Search results for: RF analyses
Commenced in January 2007
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Edition: International
Paper Count: 3541

Search results for: RF analyses

571 The Role of High-Intensity Focused Ultrasound (HIFU) in the Treatment of Fibroadenomas: A Systematic Review

Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

Abstract:

Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

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570 Modified Fuzzy Delphi Method to Incorporate Healthcare Stakeholders’ Perspectives in Selecting Quality Improvement Projects’ Criteria

Authors: Alia Aldarmaki, Ahmad Elshennawy

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There is a global shift in healthcare systems’ emphasizing engaging different stakeholders in selecting quality improvement initiatives and incorporating their preferences to improve the healthcare efficiency and outcomes. Although experts bring scientific knowledge based on the scientific model and their personal experience, other stakeholders can bring new insights and information into the decision-making process. This study attempts to explore the impact of incorporating different stakeholders’ preference in identifying the most significant criteria that should be considered in healthcare for electing the improvement projects. A Framework based on a modified Fuzzy Delphi Method (FDM) was built. In addition to, the subject matter experts, doctors/physicians, nurses, administrators, and managers groups contribute to the selection process. The research identifies potential criteria for evaluating projects in healthcare, then utilizes FDM to capture expertise knowledge. The first round in FDM is intended to validate the identified list of criteria from experts; which includes collecting additional criteria from experts that the literature might have overlooked. When an acceptable level of consensus has been reached, a second round is conducted to obtain experts’ and other related stakeholders’ opinions on the appropriate weight of each criterion’s importance using linguistic variables. FDM analyses eliminate or retain the criteria to produce a final list of the critical criteria to select improvement projects in healthcare. Finally, reliability and validity were investigated using Cronbach’s alpha and factor analysis, respectively. Two case studies were carried out in a public hospital in the United Arab Emirates to test the framework. Both cases demonstrate that even though there were common criteria between the experts and the stakeholders, still stakeholders’ perceptions bring additional critical criteria into the evaluation process, which can impact the outcomes. Experts selected criteria related to strategical and managerial aspects, while the other participants preferred criteria related to social aspects such as health and safety and patients’ satisfaction. The health and safety criterion had the highest important weight in both cases. The analysis showed that Cronbach’s alpha value is 0.977 and all criteria have factor loading greater than 0.3. In conclusion, the inclusion of stakeholders’ perspectives is intended to enhance stakeholders’ engagement, improve transparency throughout the decision process, and take robust decisions.

Keywords: Fuzzy Delphi Method, fuzzy number, healthcare, stakeholders

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569 Post-Traumatic Stress Disorder and Problem Alcohol Use in Women: Systematic Analysis

Authors: Neringa Bagdonaite

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Study Aims: The current study aimed to systematically analyse various research done in the area of female post-traumatic stress disorder (PTSD) and alcohol abuse, and to critically review these results on the basis of theoretical models as well as answer following questions: (I) What is the reciprocal relationship between PTSD and problem alcohol use among females; (II) What are the moderating/mediating factors of this relationship? Methods: The computer bibliographic databases Ebsco, Scopus, Springer, Web of Science, Medline, Science Direct were used to search for scientific articles. Systematic analyses sample consisted of peer-reviewed, English written articles addressing mixed gender and female PTSD and alcohol abuse issues from Jan 2012 to May 2017. Results: Total of 1011 articles were found in scientific databases related to searched keywords of which 29 met the selection criteria and were analysed. The results of longitudinal studies indicate that (I) various trauma, especially interpersonal trauma exposure in childhood is linked with increased risk of revictimization in later life and problem alcohol use; (II) revictimization in adolescence or adulthood, rather than victimization in childhood has a greater impact on the onset and progression of problematic alcohol use in adulthood. Cross-sectional and epidemiological studies also support significant relationships between female PTSD and problem alcohol use. Regards to the negative impact of alcohol use on PTSD symptoms results are yet controversial; some evidence suggests that alcohol does not exacerbate symptoms of PTSD over time, while others argue that problem alcohol use worsens PTSD symptoms and is linked to chronicity of both disorders, especially among women with previous alcohol use problems. Analysis of moderating/mediating factors of PTSD and problem alcohol use revealed, that higher motives/expectancies, specifically distress coping motives for alcohol use significantly moderates the relationship between PTSD and problematic alcohol use. Whereas negative affective states mediate relationship between symptoms of PTSD and alcohol use, but only among woman with alcohol use problems already developed. Conclusions: Interpersonal trauma experience, especially in childhood and its reappearance in lifetime is linked with PTSD symptoms and problem drinking among women. Moreover, problem alcohol use can be both a cause and a consequence of trauma and PTSD, and if used for coping it, increases the likelihood of chronicity of both disorders. In order to effectively treat both disorders, it’s worthwhile taking into account this dynamic interplay of women's PTSD symptoms and problem drinking.

Keywords: female, trauma, post-traumatic stress disorder, problem alcohol use, systemic analysis

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568 Water Quality in Buyuk Menderes Graben, Turkey

Authors: Tugbanur Ozen Balaban, Gultekin Tarcan, Unsal Gemici, Mumtaz Colak, I. Hakki Karamanderesi

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Buyuk Menderes Graben is located in the Western Anatolia (Turkey). The graben has become the largest industrial and agricultural area with a total population exceeding 3.000.000. There are two big cities within the study areas from west to east as Aydın and Denizli. The study area is very rich with regard to cold ground waters and thermal waters. Electrical production using geothermal potential has become very popular in the last decades in this area. Buyuk Menderes Graben is a tectonically active extensional region and is undergoing a north–south extensional tectonic regime which commenced at the latest during Early Middle Miocene period. The basement of the study area consists of Menderes massif rocks that are made up of high-to low-grade metamorphics and they are aquifer for both cold ground waters and thermal waters depending on the location. Neogene terrestrial sediments, which are mainly composed by alluvium fan deposits unconformably cover the basement rocks in different facies have very low permeability and locally may act as cap rocks for the geothermal systems. The youngest unit is Quaternary alluvium which is the shallow regional aquifer consists of Holocene alluvial deposits in the study area. All the waters are of meteoric origin and reflect shallow or deep circulation according to the 8O, 2H and 3H contents. Meteoric waters move to deep zones by fractured system and rise to the surface along the faults. Water samples (drilling well, spring and surface waters) and local seawater were collected between 2010 and 2012 years. Geochemical modeling was calculated distribution of the aqueous species and exchange processes by using PHREEQCi speciation code. Geochemical analyses show that cold ground water types are evolving from Ca–Mg–HCO3 to Na–Cl–SO4 and geothermal aquifer waters reflect the water types of Na-Cl-HCO3 in Aydın. Water types of Denizli are Ca-Mg-HCO3 and Ca-Mg-HCO3-SO4. Thermal water types reflect generally Na-HCO3-SO4. The B versus Cl rates increase from east to west with the proportion of seawater introduced into the fresh water aquifers and geothermal reservoirs. Concentrations of some elements (As, B, Fe and Ni) are higher than the tolerance limit of the drinking water standard of Turkey (TS 266) and international drinking water standards (WHO, FAO etc).

Keywords: Buyuk Menderes, isotope chemistry, geochemical modelling, water quality

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567 Rapid Detection of Cocaine Using Aggregation-Induced Emission and Aptamer Combined Fluorescent Probe

Authors: Jianuo Sun, Jinghan Wang, Sirui Zhang, Chenhan Xu, Hongxia Hao, Hong Zhou

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In recent years, the diversification and industrialization of drug-related crimes have posed significant threats to public health and safety globally. The widespread and increasingly younger demographics of drug users and the persistence of drug-impaired driving incidents underscore the urgency of this issue. Drug detection, a specialized forensic activity, is pivotal in identifying and analyzing substances involved in drug crimes. It relies on pharmacological and chemical knowledge and employs analytical chemistry and modern detection techniques. However, current drug detection methods are limited by their inability to perform semi-quantitative, real-time field analyses. They require extensive, complex laboratory-based preprocessing, expensive equipment, and specialized personnel and are hindered by long processing times. This study introduces an alternative approach using nucleic acid aptamers and Aggregation-Induced Emission (AIE) technology. Nucleic acid aptamers, selected artificially for their specific binding to target molecules and stable spatial structures, represent a new generation of biosensors following antibodies. Rapid advancements in AIE technology, particularly in tetraphenyl ethene-based luminous, offer simplicity in synthesis and versatility in modifications, making them ideal for fluorescence analysis. This work successfully synthesized, isolated, and purified an AIE molecule and constructed a probe comprising the AIE molecule, nucleic acid aptamers, and exonuclease for cocaine detection. The probe demonstrated significant relative fluorescence intensity changes and selectivity towards cocaine over other drugs. Using 4-Butoxytriethylammonium Bromide Tetraphenylethene (TPE-TTA) as the fluorescent probe, the aptamer as the recognition unit, and Exo I as an auxiliary, the system achieved rapid detection of cocaine within 5 mins in aqueous and urine, with detection limits of 1.0 and 5.0 µmol/L respectively. The probe-maintained stability and interference resistance in urine, enabling quantitative cocaine detection within a certain concentration range. This fluorescent sensor significantly reduces sample preprocessing time, offers a basis for rapid onsite cocaine detection, and promises potential for miniaturized testing setups.

Keywords: drug detection, aggregation-induced emission (AIE), nucleic acid aptamer, exonuclease, cocaine

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566 Multi-Scale Spatial Difference Analysis Based on Nighttime Lighting Data

Authors: Qinke Sun, Liang Zhou

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The ‘Dragon-Elephant Debate’ between China and India is an important manifestation of global multipolarity in the 21st century. The two rising powers have carried out economic reforms one after another in the interval of more than ten years, becoming the fastest growing developing country and emerging economy in the world. At the same time, the development differences between China and India have gradually attracted wide attention of scholars. Based on the continuous annual night light data (DMSP-OLS) from 1992 to 2012, this paper systematically compares and analyses the regional development differences between China and India by Gini coefficient, coefficient of variation, comprehensive night light index (CNLI) and hot spot analysis. The results show that: (1) China's overall expansion from 1992 to 2012 is 1.84 times that of India, in which China's change is 2.6 times and India's change is 2 times. The percentage of lights in unlighted areas in China dropped from 92% to 82%, while that in India from 71% to 50%. (2) China's new growth-oriented cities appear in Hohhot, Inner Mongolia, Ordos, and Urumqi in the west, and the declining cities are concentrated in Liaoning Province and Jilin Province in the northeast; India's new growth-oriented cities are concentrated in Chhattisgarh in the north, while the declining areas are distributed in Uttar Pradesh. (3) China's differences on different scales are lower than India's, and regional inequality of development is gradually narrowing. Gini coefficients at the regional and provincial levels have decreased from 0.29, 0.44 to 0.24 and 0.38, respectively, while regional inequality in India has slowly improved and regional differences are gradually widening, with Gini coefficients rising from 0.28 to 0.32. The provincial Gini coefficient decreased slightly from 0.64 to 0.63. (4) The spatial pattern of China's regional development is mainly east-west difference, which shows the difference between coastal and inland areas; while the spatial pattern of India's regional development is mainly north-south difference, but because the southern states are sea-dependent, it also reflects the coastal inland difference to a certain extent. (5) Beijing and Shanghai present a multi-core outward expansion model, with an average annual CNLI higher than 0.01, while New Delhi and Mumbai present the main core enhancement expansion model, with an average annual CNLI lower than 0.01, of which the average annual CNLI in Shanghai is about five times that in Mumbai.

Keywords: spatial pattern, spatial difference, DMSP-OLS, China, India

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565 An Interpretative Historical Analysis of Asylum and Refugee Policies and Attitudes to Australian Immigration Laws

Authors: Kamal Kithsiri Karunadasa Hewawasam Revulge

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This paper is an interpretative historical analysis of Australian migration laws that examines asylum and refugee policies and attitudes in Australia. It looks at major turning points in Australian migration history, and in doing so, the researcher reviewed relevant literature on the aspects crucial to highlighting the current trend of Australian migration policies. The data was collected using secondary data from official government sources, including annual reports, media releases on immigration, inquiry reports, statistical information, and other available literature to identify critical historical events that significantly affected the systematic developments of asylum seekers and refugee policies in Australia and to look at the historical trends of official thinking. A reliance on using these official sources is justified as those are the most convincing sources to analyse the historical events in Australia. Additional literature provides us with critical analyses of the behaviour and culture of the Australian immigration administration. The analytical framework reviewed key Australian Government immigration policies since British colonization and the settlement era of 1787–the 1850s and to the present. The fundamental basis for doing so is that past events and incidents offer us clues and lessons relevant to the present day. Therefore, providing a perspective on migration history in Australia helps analyse how current policymakers' strategies developed and changed over time. Attention is also explicitly focused on Australian asylum and refugee policy internationally, as it helped to broaden the analysis. The finding proved a link between past events and adverse current Australian government policies towards asylum seekers and refugees. It highlighted that Australia's current migration policies are part of a carefully and deliberately planned pattern that arose from the occupation of Australia by early British settlers. In this context, the remarkable point is that the historical events of taking away children from their Australian indigenous parents, widely known as the 'stolen generation' reflected a model of assimilation, or a desire to absorb other cultures into Australian society by fully adopting the settlers' language, their culture, and losing indigenous people's traditions. Current Australian policies towards migrants reflect the same attitude. Hence, it could be argued that policies and attitudes towards asylum seekers and refugees, particularly so-called 'boat people' to some extent, still reflect Australia's earlier colonial and 'white Australia' history.

Keywords: migration law, refugee law, international law, administrative law

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564 Relation of Consumer Satisfaction on Organization by Focusing on the Different Aspects of Buying Behavior

Authors: I. Gupta, N. Setia

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Introduction. Buyer conduct is a progression of practices or examples that buyers pursue before making a buy. It begins when the shopper ends up mindful of a need or wish for an item, at that point finishes up with the buying exchange. Business visionaries can't generally simply shake hands with their intended interest group people and become more acquainted with them. Research is often necessary, so every organization primarily involves doing continuous research to understand and satisfy consumer needs pattern. Aims and Objectives: The aim of the present study is to examine the different behaviors of the consumer, including pre-purchase, purchase, and post-purchase behavior. Materials and Methods: In order to get results, face to face interview held with 80 people which comprise a larger part of female individuals having upper as well as middle-class status. The prime source of data collection was primary. However, the study has also used the theoretical contribution of many researchers in their respective field. Results: Majority of the respondents were females (70%) from the age group of 20-50. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis, and ANOVA which has rejected the null hypothesis that there is no relation between researching the consumer behavior at different stages and organizational performance. The real finding of this study is that simply focusing on the buying part isn't enough to gain profits and fame, however, understanding the pre, buy and post-buy behavior of consumer performs a huge role in organization success. The outcomes demonstrated that the organization, which deals with the three phases of research of purchasing conduct is able to establish a great brand image as compare to their competitors. Alongside, enterprises can observe customer conduct in a considerably more proficient manner. Conclusion: The analyses of consumer behavior presented in this study is an attempt to understand the factors affecting consumer purchasing behavior. This study has revealed that those corporations are more successful, which work on understanding buying behavior instead to just focus on the selling products. As a result, organizations perform good and grow rapidly because consumers are the one who can make or break the company. The interviews that were conducted face to face, clearly revealed that those organizations become at top-notch whom consumers are satisfied, not just with product but also with services of the company. The study is not targeting the particular class of audience; however, it brings out benefits to the masses, in particular to business organizations.

Keywords: consumer behavior, pre purchase, post purchase, consumer satisfaction

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563 Effect of Carbide Precipitates in Tool Steel on Material Transfer: A Molecular Dynamics Study

Authors: Ahmed Tamer AlMotasem, Jens Bergström, Anders Gåård, Pavel Krakhmalev, Thijs Jan Holleboom

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In sheet metal forming processes, accumulation and transfer of sheet material to tool surfaces, often referred to as galling, is the major cause of tool failure. Initiation of galling is assumed to occur due to local adhesive wear between two surfaces. Therefore, reducing adhesion between the tool and the work sheet has a great potential to improve the tool materials galling resistance. Experimental observations and theoretical studies show that the presence of primary micro-sized carbides and/or nitrides in alloyed steels may significantly improve galling resistance. Generally, decreased adhesion between the ceramic precipitates and the sheet material counter-surface are attributed as main reason to the latter observations. On the other hand, adhesion processes occur at an atomic scale and, hence, fundamental understanding of galling can be obtained via atomic scale simulations. In the present study, molecular dynamics simulations are used, with utilizing second nearest neighbor embedded atom method potential to investigate the influence of nano-sized cementite precipitates embedded in tool atoms. The main aim of the simulations is to gain new fundamental knowledge on galling initiation mechanisms. Two tool/work piece configurations, iron/iron and iron-cementite/iron, are studied under dry sliding conditions. We find that the average frictional force decreases whereas the normal force increases for the iron-cementite/iron system, in comparison to the iron/iron configuration. Moreover, the average friction coefficient between the tool/work-piece decreases by about 10 % for the iron-cementite/iron case. The increase of the normal force in the case of iron-cementite/iron system may be attributed to the high stiffness of cementite compared to bcc iron. In order to qualitatively explain the effect of cementite on adhesion, the adhesion force between self-mated iron/iron and cementite/iron surfaces has been determined and we found that iron/cementite surface exhibits lower adhesive force than that of iron-iron surface. The variation of adhesion force with temperature was investigated up to 600 K and we found that the adhesive force, generally, decreases with increasing temperature. Structural analyses show that plastic deformation is the main deformation mechanism of the work-piece, accompanied with dislocations generation.

Keywords: adhesion, cementite, galling, molecular dynamics

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562 Spatial Economic Attributes of O. R. Tambo Airport, South Africa

Authors: Masilonyane Mokhele

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Across the world, different planning models of the so-called airport-led developments are becoming bandwagons hailed as key to the future of cities. However, in the existing knowledge, there is paucity of empirically informed description and explanation of the economic fundamentals driving the forces of attraction of airports. This void is arguably a result of the absence of an appropriate theoretical framework to guide the analyses. Given this paucity, the aim of the paper is to contribute towards a theoretical framework that could be used to describe and explain forces that drive the location and mix of airport-centric developments. Towards achieving this aim, the objectives of the paper are: one, to establish the type of economic activities that are located on and around O.R. Tambo International Airport (ORTIA), and analyse the reasons for locating there; two, to establish changes that have occurred over time in the form of the airport-centric development of ORTIA; three, to identify the propulsive economic qualities of ORTIA; four, to analyse the spatial, economic and structural linkages within the airport-centric development of ORTIA, between the airport-centric development and the airport, as well as the airport-centric development’s linkages with their metropolitan area and other regional, national and international airport-centric developments and locations. To address the objectives above, the study adopted a case study approach, centred on ORTIA in South Africa: Africa’s busiest airport in terms of passengers and airfreight handled. Using a lens of location theory, a survey was adopted as a main research method, wherein telephonic interviews were conducted with a representative number of firms on and around ORTIA. Other data collection methods encompassed in-depth qualitative interviews (to augment the information obtained through the survey) and analysis of secondary information, particularly as regards establishing changes that have occurred in the form of ORTIA and surrounds. From the empirical findings, ORTIA was discovered to have propulsive economic qualities that act as significant forces of attraction in the clustering of firms. Together with its airport-centric development, ORTIA was discovered to have growth pole properties because of the linkages that occur within the study area, and the linkages that exist between the airport-centric firms and the airport. It was noted that the transport-oriented firms (typified by couriers and freight carriers) act as anchors in some fellow airport-centric firms making use of elements of urbanisation economies, particularly as regards the use of the airport for airfreight services. The empirical findings presented in the paper (in conjunction with results from other airport-centric development case studies) could be used as contribution towards extending theory that describes and explains forces that drive the location and mix of airport-centric developments.

Keywords: airports, airport-centric development, O. R. Tambo international airport, South Africa

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561 The Impact of Intimate Partner Violence on Women’s Mental Health in Kenya

Authors: Josephine Muchiri, Makena Muriithi

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Adverse mental health consequences are experienced by those that have been touched by Intimate Partner Violence (IPV), whether directly or indirectly. These negative effects are felt not only in the short term but in years to come. It is important to examine the prevalence and co-occurrence of mental disorders in order to provide strategic interventions for women who have experienced IPV. The aim of this study was to examine the prevalence and comorbidity of post-traumatic stress disorder (PTSD), Depression, and Anxiety among women who had experienced intimate Partner violence in two selected informal settlements in Nairobi County, Kenya. Participants were 116 women (15-60 years) selected through purposive and snowball sampling from the low social, economic settlements (Kawangware and Kibera) in Nairobi, Kenya. A social demographic questionnaire and the Woman Abuse Screening Tool (WAST) were used to collect data on intimate partner violence experiences. The PTSD Checklist for DSM-5 (PCL-5), Beck’s Depression Inventory, and the Beck’s Anxiety Inventory assessed for post-traumatic stress disorder, depression, and anxiety, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 29, utilizing descriptive and correlation analyses. Findings indicated that the women had undergone various forms of abuse from their intimate partners, which were physical abuse 111(92.5%), sexual abuse 70(88.6%), and verbal abuse 92(93.9%). The prevalence of the mental disorders was PTSD 47(32.4%); M= 44.11, S.D =14.67, depression was the highest at n=131(90.3%; M=33.37±9.98) with the levels of depression having varying prevalence rates where severe depression had the highest representation [moderate: n= 35; 24.1%, severe: n=69 (47.6%) and extremely severe: n=27(18.6%)]. Anxiety had the second highest prevalence of n=99 (68.8%; M= 28.55±13.63) with differing prevalence rates in the levels of anxiety which were normal anxiety: 45(31.3%), moderate anxiety n=62(43.1%) and severe anxiety: n=37(25.7%). Regarding comorbidities, the Pearson correlation test showed that there was a significant (p=0.000) positive relationship between PTSD and depression (r=0.379; p=.000), PTSD and anxiety (r=0.624; p=.000), and depression and anxiety (r=0.386; p=.000) such that increase in one disorder concomitantly led to increase of the other two disorders; hence comorbidity of the three disorders was ascertained. Conclusion: The study asserted the adverse impacts of IPV on women’s mental well-being, where the prevalence of PTSD, depression, and anxiety was established. Almost all the women had depressive symptoms; whereas more than half had anxiety and slightly more than a third had PTSD. Regarding the severity levels of anxiety and depression, almost half of the women with depression had severe depression whereas moderate anxiety was more prevalent for those with anxiety. The three disorders were found to co-occur where comorbidities of PTSD and anxiety had the highest probability of co-occurrence. It is thus recommended that mental health interventions with a focus on the three disorders be offered for women undergoing IPV.

Keywords: anxiety, comorbidity, depression, intimate partner violence, post-traumatic stress disorder

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560 Association of Nuclear – Mitochondrial Epistasis with BMI in Type 1 Diabetes Mellitus Patients

Authors: Agnieszka H. Ludwig-Slomczynska, Michal T. Seweryn, Przemyslaw Kapusta, Ewelina Pitera, Katarzyna Cyganek, Urszula Mantaj, Lucja Dobrucka, Ewa Wender-Ozegowska, Maciej T. Malecki, Pawel Wolkow

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Obesity results from an imbalance between energy intake and its expenditure. Genome-Wide Association Study (GWAS) analyses have led to discovery of only about 100 variants influencing body mass index (BMI), which explain only a small portion of genetic variability. Analysis of gene epistasis gives a chance to discover another part. Since it was shown that interaction and communication between nuclear and mitochondrial genome are indispensable for normal cell function, we have looked for epistatic interactions between the two genomes to find their correlation with BMI. Methods: The analysis was performed on 366 T1DM patients using Illumina Infinium OmniExpressExome-8 chip and followed by imputation on Michigan Imputation Server. Only genes which influence mitochondrial functioning (listed in Human MitoCarta 2.0) were included in the analysis – variants of nuclear origin (MAF > 5%) in 1140 genes and 42 mitochondrial variants (MAF > 1%). Gene expression analysis was performed on GTex data. Association analysis between genetic variants and BMI was performed with the use of Linear Mixed Models as implemented in the package 'GENESIS' in R. Analysis of association between mRNA expression and BMI was performed with the use of linear models and standard significance tests in R. Results: Among variants involved in epistasis between mitochondria and nucleus we have identified one in mitochondrial transcription factor, TFB2M (rs6701836). It interacted with mitochondrial variants localized to MT-RNR1 (p=0.0004, MAF=15%), MT-ND2 (p=0.07, MAF=5%) and MT-ND4 (p=0.01, MAF=1.1%). Analysis of the interaction between nuclear variant rs6701836 (nuc) and rs3021088 localized to MT-ND2 mitochondrial gene (mito) has shown that the combination of the two led to BMI decrease (p=0.024). Each of the variants on its own does not correlate with higher BMI [p(nuc)=0.856, p(mito)=0.116)]. Although rs6701836 is intronic, it influences gene expression in the thyroid (p=0.000037). rs3021088 is a missense variant that leads to alanine to threonine substitution in the MT-ND2 gene which belongs to complex I of the electron transport chain. The analysis of the influence of genetic variants on gene expression has confirmed the trend explained above – the interaction of the two genes leads to BMI decrease (p=0.0308). Each of the mRNAs on its own is associated with higher BMI (p(mito)=0.0244 and p(nuc)=0.0269). Conclusıons: Our results show that nuclear-mitochondrial epistasis can influence BMI in T1DM patients. The correlation between transcription factor expression and mitochondrial genetic variants will be subject to further analysis.

Keywords: body mass index, epistasis, mitochondria, type 1 diabetes

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559 Executive Order as an Effective Tool in Combating Insecurities and Human Rights Violations: The Case of the Special Anti-Robbery Squad and Youths in Nigeria

Authors: Cita Ayeni

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Following countless violations of Human Rights in Nigeria by the various arms and agencies of government; from the Military to the Federal Police and other law enforcement agencies, Nigeria has been riddled with several reports of acts by these agencies against the citizens, ranging from illegal arrest and imprisonment, torture, disappearing, and extrajudicial killings, just to mention a few. This paper, focuses on SARS (Special Anti-Robbery Squad), a division of the Nigeria Police Force, and its reported threats to the people’s security, particularly the Nigerian youths, with continuous violence, extortion, illegal arrest and imprisonment, terror, and extrajudicial activities resulting in maiming and in most cases death, thus infringing on the human rights of the people it’s sworn to protect. This research further analyses how the activities of SARS has over the years instigated fear on the average Nigerian youth, preventing the free participation in daily life, education, job, and individual development, in turn impeding the realization of their full potentials for growth and participation in collective national development. This research analyzes the executive order by the then Acting President (Vice-President) of Nigeria, directing the overhauling of SARS, and its implementation by the Federal Police Force in determining if it’s enough to prevent or put a stop to the continuous Human Rights abuse and threat to the security of the individual citizen. Concluding that although the order by the Acting President was given with an intent to halt the various violations by SARS, and the Inspector General of Police’s (IGP) subsequent action by releasing a statement following the order, the bureaucracy in Nigeria, with a history of incompetency and a return to 'business as usual' after a reduced public outcry, it’s most likely that there will not be adequate follow up put in place and these violations would be slowly 'swept under the rug' with SARS officials not held accountable. It is recommended therefore that the Federal Government through the NPF, following the reforms made, in collaboration with the mentioned Independent Human Rights and civil societies organizations should periodically produce unbiased and publicly accessible reports on the implementation of these reforms and progress made. This will go a long way in assuring the public of actual fulfillment of the restructuring, reduce fear by the youths and restore some public faith in the government.

Keywords: special anti-robbery squad, youths in Nigeria, overhaul, insecurities, human rights violations

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558 Support Services in Open and Distance Education: An Integrated Model of Open Universities

Authors: Evrim Genc Kumtepe, Elif Toprak, Aylin Ozturk, Gamze Tuna, Hakan Kilinc, Irem Aydin Menderis

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Support services are very significant elements for all educational institutions in general; however, for distance learners, these services are more essential than traditional (face-to-face) counterparts. One of the most important reasons for this is that learners and instructors do not share the same physical environment and that distance learning settings generally require intrapersonal interactions rather than interpersonal ones. Some learners in distance learning programs feel isolated. Furthermore, some fail to feel a sense of belonging to the institution because of lack of self-management skills, lack of motivation levels, and the need of being socialized, so that they are more likely to fail or drop out of an online class. In order to overcome all these problems, support services have emerged as a critical element for an effective and sustainable distance education system. Within the context of distance education support services, it is natural to include technology-based and web-based services and also the related materials. Moreover, institutions in education sector are expected to use information and communication technologies effectively in order to be successful in educational activities and programs. In terms of the sustainability of the system, an institution should provide distance education services through ICT enabled processes to support all stakeholders in the system, particularly distance learners. In this study, it is envisaged to develop a model based on the current support services literature in the field of open and distance learning and the applications of the distance higher education institutions. Specifically, content analysis technique is used to evaluate the existing literature in the distance education support services, the information published on websites, and applications of distance higher education institutions across the world. A total of 60 institutions met the inclusion criteria which are language option (English) and availability of materials in the websites. The six field experts contributed to brainstorming process to develop and extract codes for the coding scheme. During the coding process, these preset and emergent codes are used to conduct analyses. Two coders independently reviewed and coded each assigned website to ensure that all coders are interpreting the data the same way and to establish inter-coder reliability. Once each web page is included in descriptive and relational analysis, a model of support services is developed by examining the generated codes and themes. It is believed that such a model would serve as a quality guide for future institutions, as well as the current ones.

Keywords: support services, open education, distance learning, support model

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557 Auditory Perception of Frequency-Modulated Sweeps and Reading Difficulties in Chinese

Authors: Hsiao-Lan Wang, Chun-Han Chiang, I-Chen Chen

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In Chinese Mandarin, lexical tones play an important role to provide contrasts in word meaning. They are pitch patterns and can be quantified as the fundamental frequency (F0), expressed in Hertz (Hz). In this study, we aim to investigate the influence of frequency discrimination on Chinese children’s performance of reading abilities. Fifty participants from 3rd to 4th grades, including 24 children with reading difficulties and 26 age-matched children, were examined. A serial of cognitive, language, reading and psychoacoustic tests were administrated. Magnetoencephalography (MEG) was also employed to study children’s auditory sensitivity. In the present study, auditory frequency was measured through slide-up pitch, slide-down pitch and frequency-modulated tone. The results showed that children with Chinese reading difficulties were significantly poor at phonological awareness and auditory discrimination for the identification of frequency-modulated tone. Chinese children’s character reading performance was significantly related to lexical tone awareness and auditory perception of frequency-modulated tone. In our MEG measure, we compared the mismatch negativity (MMNm), from 100 to 200 ms, in two groups. There were no significant differences between groups during the perceptual discrimination of standard sounds, fast-up and fast-down frequencies. However, the data revealed significant cluster differences between groups in the slow-up and slow-down frequencies discrimination. In the slow-up stimulus, the cluster demonstrated an upward field map at 106-151 ms (p < .001) with a strong peak time at 127ms. The source analyses of two dipole model and localization resolution model (CLARA) from 100 to 200 ms both indicated a strong source from the left temporal area with 45.845% residual variance. Similar results were found in the slow-down stimulus with a larger upward current at 110-142 ms (p < 0.05) and a peak time at 117 ms in the left temporal area (47.857% residual variance). In short, we found a significant group difference in the MMNm while children processed frequency-modulated tones with slow temporal changes. The findings may imply that perception of sound frequency signals with slower temporal modulations was related to reading and language development in Chinese. Our study may also support the recent hypothesis of underlying non-verbal auditory temporal deficits accounting for the difficulties in literacy development seen developmental dyslexia.

Keywords: Chinese Mandarin, frequency modulation sweeps, magnetoencephalography, mismatch negativity, reading difficulties

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556 Antimicrobial Resistance: Knowledge towards Antibiotics in a Mexican Population

Authors: L. D. Upegui, Isabel Alvarez-Solorza, Karina Garduno-Ulloa, Maren Boecker

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Introduction: The increasing prevalence rate of resistant and multiresistant bacterial strains to antibiotics is a threat to public health and requires a rapid multifunctional answer. Individuals that are affected by resistant strains present a higher morbidity and mortality than individuals that are infected with the same species of bacteria but with sensitive strains. There have been identified risk factors that are related to the misuse and overuse of antibiotics, like socio-demographic characteristics and psychological aspects of the individuals that have not been explored objectively due to a lack of valid and reliable instruments for their measurement. Objective: To validate a questionnaire for the evaluation of the levels of knowledge related to the use of antibiotics in a Mexican population. Materials and Methods: Analytical cross-sectional observational study. The questionnaire consists of 12 items to evaluated knowledge (1=no, 2=not sure, 3=yes) regarding the use of antibiotics, with higher scores corresponding to a higher level of knowledge. Data are collected in a sample of students. Data collection is still ongoing. In this abstract preliminary results of 30 respondents are reported which were collected during pilot-testing. The validation of the instrument was done using the Rasch model. Fit to the Rasch model was tested checking overall fit to the model, unidimensionality, local independence and evaluating the presence of Differential Item Functioning (DIF) by age and gender. The software Rumm2030 and the SPSS were used for the analyses. Results: The participants of the pilot-testing presented an average age of 32 years ± 12.6 and 53% were women. The preliminary results indicated that the items showed good fit to the Rasch model (chi-squared=12.8 p=0.3795). Unidimensionality (number of significant t-tests of 3%) could be proven, the items were locally independent, and no DIF was observed. Knowledge was the smallest regarding statements on the role of antibiotics in treating infections, e.g., most of the respondents did not know that antibiotics would not work against viral infections (70%) and that they could also cause side effects (87%). The knowledge score ranged from 0 to 100 points with a transformed measurement (mean of knowledge 27.1 ± 4.8). Conclusions: The instrument showed good psychometric proprieties. The low scores of knowledge about antibiotics suggest that misinterpretations on the use of these medicaments were prevalent, which could influence the production of antibiotic resistance. The application of this questionnaire will allow the objective identification of 'Hight risk groups', which will be the target population for future educational campaigns, to reduce the knowledge gaps on the general population as an effort against antibiotic resistance.

Keywords: antibiotics, knowledge, misuse, overuse, questionnaire, Rasch model, validation

Procedia PDF Downloads 157
555 Sustainable Business Model Archetypes – A Systematic Review and Application to the Plastic Industry

Authors: Felix Schumann, Giorgia Carratta, Tobias Dauth, Liv Jaeckel

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In the last few decades, the rapid growth of the use and disposal of plastic items has led to their overaccumulation in the environment. As a result, plastic pollution has become a subject of global concern. Today plastics are used as raw materials in almost every industry. While the recognition of the ecological, social, and economic impact of plastics in academic research is on the rise, the potential role of the ‘plastic industry’ in dealing with such issues is still largely underestimated. Therefore, the literature on sustainable plastic management is still nascent and fragmented. Working towards sustainability requires a fundamental shift in the way companies employ plastics in their day-to-day business. For that reason, the applicability of the business model concept has recently gained momentum in environmental research. Business model innovation is increasingly recognized as an important driver to re-conceptualize the purpose of the firm and to readily integrate sustainability in their business. It can serve as a starting point to investigate whether and how sustainability can be realized under industry- and firm-specific circumstances. Yet, there is no comprehensive view in the plastic industry on how firms start refining their business models to embed sustainability in their operations. Our study addresses this gap, looking primarily at the industrial sectors responsible for the production of the largest amount of plastic waste today: plastic packaging, consumer goods, construction, textile, and transport. Relying on the archetypes of sustainable business models and applying them to the aforementioned sectors, we try to identify companies’ current strategies to make their business models more sustainable. Based on the thematic clustering, we can develop an integrative framework for the plastic industry. The findings are underpinned and illustrated by a variety of relevant plastic management solutions that the authors have identified through a systematic literature review and analysis of existing, empirically grounded research in this field. Using the archetypes, we can promote options for business model innovations for the most important sectors in which plastics are used. Moreover, by linking the proposed business model archetypes to the plastic industry, our research approach guides firms in exploring sustainable business opportunities. Likewise, researchers and policymakers can utilize our classification to identify best practices. The authors believe that the study advances the current knowledge on sustainable plastic management through its broad empirical industry analyses. Hence, the application of business model archetypes in the plastic industry will be useful for shaping companies’ transformation to create and deliver more sustainability and provides avenues for future research endeavors.

Keywords: business models, environmental economics, plastic management, plastic pollution, sustainability

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554 Unveiling the Chaura Thrust: Insights into a Blind Out-of-Sequence Thrust in Himachal Pradesh, India

Authors: Rajkumar Ghosh

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The Chaura Thrust, located in Himachal Pradesh, India, is a prominent geological feature that exhibits characteristics of an out-of-sequence thrust fault. This paper explores the geological setting of Himachal Pradesh, focusing on the Chaura Thrust's unique characteristics, its classification as an out-of-sequence thrust, and the implications of its presence in the region. The introduction provides background information on thrust faults and out-of-sequence thrusts, emphasizing their significance in understanding the tectonic history and deformation patterns of an area. It also outlines the objectives of the paper, which include examining the Chaura Thrust's geological features, discussing its classification as an out-of-sequence thrust, and assessing its implications for the region. The paper delves into the geological setting of Himachal Pradesh, describing the tectonic framework and providing insights into the formation of thrust faults in the region. Special attention is given to the Chaura Thrust, including its location, extent, and geometry, along with an overview of the associated rock formations and structural characteristics. The concept of out-of-sequence thrusts is introduced, defining their distinctive behavior and highlighting their importance in the understanding of geological processes. The Chaura Thrust is then analyzed in the context of an out-of-sequence thrust, examining the evidence and characteristics that support this classification. Factors contributing to the out-of-sequence behavior of the Chaura Thrust, such as stress interactions and fault interactions, are discussed. The geological implications and significance of the Chaura Thrust are explored, addressing its impact on the regional geology, tectonic evolution, and seismic hazard assessment. The paper also discusses the potential geological hazards associated with the Chaura Thrust and the need for effective mitigation strategies in the region. Future research directions and recommendations are provided, highlighting areas that warrant further investigation, such as detailed structural analyses, geodetic measurements, and geophysical surveys. The importance of continued research in understanding and managing geological hazards related to the Chaura Thrust is emphasized. In conclusion, the Chaura Thrust in Himachal Pradesh represents an out-of-sequence thrust fault that has significant implications for the region's geology and tectonic evolution. By studying the unique characteristics and behavior of the Chaura Thrust, researchers can gain valuable insights into the geological processes occurring in Himachal Pradesh and contribute to a better understanding and mitigation of seismic hazards in the area.

Keywords: chaura thrust, out-of-sequence thrust, himachal pradesh, geological setting, tectonic framework, rock formations, structural characteristics, stress interactions, fault interactions, geological implications, seismic hazard assessment, geological hazards, future research, mitigation strategies.

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553 Collaborative Governance in Dutch Flood Risk Management: An Historical Analysis

Authors: Emma Avoyan

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The safety standards for flood protection in the Netherlands have been revised recently. It is expected that all major flood-protection structures will have to be reinforced to meet the new standards. The Dutch Flood Protection Programme aims at accomplishing this task through innovative integrated projects such as construction of multi-functional flood defenses. In these projects, flood safety purposes will be combined with spatial planning, nature development, emergency management or other sectoral objectives. Therefore, implementation of dike reinforcement projects requires early involvement and collaboration between public and private sectors, different governmental actors and agencies. The development and implementation of such integrated projects has been an issue in Dutch flood risk management since long. Therefore, this article analyses how cross-sector collaboration within flood risk governance in the Netherlands has evolved over time, and how this development can be explained. The integrative framework for collaborative governance is applied as an analytical tool to map external factors framing possibilities as well as constraints for cross-sector collaboration in Dutch flood risk domain. Supported by an extensive document and literature analysis, the paper offers insights on how the system context and different drivers changing over time either promoted or hindered cross-sector collaboration between flood protection sector, urban development, nature conservation or any other sector involved in flood risk governance. The system context refers to the multi-layered and interrelated suite of conditions that influence the formation and performance of complex governance systems, such as collaborative governance regimes, whereas the drivers initiate and enable the overall process of collaboration. In addition, by applying a method of process tracing we identify a causal and chronological chain of events shaping cross-sectoral interaction in Dutch flood risk management. Our results indicate that in order to evaluate the performance of complex governance systems, it is important to firstly study the system context that shapes it. Clear understanding of the system conditions and drivers for collaboration gives insight into the possibilities of and constraints for effective performance of complex governance systems. The performance of the governance system is affected by the system conditions, while at the same time the governance system can also change the system conditions. Our results show that the sequence of changes within the system conditions and drivers over time affect how cross-sector interaction in Dutch flood risk governance system happens now. Moreover, we have traced the potential of this governance system to shape and change the system context.

Keywords: collaborative governance, cross-sector interaction, flood risk management, the Netherlands

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552 Gait Analysis in Total Knee Arthroplasty

Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

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551 Assessing Acceptability and Preference of Printed Posters on COVID-19 Related Stigma: A Post-Test Study Among HIV-Focused Health Workers in Greater Accra Region of Ghana

Authors: Jerry Fiave, Dacosta Aboagye, Stephen Ayisi-Addo, Mabel Kissiwah Asafo, Felix Osei-Sarpong, Ebenezer Kye-Mensah, Renee Opare-Otoo

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Background: Acceptability and preference of social and behaviour change (SBC) materials by target audiences is an important determinant of effective health communication outcomes. In Ghana, however, pre-test and post-test studies on acceptability and preference of specific SBC materials for specific audiences are rare. The aim of this study was therefore to assess the acceptability and preference of printed posters on COVID-19 related stigma as suitable SBC materials for health workers to influence behaviours that promote uptake of HIV-focused services. Methods: A total of 218 health workers who provide HIV-focused services were purposively sampled in 16 polyclinics where the posters were distributed in the Greater Accra region of Ghana. Data was collected in March 2021 using an adapted self-administered questionnaire in Google forms deployed via WhatsApp to participants. The data were imported into SPSS version 27 where chi-square test and regression analyses were performed to establish association as well as strength of association between variables respectively. Results: A total of 142 participants (physicians, nurses, midwives, lab scientists, health promoters, diseases control officers) made up of 85(60%) females and 57(40%) males responded to the questionnaire, giving a response rate of 65.14%. Only 88 (61.97%) of the respondents were exposed to the posters. The majority of those exposed said the posters were informative [82(93.18%)], relevant [85(96.59%)] and attractive [83(94.32%)]. They [82(93.20%)] also rated the material as acceptable with no statistically significant association between category of health worker and acceptability of the posters (X =1.631, df=5, p=0.898). However, participants’ most preferred forms of material on COVID-19 related stigma were social media [38(26.76%)], television [33(23.24%)], SMS [19(13.38%)], and radio [18(12.70%)]. Clinical health workers were 4.88 times more likely to prefer online or electronic versions of SBC materials than nonclinical health workers [AOR= 4.88 (95% CI= 0.31-0.98), p=0.034]. Conclusions: Printed posters on COVID-19 related stigma are acceptable SBC materials in communicating behaviour change messages that target health workers in promoting uptake of HIV-focused services. Posters are however, not among the most preferred materials for health workers. It is therefore recommended that material assessment studies are conducted to inform the development of acceptable and preferred materials for target audiences.

Keywords: acceptability, AIDS, HIV, posters, preference, SBC, stigma, social and behaviour change communication

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550 Prenatal Use of Serotonin Reuptake Inhibitors (SRIs) and Congenital Heart Anomalies (CHA): An Exploratory Pharmacogenetics Study

Authors: Aizati N. A. Daud, Jorieke E. H. Bergman, Wilhelmina S. Kerstjens-Frederikse, Pieter Van Der Vlies, Eelko Hak, Rolf M. F. Berger, Henk Groen, Bob Wilffert

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Prenatal use of SRIs was previously associated with Congenital Heart Anomalies (CHA). The aim of the study is to explore whether pharmacogenetics plays a role in this teratogenicity using a gene-environment interaction study. A total of 33 case-mother dyads and 2 mother-only (children deceased) registered in EUROCAT Northern Netherlands were included in a case-only study. Five case-mother dyads and two mothers-only were exposed to SRIs (paroxetine=3, fluoxetine=2, venlafaxine=1, paroxetine and venlafaxine=1) in the first trimester of pregnancy. The remaining 28 case-mother dyads were not exposed to SRIs. Ten genes that encode the enzymes or proteins important in determining fetal exposure to SRIs or its mechanism of action were selected: CYPs (CYP1A2, CYP2C9, CYP2C19, CYP2D6), ABCB1 (placental P-glycoprotein), SLC6A4 (serotonin transporter) and serotonin receptor genes (HTR1A, HTR1B, HTR2A, and HTR3B). All included subjects were genotyped for 58 genetic variations in these ten genes. Logistic regression analyses were performed to determine the interaction odds ratio (OR) between genetic variations and SRIs exposure on the risk of CHA. Due to low phenotype frequencies of CYP450 poor metabolizers among exposed cases, the OR cannot be calculated. For ABCB1, there was no indication of changes in the risk of CHA with any of the ABCB1 SNPs in the children and their mothers. Several genetic variations of the serotonin transporter and receptors (SLC6A4 5-HTTLPR and 5-HTTVNTR, HTR1A rs1364043, HTR1B rs6296 & rs6298, HTR3B rs1176744) were associated with an increased risk of CHA, but with too limited sample size to reach statistical significance. For SLC6A4 genetic variations, the mean genetic scores of the exposed case-mothers tended to be higher than the unexposed mothers (2.5 ± 0.8 and 1.88 ± 0.7, respectively; p=0.061). For SNPs of the serotonin receptors, the mean genetic score for exposed cases (children) tended to be higher than the unexposed cases (3.4 ± 2.2, and 1.9 ± 1.6, respectively; p=0.065). This study might be among the first to explore the potential gene-environment interaction between pharmacogenetic determinants and SRIs use on the risk of CHA. With small sample sizes, it was not possible to find a significant interaction. However, there were indications for a role of serotonin receptor polymorphisms in fetuses exposed to SRIs on fetal risk of CHA which warrants further investigation.

Keywords: gene-environment interaction, heart defects, pharmacogenetics, serotonin reuptake inhibitors, teratogenicity

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549 Secondary Prisonization and Mental Health: A Comparative Study with Elderly Parents of Prisoners Incarcerated in Remote Jails

Authors: Luixa Reizabal, Inaki Garcia, Eneko Sansinenea, Ainize Sarrionandia, Karmele Lopez De Ipina, Elsa Fernandez

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Although the effects of incarceration in prisons close to prisoners’ and their families’ residences have been studied, little is known about the effects of remote incarceration. The present study shows the impact of secondary prisonization on mental health of elderly parents of Basque prisoners who are incarcerated in prisons located far away from prisoners’ and their families’ residences. Secondary prisonization refers to the effects that imprisonment of a family member has on relatives. In the study, psychological effects are analyzed by means of comparative methodology. Specifically, levels of psychopathology (depression, anxiety, and stress) and positive mental health (psychological, social, and emotional well-being) are studied in a sample of parents over 65 years old of prisoners incarcerated in prisons located a long distance away (concretely, some of them in a distance of less than 400 km, while others farther than 400 km) from the Basque Country. The dataset consists of data collected through a questionnaire and from a spontaneous speech recording. The statistical and automatic analyses show that levels of psychopathology and positive mental health of elderly parents of prisoners incarcerated in remote jails are affected by the incarceration of their sons or daughters. Concretely, these parents show higher levels of depression, anxiety, and stress and lower levels of emotional (but not psychological or social) wellbeing than parents with no imprisoned daughters or sons. These findings suggest that parents with imprisoned sons or daughters suffer the impact of secondary prisonization on their mental health. When comparing parents with sons or daughters incarcerated within 400 kilometers from home and parents whose sons or daughters are incarcerated farther than 400 kilometers from home, the latter present higher levels of psychopathology, but also higher levels of positive mental health (although the difference between the two groups is not statistically significant). These findings might be explained by resilience. In fact, in traumatic situations, people can develop a force to cope with the situation, and even present a posttraumatic growth. Bearing in mind all these findings, it could be concluded that secondary prisonization implies for elderly parents with sons or daughters incarcerated in remote jails suffering and, in consequence, that changes in the penitentiary policy applied to Basque prisoners are required in order to finish this suffering.

Keywords: automatic spontaneous speech analysis, elderly parents, machine learning, positive mental health, psychopathology, remote incarceration, secondary prisonization

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548 Status of Sensory Profile Score among Children with Autism in Selected Centers of Dhaka City

Authors: Nupur A. D., Miah M. S., Moniruzzaman S. K.

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Autism is a neurobiological disorder that affects physical, social, and language skills of a person. A child with autism feels difficulty for processing, integrating, and responding to sensory stimuli. Current estimates have shown that 45% to 96 % of children with Autism Spectrum Disorder demonstrate sensory difficulties. As autism is a worldwide burning issue, it has become a highly prioritized and important service provision in Bangladesh. The sensory deficit does not only hamper the normal development of a child, it also hampers the learning process and functional independency. The purpose of this study was to find out the prevalence of sensory dysfunction among children with autism and recognize common patterns of sensory dysfunction. A cross-sectional study design was chosen to carry out this research work. This study enrolled eighty children with autism and their parents by using the systematic sampling method. In this study, data were collected through the Short Sensory Profile (SSP) assessment tool, which consists of 38 items in the questionnaire, and qualified graduate Occupational Therapists were directly involved in interviewing parents as well as observing child responses to sensory related activities of the children with autism from four selected autism centers in Dhaka, Bangladesh. All item analyses were conducted to identify items yielding or resulting in the highest reported sensory processing dysfunction among those children through using SSP and Statistical Package for Social Sciences (SPSS) version 21.0 for data analysis. This study revealed that almost 78.25% of children with autism had significant sensory processing dysfunction based on their sensory response to relevant activities. Under-responsive sensory seeking and auditory filtering were the least common problems among them. On the other hand, most of them (95%) represented that they had definite to probable differences in sensory processing, including under-response or sensory seeking, auditory filtering, and tactile sensitivity. Besides, the result also shows that the definite difference in sensory processing among 64 children was within 100%; it means those children with autism suffered from sensory difficulties, and thus it drew a great impact on the children’s Daily Living Activities (ADLs) as well as social interaction with others. Almost 95% of children with autism require intervention to overcome or normalize the problem. The result gives insight regarding types of sensory processing dysfunction to consider during diagnosis and ascertaining the treatment. So, early sensory problem identification is very important and thus will help to provide appropriate sensory input to minimize the maladaptive behavior and enhance to reach the normal range of adaptive behavior.

Keywords: autism, sensory processing difficulties, sensory profile, occupational therapy

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547 'It Is a Sin to Be in Love with a Disabled Woman': Stigma, Rejection and Intersections of Womanhood and Violence among Physically Disabled Women Living in South Africa

Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Commonly, womanhood is defined as the qualities considered to be natural to or characteristic of a woman. However, womanhood is not a static concept; it is contextual and negotiable. For women with disabilities, gender roles or ‘qualities’ of womanhood are often overstated or contradicted because of assumptions of weakness, passivity, asexuality and infertility. Currently, little is known about how disability stigma intersects with notions of womanhood to make women with disabilities vulnerable to violence, or how women navigate this intersection to prevent or protect themselves from violence. Objective: To describe how the stigmatized constructions of womanhood and disability promote women with physical disabilities’ exposure to or protection from violence. Methods: Qualitative data for this paper comes from a doctoral study involving women with disabilities living in Cape Town, South Africa. It presents data from repeat in-depth interviews with 30 women with a range of physical impairments. Women attending protective workshops, rehabilitative centers and residential care facilities for people living with disabilities were invited to participate. Consent procedures and interviews were conducted by the first author (who is herself a woman living with a physical disability), and a female research assistant/translator who is a qualified occupational therapist. Reasonable accommodation is central to the methodology and the study as a whole. Findings: Descriptive and thematic analyses reveal how stigma and local constructions around womanhood, as well as women’s self-image and physical limitations, promotes women’s exposure to psychological, physical and sexual violence. It reveals how disabled women feel they are presumed incapable of living up to expectations of a ‘proper’ woman. This plays out as psychological violence, with women reporting that they feel ‘devalued,' ‘rejected’ and deprived of lasting intimate relationships. Furthermore, forms of psychological violence perpetuate physical and sexual violence. Women also discuss using strategies to prevent violence; by refusing to date, avoiding certain places or avoiding isolation, creating awareness, hiding their physical impairments, and exaggerating their ‘femininity.' Implications: Service providers need to be made aware of women’s violence experiences, and provide a range of accessible psychological and mental health services to women living with disabilities, as well as raising awareness around disability, and violence prevention, among caregivers, men, and women. Violence awareness and prevention interventions need to involve disability experts, researchers and people with disabilities.

Keywords: disability, gender, stigma, violence awareness and prevention interventions

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546 Examining the Mediating and Moderating Role of Relationships in the Association between Poverty and Children’s Subjective Well-Being

Authors: Esther Yin-Nei Cho

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There is inconsistency among studies about whether there is an association between poverty and the subjective wellbeing of children. Some have found a positive association, though its magnitude could be limited, others have shown no association. One possible explanation for this inconsistency is that household income, an often-adopted measure of child poverty, may not accurately and stably reflect the actual life experience of children. Some studies have suggested, however, that material deprivation covering various dimensions of children’s lives could be a better measure of child poverty. Another possible explanation for the inconsistency is that the link between poverty and subjective wellbeing of children may not be that straightforward, as there could be underlying mechanisms, such as mediation and moderation, influencing its direction or strength. While a mediator refers to the mechanism through which an independent variable affects a dependent variable, a moderator changes the direction or strength of the relationship between an independent variable and a dependent variable. As suggested by empirical evidence, family relationships and friendships could be potential mediators or moderators of the link between poverty and subjective well-being: poverty affects relationships; relationships are an important element in children’s subjective well-being; and economic status affects child outcomes, though not necessarily subjective wellbeing, through relationships. Since the potential links have not been adequately understood, this study fills this gap by examining the possible role of family relationships and friendships as mediators or moderators between poverty (using child-derived material deprivation as measure) and the subjective wellbeing of children. Improving subjective wellbeing is increasingly considered as a policy goal. The finding of no or a limited association between poverty and subjective wellbeing of children could be a justification for less effort to improve poverty in this regard. But if the observed magnitude of that association is due to some underlying mechanisms at work, the effect of poverty may be underestimated and the potentially useful strategies that take into account both poverty and other mediators or moderators for improving children’s subjective well-being may be overlooked. Multiple mediation, and multiple moderation models, based on regression analyses, are performed to a sample of approximately 1,600 children, who are aged 10 to 15, from the wellbeing survey conducted by The Children’s Society in England from 2010 to 2011. Results show that the effect of children’s material deprivation on their subjective well-being is mediated by their family relationships and friendships. Moreover, family relationships are a significant moderator. It is found that the negative impact of child deprivation on subjective wellbeing could be exacerbated if family relationships are not going well, while good family relationships may prevent the further decline in subjective well-being. Policy implications of the findings are discussed. In particular, policy measures that focus on strengthening the family relationships or nurturing home environment through supporting household’s economic security and parental time with children could promote the subjective wellbeing of children.

Keywords: child poverty, mediation, moderation, subjective well-being of children

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545 Association of Genetically Proxied Cholesterol-Lowering Drug Targets and Head and Neck Cancer Survival: A Mendelian Randomization Analysis

Authors: Danni Cheng

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Background: Preclinical and epidemiological studies have reported potential protective effects of low-density lipoprotein cholesterol (LDL-C) lowering drugs on head and neck squamous cell cancer (HNSCC) survival, but the causality was not consistent. Genetic variants associated with LDL-C lowering drug targets can predict the effects of their therapeutic inhibition on disease outcomes. Objective: We aimed to evaluate the causal association of genetically proxied cholesterol-lowering drug targets and circulating lipid traits with cancer survival in HNSCC patients stratified by human papillomavirus (HPV) status using two-sample Mendelian randomization (MR) analyses. Method: Single-nucleotide polymorphisms (SNPs) in gene region of LDL-C lowering drug targets (HMGCR, NPC1L1, CETP, PCSK9, and LDLR) associated with LDL-C levels in genome-wide association study (GWAS) from the Global Lipids Genetics Consortium (GLGC) were used to proxy LDL-C lowering drug action. SNPs proxy circulating lipids (LDL-C, HDL-C, total cholesterol, triglycerides, apoprotein A and apoprotein B) were also derived from the GLGC data. Genetic associations of these SNPs and cancer survivals were derived from 1,120 HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) and 2,570 non-HPV-driven HNSCC patients in VOYAGER program. We estimated the causal associations of LDL-C lowering drugs and circulating lipids with HNSCC survival using the inverse-variance weighted method. Results: Genetically proxied HMGCR inhibition was significantly associated with worse overall survival (OS) in non-HPV-drive HNSCC patients (inverse variance-weighted hazard ratio (HR IVW), 2.64[95%CI,1.28-5.43]; P = 0.01) but better OS in HPV-positive OPSCC patients (HR IVW,0.11[95%CI,0.02-0.56]; P = 0.01). Estimates for NPC1L1 were strongly associated with worse OS in both total HNSCC (HR IVW,4.17[95%CI,1.06-16.36]; P = 0.04) and non-HPV-driven HNSCC patients (HR IVW,7.33[95%CI,1.63-32.97]; P = 0.01). A similar result was found that genetically proxied PSCK9 inhibitors were significantly associated with poor OS in non-HPV-driven HNSCC (HR IVW,1.56[95%CI,1.02 to 2.39]). Conclusion: Genetically proxied long-term HMGCR inhibition was significantly associated with decreased OS in non-HPV-driven HNSCC and increased OS in HPV-positive OPSCC. While genetically proxied NPC1L1 and PCSK9 had associations with worse OS in total and non-HPV-driven HNSCC patients. Further research is needed to understand whether these drugs have consistent associations with head and neck tumor outcomes.

Keywords: Mendelian randomization analysis, head and neck cancer, cancer survival, cholesterol, statin

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544 Nurse-Reported Perceptions of Medication Safety in Private Hospitals in Gauteng Province.

Authors: Madre Paarlber, Alwiena Blignaut

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Background: Medication administration errors remains a global patient safety problem targeted by the WHO (World Health Organization), yet research on this matter is sparce within the South African context. Objective: The aim was to explore and describe nurses’ (medication administrators) perceptions regarding medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province of South Africa, and to determine any relationships between perceived variables concerned with medication safety (safety culture, incidences, causes, reporting of incidences, and reasons for non-reporting). Method: A quantitative research design was used through which self-administered online surveys were sent to 768 nurses (medication administrators) (n=217). The response rate was 28.26%. The survey instrument was synthesised from the Agency of Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture, the Registered Nurse Forecasting (RN4CAST) survey, a survey list prepared from a systematic review aimed at generating a comprehensive list of medication administration error causes and the Medication Administration Error Reporting Survey from Wakefield. Exploratory and confirmatory factor analyses were used to determine the validity and reliability of the survey. Descriptive and inferential statistical data analysis were used to analyse quantitative data. Relationships and correlations were identified between items, subscales and biographic data by using Spearmans’ Rank correlations, T-Tests and ANOVAs (Analysis of Variance). Nurses reported on their perceptions of medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province. Results: Units’ teamwork deemed satisfactory, punitive responses to errors accentuated. “Crisis mode” working, concerns regarding mistake recording and long working hours disclosed as impacting patient safety. Overall medication safety graded mostly positively. Work overload, high patient-nurse ratios, and inadequate staffing implicated as error-inducing. Medication administration errors were reported regularly. Fear and administrative response to errors effected non-report. Non-report of errors’ reasons was affected by non-punitive safety culture. Conclusions: Medication administration safety improvement is contingent on fostering a non-punitive safety culture within units. Anonymous medication error reporting systems and auditing nurses’ workload are recommended in the quest of improved medication safety within Gauteng Province private hospitals.

Keywords: incidence, medication administration errors, medication safety, reporting, safety culture

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543 Variability of the Speaker's Verbal and Non-Verbal Behaviour in the Process of Changing Social Roles in the English Marketing Discourse

Authors: Yuliia Skrynnik

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This research focuses on the interaction of verbal, non-verbal, and super-verbal communicative components used by the speaker changing social roles in the marketing discourse. The changing/performing of social roles is implemented through communicative strategies and tactics, the structural, semantic, and linguo-pragmatic means of which are characterized by specific features and differ for the performance of either a role of a supplier or a customer. Communication within the marketing discourse is characterized by symmetrical roles’ relation between communicative opponents. The strategy of a supplier’s social role realization and the strategy of a customer’s role realization influence the discursive personality's linguistic repertoire in the marketing discourse. This study takes into account that one person can be both a supplier and a customer under different circumstances, thus, exploring the one individual who can be both a supplier and a customer. Cooperative and non-cooperative tactics are the instruments for the implementation of these strategies. In the marketing discourse, verbal and non-verbal behaviour of the speaker performing a customer’s social role is highly informative for speakers who perform the role of a supplier. The research methods include discourse, context-situational, pragmalinguistic, pragmasemantic analyses, the method of non-verbal components analysis. The methodology of the study includes 5 steps: 1) defining the configurations of speakers’ social roles on the selected material; 2) establishing the type of the discourse (marketing discourse); 3) describing the specific features of a discursive personality as a subject of the communication in the process of social roles realization; 4) selecting the strategies and tactics which direct the interaction in different roles configurations; 5) characterizing the structural, semantic and pragmatic features of the strategies and tactics realization, including the analysis of interaction between verbal and non-verbal components of communication. In the marketing discourse, non-verbal behaviour is usually spontaneous but not purposeful. Thus, the adequate decoding of a partner’s non-verbal behavior provides more opportunities both for the supplier and the customer. Super-verbal characteristics in the marketing discourse are crucial in defining the opponent's social status and social role at the initial stage of interaction. The research provides the scenario of stereotypical situations of the play of a supplier and a customer. The performed analysis has perspectives for further research connected with the study of discursive variativity of speakers' verbal and non-verbal behaviour considering the intercultural factor influencing the process of performing the social roles in the marketing discourse; and the formation of the methods for the scenario construction of non-stereotypical situations of social roles realization/change in the marketing discourse.

Keywords: discursive personality, marketing discourse, non-verbal component of communication, social role, strategy, super-verbal component of communication, tactic, verbal component of communication

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542 Rohingya Problem and the Impending Crisis: Outcome of Deliberate Denial of Citizenship Status and Prejudiced Refugee Laws in South East Asia

Authors: Priyal Sepaha

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A refugee crisis is manifested by challenges, both for the refugees and the asylum giving state. The situation turns into a mega-crisis when the situation is prejudicially handled by the home state, inappropriate refugee laws, exploding refugee population, and above all, no hope of any foreseeable solution or remedy. This paper studies the impact on the capability of stateless Rohingyas to migrate and seek refuge due to the enforcement of rigid criteria of movement imposed both by Myanmar as well as the adjoining countries in the name of national security. This theoretical study identifies the issues and the key factors and players which have precipitated the crisis. It further discusses the possible ramifications in the home, asylum giving, and the adjoining countries for not discharging their roles aptly. Additionally, an attempt has been made to understand the scarce response given to the impending crisis by the regional organizations like SAARC, ASEAN and CHOGAM as well as international organizations like United Nations Human Rights Council, Security Council, Office of High Commissioner for Refugees and so on, in the name of inadequacy of monetary funds and physical resources. Based on the refugee laws and practices pertaining to the case of Rohingyas, this paper analyses that the Rohingya Crisis is in dire need of an effective action plan to curb and resolve the biggest humanitarian crisis situation of the century. This mounting human tragedy can be mitigated permanently, by strengthening existing and creating new interdependencies among all stakeholders, as further ignorance can drive the countries of the Indian Sub-continent, in particular, and South East Asia, by and large into a violent civil war for seizing long-awaited civil rights by the marginalized Rohingyas. To curb this mass crisis, it will require the application of coercive pressure and diplomatic pursuance on the home country to acknowledge the rights of its fleeing citizens. This further necessitates mustering adequate monetary funds and physical resources for the asylum providing state. Additional challenges such as devising mechanisms for the refugee’s safe return, comprehensive planning for their holistic economic development and rehabilitation plan are needed. These, however, can only come into effect with a conscious strive by the regional and international community to fulfil their assigned role.

Keywords: asylum, citizenship, crisis, humanitarian, human rights, refugee, rohingya

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