University of the Philippines Manila

Objectives Healthcare professionals have always endeavored to maintain and improve their competencies to provide the best quality of service. The dynamic health and social care milieu entails occupational therapists (OTs) to engage in continuing professional development (CPD). The research aims to identify the CPD activities OTs engage in, describe the attitudes of OTs toward CPD, and compare the attitudes of OTs toward CPD according to person-related and practice-related characteristics. Material and Methods The study utilized an explanatory sequential mixed methods design. One hundred and five members of the Philippine Academy of Occupational Therapists (PAOTs) completed the adapted revised adult attitudes toward continuing education scale on complete enumeration with a response rate of 28.38%. Results were analyzed through descriptive statistics, a two-tailed t -test, and analysis of variance. One focus group discussion and seven online interviews with a total of 10 participants were conducted on purposive sampling. Results were analyzed through coding and thematic analysis and these were used to explain quantitative data. Results Formal CPD activities such as workshops and conferences are preferred by Filipino OTs over informal CPD activities such as mentoring and journal writing. Filipino OTs have positive attitudes toward CPD. There are no significant differences in attitudes toward CPD according to any of the personal-related and practice-related characteristics. Conclusion In a rapidly changing society, professionals, including OTs, must adapt and be open to new opportunities. Engaging in CPD is an ideal first step to stay relevant. Although the demand for OTs is strong, complacency is not advised. CPD is viewed as an investment with an expectation of a return. There is a lack of awareness of informal CPD activities, and a cost-benefit analysis is used to select CPD activities. Personal development and quality of service are motivating factors, but cost and prioritization influence the decision. In-depth needs assessments are recommended for tailored CPD programs, shared responsibility by employers is encouraged, and CPD advocacy should start at the school level. Strengthening CPD guidelines by PAOT and the Professional Regulation Commission is also recommended.

Background Nasal cancer is a rare and fatal disease, with an incidence rate of <1 in 100,000, and a 5‐year survival rate of around 30%. The study aims to investigate the worldwide disease burden, associated risk factors, and temporal incidence patterns of nasal cancer. Methods Data were obtained from multiple sources, including the Global Cancer Observatory, Cancer Incidence in Five Continents Plus, the Global Burden of Disease database, the World Bank, and the United Nations. The study utilized multivariable linear regression to investigate the relationship between risk factors and the incidence of nasal cancer by age for each country. Trend analysis was conducted using the joinpoint regression analysis program, and the average annual percentage change (AAPC) was calculated. The accuracy of trend estimations was assessed using the 95% confidence interval (CI). Additionally, the incidence of nasal cancer was examined by age and geographic location. Results A total of 37,674 new cases were reported in 2020 (ASR 4.2 per 1,000,000). The highest ASRs were observed in South‐Eastern Asia (5.3) and Central and Eastern Europe (4.8). A number of risk factors were identified, such as higher HDI regions, higher prevalence of smoking, alcohol drinking, unhealthy dietary, and hypertension. In addition, physical inactivity was related to lower incidence. An overall decreasing trend was reported in the global population, but an increasing trend was discovered in males. Conclusions The highest burden of nasal cancer was found in South‐Eastern Asia and Central and Eastern Europe, potentially due to regional genetic factors and pollution issues. Targeted interventions are need in high‐risk regions. Further studies are needed to investigate factors contributing to the increasing temporal trend of nasal cancer among the male population.

Mental health is a critical aspect of well-being, influencing an individual's ability to think, express emotions, interact with others, and work productively. Military personnel, particularly sailors and marines, are frequently exposed to psychological and physiological stressors due to prolonged deployments, separation from family, and the demanding nature of their duties. This study aims to assess the mental health status and associated risk factors among deployed and field-assigned Philippine Navy sailors and marines. A cross-sectional survey was conducted from May 6-20, 2022, using an online survey with responses from 345 personnel stationed in Cebu, Palawan, and Tawi-Tawi. The study utilized standardized psychological assessment tools: the Short General Health Questionnaire (GHQ-12) for distress, the Patient Health Questionnaire (PHQ-9) for depression, the Generalized Anxiety Disorder Scale-7 (GADS-7) for anxiety, and the Patient Health Questionnaire Somatic Symptoms-15 (PHQSS-15) for somatic symptoms. Statistical analyses, including ANOVA, Pearson correlations, and multiple linear regression, were applied to determine significant associations. Results indicate prevalence rates of 20.87% for distress, 47.83% for depression, 22.32% for generalized anxiety, and 33.33% for somatic symptoms. Officers and non-commissioned officers exhibited higher distress and depression levels. Tenure in service significantly influenced distress, depression, and anxiety, with symptoms peaking at five years of service and decreasing over time. Sleep duration and quality were critical factors, as shorter sleep was linked to heightened depression, anxiety, and somatic symptoms. These findings highlight the importance of routine mental health assessments, accessible psychological support, and targeted interventions, such as mindfulness training and stress management programs, to promote well-being among military personnel.

This paper studies a lightweight construction safety behavior detection model based on improved YOLOv8, aiming to improve the detection accuracy of safety behaviors on construction sites and achieve lightweight models. YOLO (You Only Look Once) is an object detection algorithm that can achieve real-time and efficient object detection by dividing images into grids and predicting the bounding boxes and categories of objects in each grid. Traditional YOLO models often have problems of missed detection and insufficient feature processing when dealing with complex scenes, especially when facing large-scale data sets. In order to solve this problem, this paper improves on the basis of YOLOv8 and uses a lighter Mobilenetv3 as the backbone network to replace the original CSPDARKNET53 to reduce the amount of calculation and improve the processing speed. At the same time, the receptive field is expanded by combining the Receptive Field Block (RFB) module, the ability to capture multi-scale features is enhanced, and the Global Attention Mechanism (GAM)-Attention mechanism is introduced to enhance the recognition ability of local features. Through experimental results, the improved YOLOv8 model performed excellently in detecting five common unsafe behaviors of construction workers, with an mAP of 0.86, a precision of 0.84, a recall rate of 0.87, an F1 value of 0.85, and an IoU of 0.8, which are significantly better than traditional methods. This shows that the model has successfully achieved the goal of lightweight while improving detection accuracy, and has broad application prospects.

Importance Approximately 29.9 million cancer cases and 15.3 million deaths are anticipated by 2040 globally, necessitating cancer system strengthening. A greater understanding of health system factors that can be leveraged to improve cancer control may guide health system planning. Objective To evaluate predictors of improved cancer outcomes globally. Design, Setting, and Participants This pan-cancer ecological study used the most recent available national health system metrics and cancer statistics, spanning the breadth of global income levels across 185 countries. Estimates of age-standardized mortality to incidence ratios were derived from GLOBOCAN 2022 for patients with cancer of all ages. The analysis took place on November 27, 2024. Main Outcomes and Measures Health spending as a percent of gross domestic product (GDP), physicians per 1000 population, nurses and midwives per 1000 population, surgical workforce per 1000 population, GDP per capita, Universal Health Coverage (UHC) service coverage index, availability of pathology services, human development index, gender inequality index (GII), radiotherapy centers per 1000 population, and out-of-pocket expenditure as percentage of current health expenditure were collected. The association between the mortality to incidence ratio (MIR) and each metric was evaluated using univariable linear regressions (α = .0045), which were used to construct multivariable models (α = .05). Variation inflation factor allowed exclusion of variables with significant multicollinearity. R ² measured goodness of fit. Results On univariable analysis, all metrics were significantly associated with MIR of cancer ( P < .001 for all), including UHC index (β, −0.0076 [95% CI, −0.0083 to −0.0068]), GDP per capita (β, −5.10 × 10 ⁻⁶ [95% CI, −5.75 × 10 ⁻⁶ to −4.46 × 10 ⁻⁶ ]), clinical and workforce capacity, radiotherapy capacity (β, −88.25 [95% CI, −100.43 to −76.06]), and gender inequality index (β, 0.63 [95% CI, 0.57-0.70]). After including metrics significant on univariable analysis and correcting for multicollinearity, on multivariable analysis, greater UHC index and GDP per capita were independently associated with lower (improved) MIR for cancer. The multivariable model had R ² of 0.87. On multivariable analysis stratified by sex, greater UHC index and greater GDP per capita were independently associated with improved MIR for all cancers. R ² for the multivariable models was 0.87 for females and 0.85 for males. Conclusions This study found that global health system metrics related to progress toward universal health care, greater health care spending and GDP per capita, strengthened clinical workforce and capacity, and increased gender equity were associated with improved pan-cancer outcomes at a population level on univariable analysis. The degree of UHC and GDP per capita were independently associated with improved cancer outcomes in multivariable models with good explanatory power. These exploratory findings merit further validation and may guide health system planning and prioritization.

Background: Precision prevention involves using biological, behavioral, socioeconomic, and epidemiological data to improve health for a particular individual or group. With almost 63% of the global population using social media, these platforms show promise to deliver tailored messaging and personalized interventions to individuals. Objectives: To describe the personalization elements and behavior components used in a sample of precision prevention interventions delivered through social media. Methods: To identify examples of cases, a search was done on clinicaltrials.gov, searching for ‘other terms: prevention’ + ‘Intervention/Treatment: social media intervention’ + ‘study results: With results. The selected cases were described, personalization elements reported, and their adopted intervention components were coded according to the Behavior Change Wheel (BCW) framework. Results: A total of four cases employing personalization in their interventions were identified. Three of these cases targeted women's health. The intervention period varied from two to eight months, with participant commitment ranging from active involvement on five out of seven days to monthly participation. The BCW interventions of persuasion and incentivization, were most frequently utilized, while education and coercion were used sparingly in the selected cases. Notably, none of the four cases reported the use of training, restrictions, or modeling. Conclusions: Social media has the potential to serve as a tool for digital phenotyping and contribute to the advancement of precision prevention. Challenges include the social media platform set-up and ensuring all ethical considerations are met.

Introduction: Precision and personalised medicine requires comprehensive genetic, epigenetic, lifestyle, social, community and environmental knowledge of the patient. This approach highlights the importance of the social determinants of health (SDoH), described by the World Health Organization (WHO) as ‘the non-medical factors that influence health outcomes, the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life such as economic policies and systems, development agendas, social norms, social policies and political systems’. Methods: This study examined if countries collect SDoH indicators and, if they do, the quality of the data and whether they are fit for clinical and population health purposes. The sources of data were EHR networks and, where not available, national data collections. Results: While demographic details (age, gender) and rurality were well documented in most countries, we found that data availability and quality for education, occupation, income, socio-economic status, and residential care varied considerably between countries. Data for smoking, obesity, alcohol use, mental health, and substance use were generally poorly recorded. Conclusion: Recommendations include a universal set of indicators and taxonomy for SDoH; common data model and metadata standards for national and global harmonisation and monitoring; benchmarks for data quality and fitness-for-purpose; capacity building at national and subnational levels in data collection, data analysis, communication and dissemination of results; ethical and transparent data stewardship; and governance, leadership and diplomacy across multiple sectors to co-create an enabling policy and regulatory environment.

One of the fundamental problems in quantum mechanics is finding the correct quantum image of a classical observable that would correspond to experimental measurements. We investigate for the appropriate quantization rule that would yield a Hamiltonian that obeys the quantum analogue of Hamilton’s equations of motion, which includes differentiation of operators with respect to another operator. To give meaning to this type of differentiation, Born and Jordan established two definitions called the differential quotients of first type and second type. In this paper we modify the definition for the differential quotient of first type and establish its consistency with the differential quotient of second type for different basis operators corresponding to different quantizations. Theorems and differentiation rules including differentiation of operators with negative powers and multiple differentiation were also investigated. We show that the Hamiltonian obtained from Weyl, simplest symmetric, and Born-Jordan quantization all satisfy the required algebra of the quantum equations of motion.

Introduction: The classical swine fever virus (CSFV) causes significant economic losses in the livestock industry. While the existing E2 marker vaccine offers protection against infections, it is characterized by delayed immunity and reduced effectiveness over time. Optimizing the existing vaccine is crucial to better control CSFV outbreaks worldwide. This study aimed to improve the existing E2 marker vaccine for CSFV by integrating NS3 T lymphocyte-inducing epitopes into the conserved E2 protein sequence and using mRNA technology for vaccine delivery. Methods: The design and evaluation of the vaccine were carried out exclusively through in silico methods. T lymphocyte epitopes were identified from the CSFV NS3 protein using multiple epitope prediction tools. A vaccine construct was formed after linking the predicted NS3 epitopes, E2 protein, and an immunogenic adjuvant. Molecular docking and dynamics simulations were performed to analyze the interaction between the adjuvant used and its immune receptor. Signal peptides were incorporated into the design, and mRNA sequences with varying codon usage biases were generated using LinearDesign. The mRNA sequence with minimum free energy (MFE) and codon adaptation index (CAI) closest to the controls was selected as the final design. Results: Twenty epitopes with high binding affinity to major histocompatibility complexes (MHCs) were identified from the CSFV NS3 protein. The vaccine construct with swine CD154 adjuvant demonstrated high antigenicity, making it the optimal choice for the final vaccine design. Molecular docking and dynamics simulations confirmed the adjuvant's strong affinity and stable interaction with its canonical receptor, swine CD40. Moreover, the final vaccine design exhibited higher populations of lymphocytes and antibodies compared to the components of the commercialized E2 marker vaccine in immune simulation. The final mRNA vaccine sequence exhibited a higher MFE and CAI than the two licensed mRNA vaccine controls. Conclusion: The mRNA vaccine designed in this study serves as a potential CSFV vaccine candidate. In vivo and in vitro validation is needed to confirm its efficacy.

Background Patient age can impact the safety and efficacy of ulcerative colitis (UC) treatments. Etrasimod is an oral, once daily (QD), selective sphingosine 1-phosphate1,4,5 receptor modulator for the treatment of moderately to severely active UC. Here, we evaluate the impact of age on etrasimod safety and efficacy in patients with UC in the phase 3 ELEVATE UC clinical program. Methods Data were pooled from ELEVATE UC 52 and ELEVATE UC 12 in patients receiving etrasimod 2 mg QD or placebo. Proportions and incidence rates (IRs) per 100 patient-years of treatment-emergent adverse events (AEs) were stratified by age (<40, 40-59, and ≥60 years). With the same age stratifications, efficacy was evaluated in patients with baseline Modified Mayo scores of 5-9 and 4-9 for the primary efficacy endpoint (clinical remission) and secondary efficacy endpoints. Results Overall, 787 patients were enrolled (<40 years, n = 420 [53.4%]; 40-59 years, n = 276 [35.1%]; and ≥60 years, n = 91 [11.6%]). Arthralgia, fatigue, and hypertension IRs were higher in older patients, irrespective of treatment. Serious AEs and AEs leading to treatment discontinuation were low and consistent across age groups. Significantly more patients receiving etrasimod 2 mg QD vs placebo achieved efficacy endpoints, regardless of age. Conclusions The safety profile of etrasimod 2 mg QD in the ELEVATE UC population was consistent across age groups, with no change in the incidence of AEs. Patients receiving etrasimod vs placebo showed significant clinical benefit, regardless of age. ClinicalTrials.gov NCT03945188; NCT03996369.

This book is addressed to business and academic executives and senior managers in small and medium-sized businesses or scale-ups that need to understand how to effectively manage the business secrets within their organisation, particularly during new product launches, finance raising, and mergers and acquisitions (M&A). The book keeps away from technical legal details that are important for legal experts but are not absolutely necessary for managers and executives in their daily lives. It may happen, nevertheless, that some of these terms appear while reading the chapters below, because the authors believed they were necessary to reach some level of understanding the strategic issues concerning business secrets. The authors also believe that non-legal business executives can grasp the essentiality of these terms and then use them to design and implement comprehensive business secrets strategies for all employees. Moreover, having a foundational understanding of the legal concepts at play will also increase their ability to communicate with companies’ legal teams and external advisers. A number of recent confidential information and secret-related legal cases are believed to be representative of the issues that require attention from managers and executives. These are also summarised in this section. These cases come from small to big size companies and involving multiple industries such as chemicals, drugs, biotechnology, information technology, car fleets, car manufacturing, food technology, pharmacy, admin services, and metal industry. This section summarises the elements that are useful to refer to when reading its chapters.

In this chapter we consider the contractual protections a company can adopt to effectively protect its business secrets, which include but are not limited to trade secrets and sensitive information. As a practical matter, in order to leverage the value of confidential business information, the information must be shared with others—employees, partners, suppliers, customers. There is no way to reap the benefits of valuable confidential information if that information is merely locked away in a vault for no one to see or learn or use. Protecting confidential business information through contract is a ubiquitous practice. Those who share or receive confidential information in their day-to-day responsibilities are no doubt familiar with non-disclosure agreements. Sometimes the use of such agreements becomes so commonplace that little thought may be given to the strategic implications of the agreements. But recent developments in law and policy suggest that owners of confidential business information should carefully evaluate their contractual protection strategies. Specifically, the fundamentals regarding contractual protections in the context of disclosures to employees, other entities, and even end consumers can be evaluated and considered as part of an overall strategy to protect business information through the use of contracts. In this chapter we consider the contractual protections in three contexts, when sharing (1) with employees, (2) with external entities, and (3) with end customers.

This chapter aims to provide an in-depth review of the strategies and practices necessary to protect business secrets and thereby enhance business value. Our discussion will cover the legal principles governing breach of confidence, as well as the management processes and best practices in security that practitioners should implement to safeguard their business secrets from breach. Throughout this chapter, business secrets refer to trade secrets and any sensitive information. The digitalization of business processes and the explosion of digital services amplify the challenges associated with protecting data, confidential information in general and especially business secrets. A general trend in the protection of business secrets, by effect of substantive law or case laws, is to place greater responsibility on the recipients of information (and employees in particular) not to take or misuse confidential information, provided that the owners of such information take reasonable steps to protect it. We describe in Chap. 5 the regulation and case law applicable to business secrets and breach of confidence in each of the USA, Europe, and the UK. To further aid in illustration, examples are provided in Singapore and the Philippines, respectively. Additionally, this chapter describes how companies can implement a governance and business secrets policy addressing the physical, human, and IT elements necessary to reduce the overall risks of business secret leakage and loss of value. Finally, this chapter looks at mechanisms that can be deployed during negotiations and deal-making. We consider when and how to use non-disclosure agreements (NDAs), and where memorandum of understanding (MOUs) can capture details of business secrets.

This chapter reviews the macro-level drivers for the need to develop better practices for business secrets, which include but are not limited to trade secrets and sensitive information, and are the basic elements necessary to build Intangible Assets. Many companies focus on specific types of Intangible Assets particularly patents, which may bring high value due to their monopoly power. But patents may no longer ensure good future revenues in an IT and data driven economy; in many sectors, technologies’ lifetime is shorter, and it becomes easier for competitors to bypass patented technology. Business secrets have become more important, as secrecy is sometimes the only way to protect their competitive advantage (whether strategic, business, technical, financial, etc.) in a context of strong competition worldwide (and even more so where international trade restrictions are imposed). But an increasing digital world creates new risks of information leakage. We set out the global trends and some of the obstacles that companies face when trying to control business secrets; we look at how financial reporting standards play a role in establishing support for proactive management of business secrets as well as how HR, IT, and Legal functions support an overall governance—to address the question: “How can Confidential Information become a business secret, benefiting from legal protection and, as a consequence, how can its value and even therefore its recognition as an Intangible Asset be established to the benefit of the company and its users?”

Background Antimicrobial resistance (AMR) poses a global health threat, particularly in low- and middle-income countries (LMICs). Clustered regularly interspaced short palindromic repeats (CRISPR)–Cas system technology offers a promising tool to combat AMR by targeting and disabling resistance genes in WHO bacterial priority pathogens. Thus, we systematically reviewed the potential of CRISPR–Cas technology to address AMR. Methods This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted using the Scopus and PubMed databases, focusing on publications from 2014 to June 2024. Keywords included “CRISPR/Cas,” “antimicrobial resistance,” and “pathogen.” The eligibility criteria required original studies involving CRISPR/Cas systems that targeted AMR. Data were extracted from eligible studies, qualitatively synthesized, and assessed for bias using the Joanna Briggs Institute (JBI)-standardized tool. Results Data from 48 eligible studies revealed diverse CRISPR–Cas systems, including CRISPR–Cas9, CRISPR–Cas12a, and CRISPR–Cas3, targeting various AMR genes, such as blaOXA-232, blaNDM, blaCTX-M, ermB, vanA, mecA , fosA3 , blaKPC , and mcr-1, which are responsible for carbapenem, cephalosporin, methicillin, macrolide, vancomycin, colistin, and fosfomycin resistance. Some studies have explored the role of CRISPR in virulence gene suppression, including enterotoxin genes, tsst1 , and iutA in Staphylococcus aureus and Klebsiella pneumoniae . Delivery mechanisms include bacteriophages, nanoparticles, electro-transformation, and conjugative plasmids, which demonstrate high efficiency in vitro and in vivo. CRISPR-based diagnostic applications have demonstrated high sensitivity and specificity, with detection limits as low as 2.7 × 10 ² CFU/mL, significantly outperforming conventional methods. Experimental studies have reported significant reductions in resistant bacterial populations and complete suppression of the targeted strains. Engineered phagemid particles and plasmid-curing systems have been shown to eliminate IncF plasmids, cured plasmids carrying vanA , mcr-1 , and blaNDM with 94% efficiency, and restore antibiotic susceptibility. Gene re-sensitization strategies have been used to restore fosfomycin susceptibility in E. coli and eliminate blaKPC-2-mediated carbapenem resistance in MDR bacteria. Whole-genome sequencing and bioinformatics tools have provided deeper insights into CRISPR-mediated defense mechanisms. Optimization strategies have significantly enhanced gene-editing efficiencies, offering a promising approach for tackling AMR in high-priority WHO pathogens. Conclusions CRISPR–Cas technology has the potential to address AMR across priority WHO pathogens. While promising, challenges in optimizing in vivo delivery, mitigating potential resistance, and navigating ethical-regulatory barriers must be addressed to facilitate clinical translation.

In the WHO Western Pacific Region, primary health care (PHC) is considered ‘the future of health’ and the key to achieving universal health coverage. However, political, economic and social forces underlying curative, hospital-centric models have eroded public, local-level health service capacity—contributing to fragmented systems and persisting health inequities. Drawing insights from seven published country case studies from East Asia examining PHC in the context of the COVID-19 pandemic, this paper discusses key factors influencing the implementation of PHC. Countries are improving service delivery through a PHC approach, but persisting governance and structural barriers to PHC reform include vertical approaches to health care planning and programme delivery, health workforce shortages and maldistribution, and market forces that have shaped health care and workforce models towards curative care. Three domains for future policy and research to strengthen PHC are proposed. First, managing the political economy of PHC reform requires mapping relationships and systematically unravelling political, social and economic factors shaping accountability, receptiveness and capacity for change. Second, strengthening participatory governance involves shifting power to communities through platforms for shared policy creation and implementation, decentralised governance and empowering community-oriented health workers. Third, improving conceptual clarity and policy guidance on PHC can use the Sustainable Development Goals to orient systems towards preventing illness and valuing good health. The case studies offer a practice model of applied health policy and systems research coproduced with policy stakeholders.

Over the past decade, organ-on-chip technology (microphysiological systems or tissue chips) has reshaped in-vitro physiological and pathological modeling and pharmaceutical drug assessment. FDA Modernization Act 2.0 allows for alternatives to animal testing or the use of appropriate non-animal models/new approach methods (NAMs), such as Organ-on-chips (OC) platforms or in silico simulation models, to generate pre-clinical in-vitro drug trial data for regulatory purposes primes the microfluidic field to have exponential growth in the coming years. The changes in the approaches of regulatory agencies could significantly impact the development of therapeutics for use during pregnancy. However, limitations of the devices and molecular and biochemical assay shortfalls hinder the progress of the OOC field. This review describes available reproductive and pregnancy-related OOC platforms, and the current methodologies utilized to generate endpoint datasets (e.g., microscopic imaging, immunocytochemistry, real-time polymerase chain reaction, cytokine multiplex analysis). Microfluidic platform limitations, such as fewer number of cells or low supernatant volumes and restrictions regarding fabrication materials, are described. Novel approaches (e.g., spatial transcriptomics, imaging cytometry by time of flight, exosomes analysis using Exoview) to overcome these challenges are described. OOC platforms are primed to provide biologically relevant and clinically translational data that can revolutionize in-vitro physiological modeling, drug discovery, and toxicologic risk assessment. However, engineering adaptations to increase the throughput of devices (i.e., device arrays) and biological advancements to improve data throughput are both needed for these platforms to reach their full potential.