PDAC patients are asymptomatic and end up being diagnosed after the cancer has advanced to a late stage. Another major obstacle in PDAC management is that PDAC cells are highly resistant to currently available anticancer drugs and the resistant cells metastasize to vital organs leading to a high rate of fatalities. Cancer stem cells (CSCs) are responsible for chemoresistance, relapse and metastasis. It is widely accepted that CSCs are located in the hypoxic niche which is responsible for maintaining stemness and epithelial to mesenchymal transition (EMT). The stemness of cancer cells is a reversible state mediated by the hypoxic tumour microenvironment. Hypoxia initiates stemness in cancer cells by activating genes which inhibit apoptosis, modify glucose metabolism, increase cell proliferation and enhance cell pluripotency. Therefore, development of new drugs to target hypoxia-induced CSCs will be of clinical urgency in PDAC treatment. Due to the time and costs for new drug development, repositioning of old drugs for new ailments is an emerging drug R&D strategy in recent years. Disulfiram (DS) is an anti-alcoholism drug used in clinic for over 60 years. It demonstrates excellent activity against a wide range of cancers such as glioblastoma, non-small cell lung cancer and, head and neck squamous cell carcinoma without toxicity to normal cells. Whereas, its effect on PDAC cells is still largely unknown. In this study, the in vitro effect of hypoxia on the stemness, chemosensitivity and invasiveness of Panc-1, a PDAC cell line, and a panel of patient-derived PDAC primary cultures was investigated. The sphere-cultured PDAC cells contained high hypoxic population which demonstrated CSC/EMT traits and were resistant to the first line anti-PDAC drugs; gemcitabine and paclitaxel. The study manifested that the hypoxia-cultured monolayer PDAC cell line and primary cells also expressed CSC markers, ‘ALDH, CD133, ABCG2’ and EMT markers, ‘Vimentin, Snail1, N-cadherin, Snail2’. The hypoxia-cultured cells were highly resistant to gemcitabine and paclitaxel. Significantly higher migration and invasion activities were detected in the hypoxia-cultured PDAC cells compared to the normoxic cultures. Our previous studies demonstrated that copper is essential for the anticancer activity of DS. In this study, the effect of cyclodextrin encapsulated DS and copper (CycDex DS/Cu) on PDAC cells was examined. In line with previous studies, CycDex DS/Cu showed strong cytotoxicity in sphere- and hypoxia-cultured PDAC cells. It blocked hypoxia-induced CSC/EMT traits and reversed hypoxia-induced chemoresistance to gemcitabine and paclitaxel in PDAC cells. DS is an FDA approved medicine. The study suggests that further studies may translate it into PDAC clinic application in a fast track. Many hypotheses claim that hypoxia activates NFкB which in turn activates a cascade of genes that promote metastasis and chemoresistance in cancer. Our previous results indicate that NFкB plays a key role in chemoresistance and invasiveness in some types of cancer. For these reasons, the effect of NFкB on PDAC cells was investigated, NFкBp65 was genetically overexpressed and knocked out in Panc-1 PDAC cell line. The NFкBp65 overexpressed clones showed significantly higher migration rate but failed to induce chemoresistance. In contrast to our previous findings, the NFкBp65 overexpression and knockout did not influence the expression of CSC/EMT markers. These results suggest that we still need to set up further studies to elucidate the molecular anti-PDAC mechanisms of cyclodextrin encapsulated DS/Cu in PDAC cells.
Knowledge sharing within the Kingdom of Saudi Arabia large construction organisationsAn increasing number of Kingdom of Saudi Arabia (KSA) construction organisations are turning to knowledge sharing as a key to leverage their distinctive core competencies in their pursuit of competitive advantage. However, the construction industry is one of the most challenging environments where managing people effectively is vital to ensure that they contribute their knowledge to organisational success. Knowledge sharing is part of knowledge management process, one of the building blocks for an organisation’s success and acts as a survival strategy in this knowledge era. However, knowledge sharing is an under-researched area in the KSA large construction organisations context, despite several policy transformations announced by the KSA government. Thus, the main aim of this research was to investigate how KSA large construction organisations are knowledge sharing en-route to competitiveness. The findings are based on qualitative methodology adopting semi-structured interviews with 44 professionals. The content analysis revealed five key drivers for knowledge sharing. The single most important driver for knowledge sharing is the integration of knowledge assets. Furthermore, seven key knowledge sharing strategies are implemented in large construction organisations in the KSA. Regular sharing of best practices related to project knowledge is the most widely implemented. The study revealed eight knowledge sharing techniques and technologies that are extensively used in the KSA large construction organisations. The key challenge for knowledge sharing is the lack of communication skills whereas knowledge sharing strategies contribute to the acceleration of construction processes. A framework for knowledge sharing was developed and evaluated for the benefit of KSA large construction organisations, which is the main contribution to the knowledge. The study concludes that knowledge sharing is an integrated and complex process. The results suggest that, for effective implementation of knowledge sharing strategies, there is an urgent need for the KSA large construction organisations to develop and deploy appropriate knowledge sharing related management training programmes. The most estimable contribution of this study is to provide valuable insights that would help the KSA construction industry’s decision makers to implement knowledge sharing strategies to improves the sector’s competitiveness. The findings of this research are limited to the KSA construction industry context only; as such, the generalisability of the results outside this context may be very limited.