Search results for: fire probabilistic risk assessment
Commenced in January 2007
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Edition: International
Paper Count: 11133

Search results for: fire probabilistic risk assessment

8163 Validity and Reliability of Communication Activities of Daily Living- Second Edition and Assessment of Language-related Functional Activities: Comparative Evidence from Arab Aphasics

Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

Abstract:

Background: Validation of communication activities of daily living-second edition (CADL-2) and assessment of language-related functional activities (ALFA) tests is a critical investment decision, and activities related to language impairments often are underestimated. Literature indicates that age factors, and gender differences may affect the performance of the aphasics. Thus, understanding these influential factors is highly important to neuropsycholinguists and speech language pathologists (SLPs). Purpose: The goal of this study is twofold: (1) to in/validate CADL-2 and ALFA tests, and (2) to investigate whether or not the two assessment tests are reliable. Design: A comparative study is made between the results obtained from the analyses of the Arabic versions of CADL-2 and ALFA tests. Participants: The communication activities of daily-living and language-related functional activities were assessed from the obtained results of 100 adult aphasics (50 males, 50 females; ages 16 to 65). Procedures: Firstly, the two translated and standardized Arabic versions of CADL-2 and ALFA tests were introduced to the Arab aphasics under investigation. Armed with the new two versions of the tests, one of the researchers assessed the language-related functional communication and activities. Outcomes drawn from the obtained analysis of the comparative studies were then qualitatively and statistically analyzed. Main outcomes and Results: Regarding the validity of CADL-2 and ALFA, it is found that …. Is more valid in both pre-and posttests. Concerning the reliability of the two tests, it is found that ….is more reliable in both pre-and-posttests which undoubtedly means that …..is more trustable. Nor must we forget to indicate here that the relationship between age and gender was very weak due to that no remarkable gender differences between the two in both CADL-2 and ALFA pre-and-posttests. Conclusions & Implications: CADL-2 and ALFA tests were found to be valid and reliable tests. In contrast to previous studies, age and gender were not significantly associated with the results of validity and reliability of the two assessment tests. In clearer terms, age and gender patterns do not affect the validation of these two tests. Future studies might focus on complex questions including the use of CADL-2 and ALFA functionally; how gender and puberty influence the results in case the sample is large; the effects of each type of aphasia on the final outcomes, and measurements’ results of imaging techniques.

Keywords: CADL-2, ALFA, comparison, language test, arab aphasics, validity, reliability, neuropsycholinguistics, comparison

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8162 Acylated Ghrelin in Response to Aerobic Training Induced Weight Loss in Obese Men

Authors: Masoumeh Hosseini

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Obesity is known to be associated with cardiovascular diseases and metabolic syndrome. This study aimed to assess the effect of a long term aerobic training program on serum ghrelin in obese men. For this purpose, twenty four sedentary adult obese men aged 30-40 years and body mass index 30-36 kg/m2 were participated in this study and divided randomly into exercise (3 months aerobic training, 3 times/weekly) or control (no training) groups. Serum ghrelin and cardiovascular risk factor (TG, TC, LDL, and HDL) were measured before and after treatment. Anthropometrical markers were measured at two occasions. Data were analyzed by independent-paired T-test. Significance was accepted at P < 0.05. Aerobic training resulted in significant decrease in serum ghrelin and TG in exercise group. All anthropometrical markers decreased significantly in exercise group but not in control subjects. Based on these data, it is concluded that weight loss by aerobic training can be affect serum ghrelin in obese subject, although some cardiovascular risk factor remained without changed.

Keywords: aerobic training, homeostasis, lipid profile, obesity

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8161 Modeling of Erosion and Sedimentation Impacts from off-Road Vehicles in Arid Regions

Authors: Abigail Rosenberg, Jennifer Duan, Michael Poteuck, Chunshui Yu

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The Barry M. Goldwater Range, West in southwestern Arizona encompasses 2,808 square kilometers of Sonoran Desert. The hyper-arid range has an annual rainfall of less than 10 cm with an average high temperature of 41 degrees Celsius in July to an average low of 4 degrees Celsius in January. The range shares approximately 60 kilometers of the international border with Mexico. A majority of the range is open for recreational use, primarily off-highway vehicles. Because of its proximity to Mexico, the range is also heavily patrolled by U.S. Customs and Border Protection seeking to intercept and apprehend inadmissible people and illicit goods. Decades of off-roading and Border Patrol activities have negatively impacted this sensitive desert ecosystem. To assist the range program managers, this study is developing a model to identify erosion prone areas and calibrate the model’s parameters using the Automated Geospatial Watershed Assessment modeling tool.

Keywords: arid lands, automated geospatial watershed assessment, erosion modeling, sedimentation modeling, watershed modeling

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8160 Coalescence of Insulin and Triglyceride/High Density Lipoprotein Cholesterol Ratio for the Derivation of a Laboratory Index to Predict Metabolic Syndrome in Morbid Obese Children

Authors: Orkide Donma, Mustafa M. Donma

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Morbid obesity is a health threatening condition particularly in children. Generally, it leads to the development of metabolic syndrome (MetS) characterized by central obesity, elevated fasting blood glucose (FBG), triglyceride (TRG), blood pressure values and suppressed high density lipoprotein cholesterol (HDL-C) levels. However, some ambiguities exist during the diagnosis of MetS in children below 10 years of age. Therefore, clinicians are in the need of some surrogate markers for the laboratory assessment of pediatric MetS. In this study, the aim is to develop an index, which will be more helpful during the evaluation of further risks detected in morbid obese (MO) children. A total of 235 children with normal body mass index (N-BMI), with varying degrees of obesity; overweight (OW), obese (OB), MO as well as MetS participated in this study. The study was approved by the Institutional Ethical Committee. Informed consent forms were obtained from the parents of the children. Obesity states of the children were classified using BMI percentiles adjusted for age and sex. For the purpose, tabulated data prepared by WHO were used. MetS criteria were defined. Systolic and diastolic blood pressure values were measured. Parameters related to glucose and lipid metabolisms were determined. FBG, insulin (INS), HDL-C, TRG concentrations were determined. Diagnostic Obesity Notation Model Assessment Laboratory (DONMALAB) Index [ln TRG/HDL-C*INS] was introduced. Commonly used insulin resistance (IR) indices such as Homeostatic Model Assessment for IR (HOMA-IR) as well as ratios such as TRG/HDL-C, TRG/HDL-C*INS, HDL-C/TRG*INS, TRG/HDL-C*INS/FBG, log, and ln versions of these ratios were calculated. Results were interpreted using statistical package program (SPSS Version 16.0) for Windows. The data were evaluated using appropriate statistical tests. The degree for statistical significance was defined as 0.05. 35 N, 20 OW, 47 OB, 97 MO children and 36 with MetS were investigated. Mean ± SD values of TRG/HDL-C were 1.27 ± 0.69, 1.86 ± 1.08, 2.15 ± 1.22, 2.48 ± 2.35 and 4.61 ± 3.92 for N, OW, OB, MO and MetS children, respectively. Corresponding values for the DONMALAB index were 2.17 ± 1.07, 3.01 ± 0.94, 3.41 ± 0.93, 3.43 ± 1.08 and 4.32 ± 1.00. TRG/HDL-C ratio significantly differed between N and MetS groups. On the other hand, DONMALAB index exhibited statistically significant differences between N and all the other groups except the OW group. This index was capable of discriminating MO children from those with MetS. Statistically significant elevations were detected in MO children with MetS (p < 0.05). Multiple parameters are commonly used during the assessment of MetS. Upon evaluation of the values obtained for N, OW, OB, MO groups and for MO children with MetS, the [ln TRG/HDL-C*INS] value was unique in discriminating children with MetS.

Keywords: children, index, laboratory, metabolic syndrome, obesity

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8159 A Case Study on the Numerical-Probability Approach for Deep Excavation Analysis

Authors: Komeil Valipourian

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Urban advances and the growing need for developing infrastructures has increased the importance of deep excavations. In this study, after the introducing probability analysis as an important issue, an attempt has been made to apply it for the deep excavation project of Bangkok’s Metro as a case study. For this, the numerical probability model has been developed based on the Finite Difference Method and Monte Carlo sampling approach. The results indicate that disregarding the issue of probability in this project will result in an inappropriate design of the retaining structure. Therefore, probabilistic redesign of the support is proposed and carried out as one of the applications of probability analysis. A 50% reduction in the flexural strength of the structure increases the failure probability just by 8% in the allowable range and helps improve economic conditions, while maintaining mechanical efficiency. With regard to the lack of efficient design in most deep excavations, by considering geometrical and geotechnical variability, an attempt was made to develop an optimum practical design standard for deep excavations based on failure probability. On this basis, a practical relationship is presented for estimating the maximum allowable horizontal displacement, which can help improve design conditions without developing the probability analysis.

Keywords: numerical probability modeling, deep excavation, allowable maximum displacement, finite difference method (FDM)

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8158 Exploring Suicidal Behaviors among Transgender and Gender Nonconforming Youth in China

Authors: Krystal Wang, Chongzheng Wei, Runsen Chen, Shufang Sun

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Suicide is a global public mental health issue and is the tenth leading cause of death globally. Approximately 75% of suicides occur in low- and middle-income countries (LMIC). Compared to the general population, transgender and gender nonconforming (TGNC) young people have higher suicidal risks. Research has shown that the prevalence of suicidal behaviors among TGNC populations was high in both the United States and China. However, studies were mostly embedded within Western cultures. Limited data and research were available to assess suicidal behaviors among TGNC youth in LMIC countries and to consider various types of TGNC youth. The goal of the current project is to 1) investigate the prevalence of lifetime and past-year suicidal ideations, plans, and attempts among Chinese TGNC youth, 2) explore the relationship between gender identity and suicidal outcomes among TGNC youth in China, 3) identify individual, school, and family level risk and protective factors for suicidal behaviors. The study used data from a cross-sectional survey conducted by Beijing LGBTQ Center in 2021. The survey was the largest TGNC population study in China to understand the health conditions of TGNC individuals. Of the 7612 individuals who completed the survey, a total of 5632 youth (aged 10 to 19) was included in the final analysis. 2259 (40.11%) participants were categorized as transfeminine youth, 1034 (18.36%) as transmasculine youth, 1169 (20.76%) as nonbinary youth AFAB, 568 (10.09%) as nonbinary youth AMAB, 344 (6.11%) as questioning youth AFAB and 258 (4.58%) as questioning youth AMAB. Suicidal behaviors were assessed by asking about lifetime suicidal ideation and attempts, past 12 months suicidal ideation, plan and attempts, and suicidal methods. To achieve the aims, we conducted statistical analysis in Stata/SE 17.0 to 1) describe the prevalence of suicidal outcomes and 2) assess the relationship between gender identity and suicidal outcomes by performing crosstabs, bivariate and multivariate logistic regressions, and adjusting for covariates. The lifetime prevalence of suicidal ideations and attempts for the whole sample was 85.13% and 51.7%. Transfeminine youth had a significantly higher risk for lifetime suicidal ideations (Odds Ratios (OR) = 1.67, CI:1.28,2.18) and attempts than transmasculine youth (OR=1.66, CI: 1.35,2.03), adjusting for age and past year binge drinking, known risk factors of suicide behavior. Past-year prevalence of suicidal behaviors was also high among TGNC youth, with 75.69% in suicidal ideation, 88.77% in suicidal plans, and 57.96% in suicidal attempts. Transfeminine youth, among six subgroups, had the highest risk for past-year suicidal ideations and attempts compared to transmasculine youth. Non-binary youth, regardless of sex assigned at birth, also had a significantly higher risk for suicidal ideations. The prevalence of lifetime and past-year suicidal behaviors was alarming among TGNC youth in China. Among different categories of TGNC youth, transfeminine youth reported the most elevated suicidal risk. The findings indicated a compelling need for researchers and practitioners to address the mental health risks for this specific group and target interventions for TGNC youth in China.

Keywords: child and adolescent mental health, gender minority health, cross-cultural perspective, preventing suicide in youth

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8157 Right Ventricular Dynamics During Breast Cancer Chemotherapy in Low Cardiovascular Risk Patients

Authors: Nana Gorgiladze, Tamar Gaprindashvili, Mikheil Shavdia, Zurab Pagava

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Introduction/Purpose Chemotherapy is a common treatment for breast cancer, but it can also cause damage to the heart and blood vessels. This damage, known as cancer therapy-related cardiovascular toxicity (CTR-CVT), can increase the risk of heart failure and death in breast cancer patients. The left ventricle is often affected by CTR-CVT, but the right ventricle (RV) may also be vulnerable to CTR-CVT and may show signs of dysfunction before the left ventricle. The study aims to investigate how the RV function changes during chemotherapy for breast cancer by using conventional echocardiographic and global longitudinal strain (GLS) techniques. By measuring the GLS strain of the RV, researchers tend to detect early signs of CTR-CVT and improve the management of breast cancer patients. Methods The study was conducted on 28 women with low cardiovascular risk who received anthracycline chemotherapy for breast cancer. Conventional 2D echocardiography (LVEF, RVS’, TAPSE) and speckle-tracking echocardiography (STE) measurements of the left and right ventricles (LVGLS, RVGLS) were used to assess cardiac function before and after chemotherapy. All patients had normal LVEF at the beginning of the study. Cardiotoxicity was defined as a new LVEF reduction of 10 percentage points to an LVEF of 40-49% and/or a new decline in GLS of 15% from baseline, as proposed by the most recent cardio-oncology guideline. ResultsThe research found that the LVGLS decreased from -21.2%2.1% to -18.6%2.6% (t-test = -4.116; df = 54, p=0.001). The change in value LV-GLS was 2.6%3.0%. The mean percentage change of the LVGLS was 11,6%13,3%; p=0.001. Similarly, the right ventricular global longitudinal strain (RVGLS) decreased from -25.2%2.9% to -21.4%4.4% (t-test = -3.82; df = 54, p=0.001). The RV-GLS value of change was 3.8%3.6%. Likewise, the percentage decrease of the RVGLS was 15,0%14,3%, p=0.001.However, the measurements of the right ventricular systolic function (RVS) and tricuspid annular plane systolic excursion (TAPSE) were insignificant, and the left ventricular ejection fraction ( LVEF) remained unchanged.

Keywords: cardiotoxicity, chemotherapy, GLS, right ventricle

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8156 The Significance of Cultural Risks for Western Consultants Executing Gulf Cooperation Council Megaprojects

Authors: Alan Walsh, Peter Walker

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Differences in commercial, professional and personal cultural traditions between western consultants and project sponsors in the Gulf Cooperation Council (GCC) region are potentially significant in the workplace, and this can impact on project outcomes. These cultural differences can, for example, result in conflict amongst senior managers, which can negatively impact the megaproject. New entrants to the GCC often experience ‘culture shock’ as they attempt to integrate into their unfamiliar environments. Megaprojects are unique ventures with individual project characteristics, which need to be considered when managing their associated risks. Megaproject research to date has mostly ignored the significance of the absence of cultural congruence in the GCC, which is surprising considering that there are large volumes of megaprojects in various stages of construction in the GCC. An initial step to dealing with cultural issues is to acknowledge culture as a significant risk factor (SRF). This paper seeks to understand the criticality for western consultants to address these risks. It considers the cultural barriers that exist between GCC sponsors and western consultants and examines the cultural distance between the key actors. Initial findings suggest the presence to a certain extent of ethnocentricity. Other cultural clashes arise out of a lack of appreciation of the customs, practices and traditions of ‘the Other’, such as the need for avoiding public humiliation and the hierarchal significance rankings. The concept and significance of cultural shock as part of the integration process for new arrivals are considered. Culture shock describes the state of anxiety and frustration resulting from the immersion in a culture distinctly different from one's own. There are potentially substantial project risks associated with underestimating the process of cultural integration. This paper examines two distinct but intertwined issues: the societal and professional culture differences associated with expatriate assignments. A case study examines the cultural congruences between GCC sponsors and American, British and German consultants, over a ten-year cycle. This provides indicators as to which nationalities encountered the most profound cultural issues and the nature of these. GCC megaprojects are typically intensive fast track demanding ventures, where consultant turnover is high. The study finds that building trust-filled relationships is key to successful project team integration and therefore, to successful megaproject execution. Findings indicate that both professional and social inclusion processes have steep learning curves. Traditional risk management practice is to approach any uncertainty in a structured way to mitigate the potential impact on project outcomes. This research highlights cultural risk as a significant factor in the management of GCC megaprojects. These risks arising from high staff turnover typically include loss of project knowledge, delays to the project, cost and disruption in replacing staff. This paper calls for cultural risk to be recognised as an SRF, as the first step to developing risk management strategies, and to reduce staff turnover for western consultants in GCC megaprojects.

Keywords: western consultants in megaprojects, national culture impacts on GCC megaprojects, significant risk factors in megaprojects, professional culture in megaprojects

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8155 Infilling Strategies for Surrogate Model Based Multi-disciplinary Analysis and Applications to Velocity Prediction Programs

Authors: Malo Pocheau-Lesteven, Olivier Le Maître

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Engineering and optimisation of complex systems is often achieved through multi-disciplinary analysis of the system, where each subsystem is modeled and interacts with other subsystems to model the complete system. The coherence of the output of the different sub-systems is achieved through the use of compatibility constraints, which enforce the coupling between the different subsystems. Due to the complexity of some sub-systems and the computational cost of evaluating their respective models, it is often necessary to build surrogate models of these subsystems to allow repeated evaluation these subsystems at a relatively low computational cost. In this paper, gaussian processes are used, as their probabilistic nature is leveraged to evaluate the likelihood of satisfying the compatibility constraints. This paper presents infilling strategies to build accurate surrogate models of the subsystems in areas where they are likely to meet the compatibility constraint. It is shown that these infilling strategies can reduce the computational cost of building surrogate models for a given level of accuracy. An application of these methods to velocity prediction programs used in offshore racing naval architecture further demonstrates these method's applicability in a real engineering context. Also, some examples of the application of uncertainty quantification to field of naval architecture are presented.

Keywords: infilling strategy, gaussian process, multi disciplinary analysis, velocity prediction program

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8154 Analyses of Adverse Drug Reactions Reported of Hospital in Taiwan

Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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8153 Risk Mapping of Road Traffic Incidents in Greater Kampala Metropolitan Area for Planning of Emergency Medical Services

Authors: Joseph Kimuli Balikuddembe

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Road traffic incidents (RTIs) continue to be a serious public health and development burden around the globe. Compared to high-income countries (HICs), the low and middle-income countries (LMICs) bear the heaviest brunt of RTIs. Like other LMICs, Uganda, a country located in Eastern Africa, has been experiencing a worryingly high burden of RTIs and their associated impacts. Over the years, the highest number of all the total registered RTIs in Uganda has taken place in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected. In this regard, the overall objective of the study was to risk map RTIs in the GKMA so as to help in the better planning of EMS for the victims of RTIs. Other objectives included: (i) identifying the factors affecting the exposure, vulnerability and EMS capacity for the victims of RTIs; (ii) identifying the RTI prone-areas and estimating their associated risk factors; (iii) identifying the weaknesses and capacities which affect the EMS systems for RTIs; and (iv) determining the strategies and priority actions that can help to improve the EMS response for RTI victims in the GKMA. To achieve these objectives, a mixed methodological approach was used in four phrases for approximately 15 months. It employed a systematic review based on the preferred reporting items for systematic reviews and meta-data analysis guidelines; a Delphi panel technique; retrospective data analysis; and a cross-sectional method. With Uganda progressing forward as envisaged in its 'Vision 2040', the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth, urbanization, infrastructure development, rapid motorization and other factors. Unless appropriate actions are taken, these changes are likely to worsen the already alarming rate of RTIs in Uganda, and in turn also to put pressure on the few existing EMS and facilities to render care for those affected. Therefore, road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that contribute to RTIs, particularly in the GKMA and Uganda as a whole.

Keywords: emergency medical services, Kampala, risk mapping, road traffic incidents

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8152 Utility of Routine Colonoscopy in Acute Diverticulitis

Authors: Naya Masood, Russell Hodgson, Mark Tacey

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Purpose: Patients with acute diverticulitis (AD) have an increased risk of underlying colorectal cancer (CRC); however, those with uncomplicated AD may have the same underlying population risk. This study informs on an Australian AD population who were not routinely offered colonoscopic follow-up. Methods: A 2-year (July 2016 – June 2018) retrospective study of patients admitted with CT-confirmed acute diverticulitis was conducted. CT findings were categorised as ‘complicated’ and ‘uncomplicated’ and were correlated with the detection of cancer in subsequent colonoscopy or follow-up. Results: 67.7% (n=292) of 431 patients were seen to have had complicated AD on an abdominopelvic CT scan. Patients were complicated most commonly due to bowel wall thickening reported on CT (90.4%), perforation (20.2%), or an abscess (12%). Follow-up colonoscopic evaluation was conducted in 52.9% (n=228) of total cases of AD, out of which 156 suffered complicated AD and the rest uncomplicated. None of the uncomplicated AD patients in our cohort were found to have CRC. Of those with complicated AD, six were found to have CRC. Conclusion: The only CRC diagnoses were made in patients with complicated AD. Despite available evidence, a significant proportion of uncomplicated AD patients were still undergoing colonoscopy. There is scope to further safely decrease the number of colonoscopies performed in AD patients.

Keywords: acute diverticulitis, colonoscopy, colorectal cancer, advanced adenoma, complicated diverticulitis

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8151 Low-Impact Development Strategies Assessment for Urban Design

Authors: Y. S. Lin, H. L. Lin

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Climate change and land-use change caused by urban expansion increase the frequency of urban flooding. To mitigate the increase in runoff volume, low-impact development (LID) is a green approach for reducing the area of impervious surface and managing stormwater at the source with decentralized micro-scale control measures. However, the current benefit assessment and practical application of LID in Taiwan is still tending to be development plan in the community and building site scales. As for urban design, site-based moisture-holding capacity has been common index for evaluating LID’s effectiveness of urban design, which ignore the diversity, and complexity of the urban built environments, such as different densities, positive and negative spaces, volumes of building and so on. Such inflexible regulations not only probably make difficulty for most of the developed areas to implement, but also not suitable for every different types of built environments, make little benefits to some types of built environments. Looking toward to enable LID to strength the link with urban design to reduce the runoff in coping urban flooding, the research consider different characteristics of different types of built environments in developing LID strategy. Classify the built environments by doing the cluster analysis based on density measures, such as Ground Space Index (GSI), Floor Space Index (FSI), Floors (L), and Open Space Ratio (OSR), and analyze their impervious surface rates and runoff volumes. Simulate flood situations by using quasi-two-dimensional flood plain flow model, and evaluate the flood mitigation effectiveness of different types of built environments in different low-impact development strategies. The information from the results of the assessment can be more precisely implement in urban design. In addition, it helps to enact regulations of low-Impact development strategies in urban design more suitable for every different type of built environments.

Keywords: low-impact development, urban design, flooding, density measures

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8150 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures

Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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8149 Statistical Classification, Downscaling and Uncertainty Assessment for Global Climate Model Outputs

Authors: Queen Suraajini Rajendran, Sai Hung Cheung

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Statistical down scaling models are required to connect the global climate model outputs and the local weather variables for climate change impact prediction. For reliable climate change impact studies, the uncertainty associated with the model including natural variability, uncertainty in the climate model(s), down scaling model, model inadequacy and in the predicted results should be quantified appropriately. In this work, a new approach is developed by the authors for statistical classification, statistical down scaling and uncertainty assessment and is applied to Singapore rainfall. It is a robust Bayesian uncertainty analysis methodology and tools based on coupling dependent modeling error with classification and statistical down scaling models in a way that the dependency among modeling errors will impact the results of both classification and statistical down scaling model calibration and uncertainty analysis for future prediction. Singapore data are considered here and the uncertainty and prediction results are obtained. From the results obtained, directions of research for improvement are briefly presented.

Keywords: statistical downscaling, global climate model, climate change, uncertainty

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8148 Agenesis of the Corpus Callosum: The Role of Neuropsychological Assessment with Implications to Psychosocial Rehabilitation

Authors: Ron Dick, P. S. D. V. Prasadarao, Glenn Coltman

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Agenesis of the corpus callosum (ACC) is a failure to develop corpus callosum - the large bundle of fibers of the brain that connects the two cerebral hemispheres. It can occur as a partial or complete absence of the corpus callosum. In the general population, its estimated prevalence rate is 1 in 4000 and a wide range of genetic, infectious, vascular, and toxic causes have been attributed to this heterogeneous condition. The diagnosis of ACC is often achieved by neuroimaging procedures. Though persons with ACC can perform normally on intelligence tests they generally present with a range of neuropsychological and social deficits. The deficit profile is characterized by poor coordination of motor movements, slow reaction time, processing speed and, poor memory. Socially, they present with deficits in communication, language processing, the theory of mind, and interpersonal relationships. The present paper illustrates the role of neuropsychological assessment with implications to psychosocial management in a case of agenesis of the corpus callosum. Method: A 27-year old left handed Caucasian male with a history of ACC was self-referred for a neuropsychological assessment to assist him in his employment options. Parents noted significant difficulties with coordination and balance at an early age of 2-3 years and he was diagnosed with dyspraxia at the age of 14 years. History also indicated visual impairment, hypotonia, poor muscle coordination, and delayed development of motor milestones. MRI scan indicated agenesis of the corpus callosum with ventricular morphology, widely spaced parallel lateral ventricles and mild dilatation of the posterior horns; it also showed colpocephaly—a disproportionate enlargement of the occipital horns of the lateral ventricles which might be affecting his motor abilities and visual defects. The MRI scan ruled out other structural abnormalities or neonatal brain injury. At the time of assessment, the subject presented with such problems as poor coordination, slowed processing speed, poor organizational skills and time management, and difficulty with social cues and facial expressions. A comprehensive neuropsychological assessment was planned and conducted to assist in identifying the current neuropsychological profile to facilitate the formulation of a psychosocial and occupational rehabilitation programme. Results: General intellectual functioning was within the average range and his performance on memory-related tasks was adequate. Significant visuospatial and visuoconstructional deficits were evident across tests; constructional difficulties were seen in tasks such as copying a complex figure, building a tower and manipulating blocks. Poor visual scanning ability and visual motor speed were evident. Socially, the subject reported heightened social anxiety, difficulty in responding to cues in the social environment, and difficulty in developing intimate relationships. Conclusion: Persons with ACC are known to present with specific cognitive deficits and problems in social situations. Findings from the current neuropsychological assessment indicated significant visuospatial difficulties, poor visual scanning and problems in social interactions. His general intellectual functioning was within the average range. Based on the findings from the comprehensive neuropsychological assessment, a structured psychosocial rehabilitation programme was developed and recommended.

Keywords: agenesis, callosum, corpus, neuropsychology, psychosocial, rehabilitation

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8147 Infection Profile of Patients Undergoing Autologous Bone Marrow Transplantation in Tabriz, Iran

Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour

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Background and Objective: Hematopoietic stem cell transplantation (HSCT) has been widely used for treating oncological and hematological diseases. Although HSCT has helped to improve patient survival, the risk of developing an infection during hospitalization is an important cause of morbidity and mortality. This study aimed to analyze the infection profile during hospitalization and the associated risk factors among patients undergoing autologous HSCT at the University Hospital, Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects and Methods: This was a cross-sectional study on patients undergoing autologous HSCT at a public university hospital. Methods: Patients with febrile neutropenia between 2015 and 2018 were retrospectively evaluated regarding their infection profile and associated risk factors. This survey included: bacterial culture and blood culture on specific media. Results: Infection occurred in 57.2% of 56 patients with febrile neutropenia. The main source of infection was the central venous catheter (25.9%). Infection was chiefly due to Gram-positive bacteria, although Gram-negative-related infections were more severe and caused a higher death rate. Sex, age, skin color, nutritional status, and underlying disease were not associated with the development of infection. Patients with severe mucositis (Grades III and IV) had a higher infection rate (P < 0.001). Patients who developed pulmonary complications during hospitalization had higher infection rates (P = 0.002). Infection was the main cause of death (57.1%) in the study sample. Conclusion: Strategies aimed at reducing infection-related mortality rates among patients undergoing autologous HSCT are necessary.

Keywords: hematopoietic stem cell, autologous bone marrow transplantation, infection profile, tabriz, Iran

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8146 Associations of Vitamin D Receptor Polymorphisms with Coronary Artery Diseases

Authors: Elham Sharif, Nasser Rizk, Sirin Abu Aqel, Ofelia Masoud

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Background: Previous studies have investigated the association of rs1544410, rs7975232 and rs731236 polymorphisms in vitamin D receptor gene and its impact on diseases such as cancer, diabetes and hypertension in different ethnic backgrounds. Aim: The aim of this study is to investigate the association between VDR polymorphisms using three SNP’s (rs1544410, rs7975232 and rs731236) and the severity of the significant lesion in coronary arteries among angiographically diagnosed CAD. Methods: A prospective-retrospective study was conducted on 192 CAD patients enrolled from the cardiology department-Heart Hospital HMC, grouped in 96 subjects with significant stenosis and 96 with non-significant stenosis with a mean age between 30 and 75 years old. Genotyping was performed for the following SNPs rs1544410, rs7975232 and rs731236 using TaqMan assay by the Real Time PCR, ABI 7500 in Health Sciences Labs at Qatar University Biomedical Research Center. Results: The results showed that both groups have matched age and gender distribution but patients with the significant stenosis have significantly higher; BMI (p=0.047); smoking status (p=0.039); FBS (p= 0.031); CK-MB (p=0.025) and Troponin (p=0.002) than the patients with non–significant lesion. Among the traditional risk factors, smoking increases the odds of the severe stenotic lesion in CAD patients by 1.984, with 95% CI between 1.024 – 7.063, with p= 0.042.HWE showed deviations of the rs1544410 and rs731236 among the study subjects. The most frequent genotype in distribution of rs7975232 is the AA among the significant stenosis patients, while the heterozygous AC was the frequent genotype in distribution among the non-significant stenosis group. The carriers of CC genotype in rs7975232 increased the risk of having significant coronary arteries stenotic lesion by 1.83 with 95% CI (1.020 – 3.280), p=0.043. No association was found between the rs7975232 with vitamin D and VDBP. Conclusion: There is a significant association between rs7975232 and the severity of CAD lesion. The carrier of CC genotype in rs7975232 increased the risk of having significant coronary arteries atherosclerotic lesion especially in patients with smoking history independent of vitamin D.

Keywords: vitamin D, vitamin D receptor, polymorphism, coronary harat disease

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8145 Radiation Protection Assessment of the Emission of a d-t Neutron Generator: Simulations with MCNP Code and Experimental Measurements in Different Operating Conditions

Authors: G. M. Contessa, L. Lepore, G. Gandolfo, C. Poggi, N. Cherubini, R. Remetti, S. Sandri

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Practical guidelines are provided in this work for the safe use of a portable d-t Thermo Scientific MP-320 neutron generator producing pulsed 14.1 MeV neutron beams. The neutron generator’s emission was tested experimentally and reproduced by MCNPX Monte Carlo code. Simulations were particularly accurate, even generator’s internal components were reproduced on the basis of ad-hoc collected X-ray radiographic images. Measurement campaigns were conducted under different standard experimental conditions using an LB 6411 neutron detector properly calibrated at three different energies, and comparing simulated and experimental data. In order to estimate the dose to the operator vs. the operating conditions and the energy spectrum, the most appropriate value of the conversion factor between neutron fluence and ambient dose equivalent has been identified, taking into account both direct and scattered components. The results of the simulations show that, in real situations, when there is no information about the neutron spectrum at the point where the dose has to be evaluated, it is possible - and in any case conservative - to convert the measured value of the count rate by means of the conversion factor corresponding to 14 MeV energy. This outcome has a general value when using this type of generator, enabling a more accurate design of experimental activities in different setups. The increasingly widespread use of this type of device for industrial and medical applications makes the results of this work of interest in different situations, especially as a support for the definition of appropriate radiation protection procedures and, in general, for risk analysis.

Keywords: instrumentation and monitoring, management of radiological safety, measurement of individual dose, radiation protection of workers

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8144 Insights into the Assessment of Intercultural Competence of Female University Students in the KSA

Authors: Agnes Havril

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The aim of this paper is to introduce some partial findings of an ongoing research project which is investigating the improvement of intercultural competence of Saudi female university students in English as a Second Language academic environment at the multicultural Jazan University. Since previous research results support the idea that this university generation has the desire to become interculturally or globally competent university students, the present-day investigation is focusing on the assessment of Saudi-specific cultural terms and intercultural competence components in comparison with the Anglo-Saxon oriented western perspective of intercultural competence theories and models. On this stage of the research quantitative research methodology is applied and a survey is being conducted among the female university students in different academic specializations. This paper discusses some empirical data with the aim of identifying and evaluating certain supplementary aspects of intercultural dimensions and components of the intercultural competence construct. The research results also highlight several gender issues in the gender separated higher education in the Kingdom of Saudi Arabia.

Keywords: gender separation, globally competent university student, intercultural competence, intercultural competence construct, higher education

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8143 The Impact of Artesunate-Amodiaquine on Schistosoma mansoni Infection among Children Infected by Plasmodium in Rural Area of Lemfu, Kongo Central, Democratic Republic of the Congo

Authors: Mbanzulu Kennedy, Zanga Josue, Wumba Roger

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Malaria and schistosomiasis remain life-threatening public health problems in sub-Saharan Africa. The infection pattern related to age indicates that preschool and school-age children are at the highest risk of malaria and schistosomiasis. Both parasitic infections, separately or combined, may have negative impacts on the haemoglobin concentration levels. The existing data revealed that artemisinin derivatives commonly used to cure malaria present also in antischistosomal activities. The current study investigated the impact of Artesunate-Amodiaquine (AS-AQ) on schistosomiasis when administered to treat malaria in rural area of Lemfu, DRC. A prospective longitudinal study including 171 coinfected children screened for anaemia, Schistosoma mansoni, and Plasmodium falciparum infections. The egg reduction rate and haemoglobin concentration were assessed four weeks after the treatment with AS-AQ, of all coinfected children of this series. One hundred and twenty-five (74.4%) out of 168 coinfected children treated and present during the assessment were found stool negative for S. mansoni eggs. Out of 43 (25.6%) children who remained positives, 37 (22%) showed a partial reduction of eggs amount, and no reduction was noted in 3.6% of coinfected. The mean of haemoglobin concentration and the prevalence of anaemia were, respectively, 10.74±1.5g/dl , 11.2±1.3g/dl, and 64.8%, 51.8%, respectively, before and after treatment, p<0.001. The AS-AQ commonly used against Plasmodium allowed curing S. mansoni in coinfected children and increasing the Hb level. For the future, the randomized and multicentric clinical trials are needed for a better understanding of the effectiveness of AS-AQ against Schistosoma spp. The trial registration number was 3487183.

Keywords: paludisme, schistosomiase, as-aq, enfants lemfu

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8142 Teacher-Student Relationship and Achievement in Chinese: Potential Mediating Effects of Motivation

Authors: Yuan Liu, Hongyun Liu

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Teacher-student relationship plays an important role on facilitating students’ learning behavior, school engagement, and academic outcomes. It is believed that good relationship will enhance the human agency—the intrinsic motivation—mainly through the strengthening of autonomic support, feeling of relatedness, and the individual’s competence to increase the academic outcomes. This is in line with self-determination theory (SDT), which generally views that the intrinsic motivation imbedded with human basic needs is one of the most important factors that would lead to better school engagement, academic outcomes, and well-being. Based on SDT, the present study explored the relation of among teacher-student relationship (teacher’s encouragement, respect), students’ motivation (extrinsic and intrinsic), and achievement outcomes. The study was based on a large scale academic assessment and questionnaire survey conducted by the Center for Assessment and Improvement of Basic Education Quality in Mainland China (2013) on Grade 8 students. The results indicated that intrinsic motivation mediated the relation between teacher-student relationship and academic achievement outcomes.

Keywords: teacher-student relationship, intrinsic motivation, academic achievement, mediation

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8141 Prevalence and Risk Factors of Cardiovascular Diseases among Bangladeshi Adults: Findings from a Cross Sectional Study

Authors: Fouzia Khanam, Belal Hossain, Kaosar Afsana, Mahfuzar Rahman

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Aim: Although cardiovascular diseases (CVD) has already been recognized as a major cause of death in developed countries, its prevalence is rising in developing countries as well, and engendering a challenge for the health sector. Bangladesh has experienced an epidemiological transition from communicable to non-communicable diseases over the last few decades. So, the rising prevalence of CVD and its risk factors are imposing a major problem for the country. We aimed to examine the prevalence of CVDs and socioeconomic and lifestyle factors related to it from a population-based survey. Methods: The data used for this study were collected as a part of a large-scale cross-sectional study conducted to explore the overall health status of children, mothers and senior citizens of Bangladesh. Multistage cluster random sampling procedure was applied by considering unions as clusters and households as the primary sampling unit to select a total of 11,428 households for the base survey. Present analysis encompassed 12338 respondents of ≥ 35 years, selected from both rural areas and urban slums of the country. Socio-economic, demographic and lifestyle information were obtained through individual by a face-to-face interview which was noted in ODK platform. And height, weight, blood pressure and glycosuria were measured using standardized methods. Chi-square test, Univariate modified Poisson regression model, and multivariate modified Poisson regression model were done using STATA software (version 13.0) for analysis. Results: Overall, the prevalence of CVD was 4.51%, of which 1.78% had stroke and 3.17% suffered from heart diseases. Male had higher prevalence of stroke (2.20%) than their counterparts (1.37%). Notably, thirty percent of respondents had high blood pressure and 5% population had diabetes and more than half of the population was pre-hypertensive. Additionally, 20% were overweight, 77% were smoker or consumed smokeless tobacco and 28% of respondents were physically inactive. Eighty-two percent of respondents took extra salt while eating and 29% of respondents had deprived sleep. Furthermore, the prevalence of risk factor of CVD varied according to gender. Women had a higher prevalence of overweight, obesity and diabetes. Women were also less physically active compared to men and took more extra salt. Smoking was lower in women compared to men. Moreover, women slept less compared to their counterpart. After adjusting confounders in modified Poisson regression model, age, gender, occupation, wealth quintile, BMI, extra salt intake, daily sleep, tiredness, diabetes, and hypertension remained as risk factors for CVD. Conclusion: The prevalence of CVD is significant in Bangladesh, and there is an evidence of rising trend for its risk factors such as hypertension, diabetes especially in older population, women and high-income groups. Therefore, in this current epidemiological transition, immediate public health intervention is warranted to address the overwhelming CVD risk.

Keywords: cardiovascular diseases, diabetes, hypertension, stroke

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8140 Information Technology Governance Implementation and Its Determinants in the Egyptian Market

Authors: Nariman O. Kandil, Ehab K. Abou-Elkheir, Amr M. Kotb

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Effective IT governance guarantees the strategic alignment of IT and business goals, risk mitigation control, and better IT and business performance. This study seeks to examine empirically the extent of IT governance implementation within the firms listed on the Egyptian stock exchange (EGX30) and its determinants. Accordingly, 18 semi-structured interviews face to face, phone, and video-conferencing interviews using various tools (e.g., WebEx, Zoom, and Microsoft Teams) were undertaken at the interviewees’ offices in Egypt between the end of November 2019 and the end of August 2020. Results suggest that there are variances in the extent of IT Governance (ITG) implementation within the firms listed on the Egyptian stock exchange (EGX30), mainly caused by the industry type and internal and external triggers. The results also suggest that the organization size, the type of auditor, the criticality of the industry, the effective processes & KPIs, and the information intensity expertise of the CIO have a significant impact on IT governance implementation within the firms.

Keywords: effective IT governance, Egyptian market, information security, risk controls

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8139 Assessment of Impact of Manpower Training and Development in the Construction Industry

Authors: Olalekan Bamidele Aruleba

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This research assessed the impact of manpower training and development in the construction industry. The aim is to determine the effect of training and development on employees for effective organizational growth in the construction industry to identify the training method for each category of employee in the construction industry, challenges to training and development of workers in the construction industry and impact of manpower training and development on employees and employers. Data for the study were obtained through a well-structured questionnaire administered to building professionals in Nigeria construction firm. Eighty (80) questionnaires were distributed among building professionals in three selected local governments within Ondo State and sixty-four (64) were returned. Data collected were analysed using descriptive statistics and ranking. Findings of the study revealed that in house training and in-service training methods were preferred by most construction industry. It concluded that the attitude of top management and lack of fund was seen as the significant challenges militating against training of employees. The study recommended that manpower training and development must be sustained by all stakeholders in the industry in order to improve workers' productivity; the organization should adopt the right method in training each category of employees and carry out the need assessment for training to avoid training wrong employees.

Keywords: construction, development, manpower, training

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8138 Assessment of Sustainable Sanitation Systems: Urban Slums

Authors: Ali Hamza, Bertug Akintug

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Having an appropriate plan of sanitation systems is one of the critical issues for global urban slums. Poor sanitation systems in urban slums outcomes an enhanced vulnerability of severe diseases, low hygiene and environmental risks within our environment. Mentioning human excreta being one of the most highly risked pollutants among all the other major contributors of sanitation pollutants is increasing public health risks and amounts of pollution loads within the slum environment. Higher population growth, urge of urbanization and illegal status of urban slums makes it impossible to increase the level of performance of sanitation systems in urban slums. According to Sustainable Sanitation Alliance, design parameters for sanitation systems were set up to ensure sustainable environment. This paper reviews the characteristics of human excreta at present, treatment technologies, and procedures of processes that can be adopted feasibly in the urban slums. Keeping these factors as our significant concern of study, assessment of sustainable sanitation systems is done using sanitation chain concept in accordance to the pre-determined sustainability indicators and criteria which reflect the potential and feasible application of waterless sanitation systems bringing sustainable sanitation systems in urban slums.

Keywords: human excreta, sanitation chain, sustainable sanitation systems, urban slums

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8137 Reliability Assessment and Failure Detection in a Complex Human-Machine System Using Agent-Based and Human Decision-Making Modeling

Authors: Sanjal Gavande, Thomas Mazzuchi, Shahram Sarkani

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In a complex aerospace operational environment, identifying failures in a procedure involving multiple human-machine interactions are difficult. These failures could lead to accidents causing loss of hardware or human life. The likelihood of failure further increases if operational procedures are tested for a novel system with multiple human-machine interfaces and with no prior performance data. The existing approach in the literature of reviewing complex operational tasks in a flowchart or tabular form doesn’t provide any insight into potential system failures due to human decision-making ability. To address these challenges, this research explores an agent-based simulation approach for reliability assessment and fault detection in complex human-machine systems while utilizing a human decision-making model. The simulation will predict the emergent behavior of the system due to the interaction between humans and their decision-making capability with the varying states of the machine and vice-versa. Overall system reliability will be evaluated based on a defined set of success-criteria conditions and the number of recorded failures over an assigned limit of Monte Carlo runs. The study also aims at identifying high-likelihood failure locations for the system. The research concludes that system reliability and failures can be effectively calculated when individual human and machine agent states are clearly defined. This research is limited to the operations phase of a system lifecycle process in an aerospace environment only. Further exploration of the proposed agent-based and human decision-making model will be required to allow for a greater understanding of this topic for application outside of the operations domain.

Keywords: agent-based model, complex human-machine system, human decision-making model, system reliability assessment

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8136 Assessment of Body Mass Index among Children of Primary School in Behbahan City

Authors: Hosseini Siahi Zohreh, Sana Mohammad Jafar

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With increase in fat and over weight in children and its undesirable effects on different organisms of the body and since many of the sicknesses are due to over weight and with losing weight these sicknesses disappear, and on the other hand with mal nutrition and under weight in children other kind of sicknesses such as derogation of body's security system, frequent infection, insufficient growth, shortness, and delay in maturity etc. are some of the signs of being under weight. Therefore recognition of signs of over weight and under weight and their prevalence in children are important. To determine this difficulty we have used the body mass index as screening tool since it is very prevalent and a good and important guide and has very good relation with body fat in children. In this study 2321 students from primary schools in Behbahan have been chosen randomly and evaluated by height and weight and their body mass index have been calculated and then recorded on the BMI percentile diagram which is for age and gender. The following results obtained: The amount of total fat, over weight and slimness are 9.3, 12.1 and 12.32 percent respectively. Therefore 21.4% of the children were over weighted. It did not show any meaningful statistical relation in fat conditions among boys and girls, but there has been a meaningful statistical relation in slimness among boys and girls.

Keywords: assessment, students, Behbahan, Body Mass Index

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8135 Meeting the Health Needs of Adolescents and Young Adults: Developing and Evaluating an Electronic Questionnaire and Health Report Form, for the Health Assessment at Youth Health Clinics – A Mixed Methods Project

Authors: P.V. Lostelius, M.Mattebo, E. Thors Adolfsson, A. Söderlund, Å. Revenäs

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Adolescents are vulnerable in healthcare settings. Early detection of poor health in young people is important to support a good quality of life and adult social functioning. Youth Health Clinics (YHCs) in Sweden provide healthcare for young people ages 13-25 years old. Using an overall mixed methods approach, the project’s main objective was to develop and evaluate an electronic health system, including a health questionnaire, a case report form, and an evaluation questionnaire to assess young people’s health risks in early stages, increase health, and quality of life. In total, 72 young people, 16-23 years old, eleven healthcare professionals and eight researchers participated in the three project studies. Results from interviews with fifteen young people gave that an electronic health questionnaire should include questions about physical-, mental-, sexual health and social support. It should specifically include questions about self-harm and suicide risk. The young people said that the questionnaire should be appealing, based on young people’s needs and be user-friendly. It was important that young people felt safe when responding to the questions, both physically and electronically. Also, they found that it had the potential to support the face-to face-meeting between young people and healthcare professionals. The electronic health report system was developed by the researchers, performing a structured development of the electronic health questionnaire, construction of a case report form to present the results from the health questions, along with an electronic evaluation questionnaire. An Information Technology company finalized the development by digitalizing the electronic health system. Four young people, three healthcare professionals and seven researchers evaluated the usability using interviews and a usability questionnaire. The electronic health questionnaire was found usable for YHCs but needed some clarifications. Essentially, the system succeeded in capturing the overall health of young people; it should be able to keep the interest of young people and have the potential to contribute to health assessment planning and young people’s self-reflection, sharing vulnerable feelings with healthcare professionals. In advance of effect studies, a feasibility study was performed by collecting electronic questionnaire data from 54 young people and interview data from eight healthcare professionals to assess the feasibility of the use of the electronic evaluation questionnaire, the case report form, and the planned recruitment method. When merging the results, the research group found that the evaluation questionnaire and the health report were feasible for future research. However, the COVID-19 pandemic, commitment challenges and drop-outs affected the recruitment of young people. Also, some healthcare professionals felt insecure about using computers and electronic devices and worried that their workload would increase. This project contributes knowledge about the development and use of electronic health tools for young people. Before implementation, clinical routines need for using the health report system need to be considered.

Keywords: adolescent health, developmental studies, electronic health questionnaire, mixed methods research

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8134 The Triple Threat: Microplastic, Nanoplastic, and Macroplastic Pollution and Their Cumulative Impacts on Marine Ecosystem

Authors: Tabugbo B. Ifeyinwa, Josephat O. Ogbuagu, Okeke A. Princewill, Victor C. Eze

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The increasing amount of plastic pollution in maritime settings poses a substantial risk to the functioning of ecosystems and the preservation of biodiversity. This comprehensive analysis combines the most recent data on the environmental effects of pollution from macroplastics, microplastics, and nanoplastics within marine ecosystems. Our goal is to provide a comprehensive understanding of the cumulative impacts that plastic waste accumulates on marine life by outlining the origins, processes, and ecological repercussions connected with each size category of plastic debris. Microplastics and nanoplastics have more sneaky effects that are controlled by chemicals. These effects can get through biological barriers and affect the health of cells and the whole body. Compared to macroplastics, which primarily contribute to physical harm through entanglement and ingestion by marine fauna, microplastics, and nanoplastics are associated with non-physical effects. The review underlines a vital need for research that crosses disciplinary boundaries to untangle the intricate interactions that the various sizes of plastic pollution have with marine animals, evaluate the long-term ecological repercussions, and identify effective measures for mitigating the effects of plastic pollution. Additionally, we urge governmental interventions and worldwide cooperation to solve this pervasive environmental concern. Specifically, we identify significant knowledge gaps in the detection and effect assessment of nanoplastics. To protect marine biodiversity and preserve ecosystem services, this review highlights how urgent it is to address the broad spectrum of plastic pollution.

Keywords: macroplastic pollution, marine ecosystem, microplastic pollution, nanoplastic pollution

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