Search results for: high performance densified small particle concrete (HPDSPC)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 32798

Search results for: high performance densified small particle concrete (HPDSPC)

698 Exploring Barriers to Quality of Care in South African Midwifery Obstetric Units: The Perspective of Nurses and Midwives

Authors: J. Dutton, L. Knight

Abstract:

Achieving quality and respectful maternal health care is part of the global agenda to improve reproductive health and achieve universal reproductive rights. Barriers to quality of care in South African maternal health facilities exist at both systemic and individual levels. Addition to this, the normalization of gender violence within South Africa has a large impact on people seeking health care as well as those who provide care within health facilities. The hierarchical environment of South Africa’s public health system penalizes both patients and providers who battle to assume any assessable power. This paper explores how systemic and individual level barriers to quality of care affect the midwifery profession within South African maternal health services and create, at times, an environment of enmity rather than care. This paper analyzes and discusses the data collected from in-depth, semi-structured interviews with nurses and midwives at three maternal health facilities in South Africa. This study has taken a holistic approach to understand the realities of nurses and midwives in order to explore the ways in which experience informs their practice and treatment of pregnant women. Through collecting and analyzing narratives, linkages between nurses and midwives day-to-day and historical experiences and disrespectful care have been made. Findings from this study show that barriers to quality of care take form in complex and interrelated ways. The physical structure of the health facility, human resource shortages, and the current model of maternal health care, which often lacks a person-centered approach, is entangled within personal beliefs and attitudes of what it means to be a midwife to create an environment that is often not conducive to a positive birthing experience. This entanglement sits within a society of high rates of violence, inequality, and poverty. Having teased out the nuances of each of these barriers and the multiple ways they reinforce each other, the findings of this paper demonstrate that birth, and the work of a midwife, are situated in a mode of discipline and punishment within this context. For analytical purposes, this paper has broken down the individual barriers to quality care and discusses the current and historical significance before returning to the interrelated forms in which barriers to quality maternal health care manifest. In conclusion this paper questions the role of agency in the ability to subvert systemic barriers to quality care and ideas around shifting attitudes and beliefs of and about midwives. International and local policies and guidelines have a role to play in realizing such shifts, however, as this paper suggests, when policy does not speak to the local context there is the risk of it contributing to frustrations and impeding the path to quality and respectful maternal health care.

Keywords: disrespect and abuse in childbirth, midwifery, South African maternal health care, quality of care

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697 Renewable Energy Utilization for Future Sustainability: An Approach to Roof-Mounted Photovoltaic Array Systems and Domestic Rooftop Rainwater Harvesting System Implementation in a Himachal Pradesh, India

Authors: Rajkumar Ghosh, Ananya Mukhopadhyay

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This scientific paper presents a thorough investigation into the integration of roof-mounted photovoltaic (PV) array systems and home rooftop rainwater collection systems in a remote community in Himachal Pradesh, India, with the goal of optimum utilization of natural resources for attaining sustainable living conditions by 2030. The study looks into the technical feasibility, environmental benefits, and socioeconomic impacts of this integrated method, emphasizing its ability to handle energy and water concerns in remote rural regions. This comprehensive method not only provides a sustainable source of electricity but also ensures a steady supply of clean water, promoting resilience and improving the quality of life for the village's residents. This research highlights the potential of such integrated systems in supporting sustainable conditions in rural areas through a combination of technical feasibility studies, economic analysis, and community interaction. There would be 20690 villages and 1.48 million homes (23.79% annual growth rate) in Himachal Pradesh if all residential buildings in the state had roof-mounted photovoltaic arrays to capture solar energy for power generation. The energy produced is utilized to power homes, lessening dependency on traditional fossil fuels. The same residential buildings housed domestic rooftop rainwater collection systems. Rainwater runoff from rooftops is collected and stored in tanks for use in a number of residential purposes, such as drinking, cooking, and irrigation. The gathered rainfall enhances the region's limited groundwater resources, easing the strain on local wells and aquifers. Although Himachal Pradesh of India is a Power state, the PV arrays have reduced the reliance of village on grid power and diesel generators by providing a steady source of electricity. Rooftop rainwater gathering has not only increased residential water supply but it has also lessened the burden on local groundwater resources. This helps to replenish groundwater and offers a more sustainable water supply for the town. The neighbourhood has saved money by utilizing renewable energy and rainwater gathering. Furthermore, lower fossil fuel consumption reduces greenhouse gas emissions, which helps to mitigate the effects of climate change. The integrated strategy of installing grid connected rooftop photovoltaic arrays and home rooftop rainwater collecting systems in Himachal Pradesh rural community demonstrates a feasible model for sustainable development. According to “Swaran Jayanti Energy Policy of Himachal Pradesh”, Himachal Pradesh is planned 10 GW from rooftop mode from Solar Power. Government of India provides 40% subsidy on solar panel of 1-3 kw and subsidy of Rs 6,000 per kw per year to encourage domestic consumers of Himachal Pradesh. This effort solves energy and water concerns, improves economic well-being, and helps to conserve the environment. Such integrated systems can serve as a model for sustainable development in rural areas not only in Himachal Pradesh, but also in other parts of the world where resource scarcity is a major concern. Long-term performance and scalability of such integrated systems should be the focus of future study. Efforts should also be made to duplicate this approach in other rural areas and examine its socioeconomic and environmental implications over time.

Keywords: renewable energy, photovoltaic arrays, rainwater harvesting, sustainability, rural development, Himachal Pradesh, India

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696 Safety and Maternal Anxiety in Mother's and Baby's Sleep: Cross-sectional Study

Authors: Rayanne Branco Dos Santos Lima, Lorena Pinheiro Barbosa, Kamila Ferreira Lima, Victor Manuel Tegoma Ruiz, Monyka Brito Lima Dos Santos, Maria Wendiane Gueiros Gaspar, Luzia Camila Coelho Ferreira, Leandro Cardozo Dos Santos Brito, Deyse Maria Alves Rocha

Abstract:

Introduction: The lack of regulation of the baby's sleep-wake pattern in the first years of life affects the health of thousands of women. Maternal sleep deprivation can trigger or aggravate psychosomatic problems such as depression, anxiety and stress that can directly influence maternal safety, with consequences for the baby's and mother's sleep. Such conditions can affect the family's quality of life and child development. Objective: To correlate maternal security with maternal state anxiety scores and the mother's and baby's total sleep time. Method: Cross-sectional study carried out with 96 mothers of babies aged 10 to 24 months, accompanied by nursing professionals linked to a Federal University in Northeast Brazil. Study variables were maternal security, maternal state anxiety scores, infant latency and sleep time, and total nocturnal sleep time of mother and infant. Maternal safety was calculated using a four-point Likert scale (1=not at all safe, 2=somewhat safe, 3=very safe, 4=completely safe). Maternal anxiety was measured by State-Trait Anxiety Inventory, state-anxiety subscale whose scores vary from 20 to 80 points, and the higher the score, the higher the anxiety levels. Scores below 33 are considered mild; from 33 to 49, moderate and above 49, high. As for the total nocturnal sleep time, values between 7-9 hours of sleep were considered adequate for mothers, and values between 9-12 hours for the baby, according to the guidelines of the National Sleep Foundation. For the sleep latency time, a time equal to or less than 20 min was considered adequate. It is noteworthy that the latency time and the time of night sleep of the mother and the baby were obtained by the mother's subjective report. To correlate the data, Spearman's correlation was used in the statistical package R version 3.6.3. Results: 96 women and babies participated, aged 22 to 38 years (mean 30.8) and 10 to 24 months (mean 14.7), respectively. The average of maternal security was 2.89 (unsafe); Mean maternal state anxiety scores were 43.75 (moderate anxiety). The babies' average sleep latency time was 39.6 min (>20 min). The mean sleep times of the mother and baby were, respectively, 6h and 42min and 8h and 19min, both less than the recommended nocturnal sleep time. Maternal security was positively correlated with maternal state anxiety scores (rh=266, p=0.009) and negatively correlated with infant sleep latency (rh= -0.30. P=0.003). Baby sleep time was positively correlated with maternal sleep time. (rh 0.46, p<0.001). Conclusion: The more secure the mothers considered themselves, the higher the anxiety scores and the shorter the baby's sleep latency. Also, the longer the baby sleeps, the longer the mother sleeps. Thus, interventions are needed to promote the quality and efficiency of sleep for both mother and baby.

Keywords: sleep, anxiety, infant, mother-child relations

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695 (De)Motivating Mitigation Behavior: An Exploratory Framing Study Applied to Sustainable Food Consumption

Authors: Youval Aberman, Jason E. Plaks

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This research provides initial evidence that self-efficacy of mitigation behavior – the belief that one’s action can make a difference on the environment – can be implicitly inferred from the way numerical information is presented in environmental messages. The scientific community sees climate change as a pressing issue, but the general public tends to construe climate change as an abstract phenomenon that is psychologically distant. As such, a main barrier to pro-environmental behavior is that individuals often believe that their own behavior makes little to no difference on the environment. When it comes to communicating how the behavior of billions of individuals affects global climate change, it might appear valuable to aggregate those billions and present the shocking enormity of the resources individuals consume. This research provides initial evidence that, in fact, this strategy is ineffective; presenting large-scale aggregate data dilutes the contribution of the individual and impedes individuals’ motivation to act pro-environmentally. The high-impact, underrepresented behavior of eating a sustainable diet was chosen for the present studies. US Participants (total N = 668) were recruited online for a study on ‘meat and the environment’ and received information about some of resources used in meat production – water, CO2e, and feed – with numerical information that varied in its frame of reference. A ‘Nation’ frame of reference discussed the resources used in the beef industry, such as the billions of CO2e released daily by the industry, while a ‘Meal’ frame of reference presented the resources used in the production of a single beef dish. Participants completed measures of pro-environmental attitudes and behavioral intentions, either immediately (Study 1) or two days (Study 2) after reading the information. In Study 2 (n = 520) participants also indicated whether they consumed less or more meat than usual. Study 2 included an additional control condition that contained no environmental data. In Study 1, participants who read about meat production at a national level, compared to at a meal level, reported lower motivation to make ecologically conscious dietary choices and reported lower behavioral intention to change their diet. In Study 2, a similar pattern emerged, with the added insight that the Nation condition, but not the Meal condition, deviated from the control condition. Participants across conditions, on average, reduced their meat consumption in the duration of Study 2, except those in the Nation condition who remained unchanged. Presenting nation-wide consequences of human behavior is a double-edged sword: Framing in a large scale might reveal the relationship between collective actions and environmental issues, but it hinders the belief that individual actions make a difference.

Keywords: climate change communication, environmental concern, meat consumption, motivation

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694 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic

Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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693 Integrating Natural Language Processing (NLP) and Machine Learning in Lung Cancer Diagnosis

Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

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692 Reinforcement of Calcium Phosphate Cement with E-Glass Fibre

Authors: Kanchan Maji, Debasmita Pani, Sudip Dasgupta

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Calcium phosphate cement (CPC) due to its high bioactivity and optimum bioresorbability shows excellent bone regeneration capability. Despite it has limited applications as bone implant due to its macro-porous microstructure causing its poor mechanical strength. The reinforcement of apatitic CPCs with biocompatible fibre glass phase is an attractive area of research to improve its mechanical strength. Here we study the setting behaviour of Si-doped and un-doped alpha tri-calcium phosphate (α-TCP) based CPC and its reinforcement with the addition of E-glass fibre. Alpha tri-calcium phosphate powders were prepared by solid state sintering of CaCO3, CaHPO4 and tetra ethyl ortho silicate (TEOS) was used as silicon source to synthesise Si doped α-TCP powders. Alpha tri-calcium phosphate based CPC hydrolyzes to form hydroxyapatite (HA) crystals having excellent osteoconductivity and bone-replacement capability thus self-hardens through the entanglement of HA crystals. Setting time, phase composition, hydrolysis conversion rate, microstructure, and diametral tensile strength (DTS) of un-doped CPC and Si-doped CPC were studied and compared. Both initial and final setting time of the developed cement was delayed because of Si addition. Crystalline phases of HA (JCPDS 9-432), α-TCP (JCPDS 29-359) and β-TCP (JCPDS 9-169) were detected in the X-ray diffraction (XRD) pattern after immersion of CPC in simulated body fluid (SBF) for 0 hours to 10 days. The intensities of the α-TCP peaks of (201) and (161) at 2θ of 22.2°and 24.1° decreased when the time of immersion of CPC in SBF increased from 0 hours to 10 days, due to its transformation into HA. As Si incorporation in the crystal lattice stabilised the TCP phase, Si doped CPC showed a little slower rate of conversion into HA phase as compared to un-doped CPC. The SEM image of the microstructure of hardened CPC showed lower grain size of HA in un-doped CPC because of premature setting and faster hydrolysis of un-doped CPC in SBF as compared that in Si-doped CPC. Premature setting caused generation of micro and macro porosity in un-doped CPC structure which resulted in its lower mechanical strength as compared to that in Si-doped CPC. This lower porosity and greater compactness in the microstructure attributes to greater DTS values observed in Si-doped CPC. E-glass fibres of the average diameter of 12 μm were cut into approximately 1 mm in length and immersed in SBF to deposit carbonated apatite on its surface. This was performed to promote HA crystal growth and entanglement along the fibre surface to promote stronger interface between dispersed E-glass fibre and CPC matrix. It was found that addition of 10 wt% of E-glass fibre into Si-doped α-TCP increased the average DTS of CPC from 8 MPa to 15 MPa as the fibres could resist the propagation of crack by deflecting the crack tip. Our study shows that biocompatible E-glass fibre in optimum proportion in CPC matrix can enhance the mechanical strength of CPC without affecting its bioactivity.

Keywords: Calcium phosphate cement, biocompatibility, e-glass fibre, diametral tensile strength

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691 Monitoring the Effect of Doxorubicin Liposomal in VX2 Tumor Using Magnetic Resonance Imaging

Authors: Ren-Jy Ben, Jo-Chi Jao, Chiu-Ya Liao, Ya-Ru Tsai, Lain-Chyr Hwang, Po-Chou Chen

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Cancer is still one of the serious diseases threatening the lives of human beings. How to have an early diagnosis and effective treatment for tumors is a very important issue. The animal carcinoma model can provide a simulation tool for the study of pathogenesis, biological characteristics and therapeutic effects. Recently, drug delivery systems have been rapidly developed to effectively improve the therapeutic effects. Liposome plays an increasingly important role in clinical diagnosis and therapy for delivering a pharmaceutic or contrast agent to the targeted sites. Liposome can be absorbed and excreted by the human body, and is well known that no harm to the human body. This study aimed to compare the therapeutic effects between encapsulated (doxorubicin liposomal, LipoDox) and un-encapsulated (doxorubicin, Dox) anti-tumor drugs using Magnetic Resonance Imaging (MRI). Twenty-four New Zealand rabbits implanted with VX2 carcinoma at left thigh were classified into three groups: control group (untreated), Dox-treated group and LipoDox-treated group, 8 rabbits for each group. MRI scans were performed three days after tumor implantation. A 1.5T GE Signa HDxt whole body MRI scanner with a high resolution knee coil was used in this study. After a 3-plane localizer scan was performed, Three-Dimensional (3D) Fast Spin Echo (FSE) T2-Weighted Images (T2WI) was used for tumor volumetric quantification. And Two-Dimensional (2D) spoiled gradient recalled echo (SPGR) dynamic Contrast-enhanced (DCE) MRI was used for tumor perfusion evaluation. DCE-MRI was designed to acquire four baseline images, followed by contrast agent Gd-DOTA injection through the ear vein of rabbits. Afterwards, a series of 32 images were acquired to observe the signals change over time in the tumor and muscle. The MRI scanning was scheduled on a weekly basis for a period of four weeks to observe the tumor progression longitudinally. The Dox and LipoDox treatments were prescribed 3 times in the first week immediately after VX2 tumor implantation. ImageJ was used to quantitate tumor volume and time course signal enhancement on DCE images. The changes of tumor size showed that the growth of VX2 tumors was effectively inhibited for both LipoDox-treated and Dox-treated groups. Furthermore, the tumor volume of LipoDox-treated group was significantly lower than that of Dox-treated group, which implies that LipoDox has better therapeutic effect than Dox. The signal intensity of LipoDox-treated group is significantly lower than that of the other two groups, which implies that targeted therapeutic drug remained in the tumor tissue. This study provides a radiation-free and non-invasive MRI method for therapeutic monitoring of targeted liposome on an animal tumor model.

Keywords: doxorubicin, dynamic contrast-enhanced MRI, lipodox, magnetic resonance imaging, VX2 tumor model

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690 Subtropical Potential Vorticity Intrusion Drives Increasing Tropospheric Ozone over the Tropical Central Pacific

Authors: Debashis Nath

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Drawn from multiple reanalysis datasets, an increasing trend and westward shift in the number of Potential Vorticity (PV) intrusion events over the Pacific are evident. The increased frequency can be linked to a long-term trend in upper tropospheric (UT, 200 hPa) equatorial westerly wind and subtropical jets (STJ) during boreal winter to spring. These may be resulting from anomalous warming and cooling over the western Pacific warm pool and the tropical eastern Pacific, respectively. The intrusions brought dry and ozone rich air of stratospheric origin deep into the tropics. In the tropical UT, interannual ozone variability is mainly related to convection associated with El Niño/Southern Oscillation. Zonal mean stratospheric overturning circulation organizes the transport of ozone rich air poleward and downward to the high and midlatitudes leading there to higher ozone concentration. In addition to these well described mechanisms, we observe a long-term increasing trend in ozone flux over the northern hemispheric outer tropical (10–25°N) central Pacific that results from equatorward transport and downward mixing from the midlatitude UT and lower stratosphere (LS) during PV intrusions. This increase in tropospheric ozone flux over the Pacific Ocean may affect the radiative processes and changes the budget of atmospheric hydroxyl radicals. The results demonstrate a long-term increase in outer tropical Pacific PV intrusions linked with the strengthening of the upper tropospheric equatorial westerlies and weakening of the STJ. Zonal variation in SST, characterized by gradual warming in the western Pacific–warm pool and cooling in the central–eastern Pacific, is associated with the strengthening of the Pacific Walker circulation. In the Western Pacific enhanced convective activity leads to precipitation, and the latent heat released in the process strengthens the Pacific Walker circulation. However, it is linked with the trend in global mean temperature, which is related to the emerging anthropogenic greenhouse signal and negative phase of PDO. On the other hand, the central-eastern Pacific cooling trend is linked to the weakening of the central–eastern Pacific Hadley circulation. It suppresses the convective activity due to sinking air motion and imports less angular momentum to the STJ leading to a weakened STJ. While, more PV intrusions result from this weaker STJ on its equatorward side; significantly increase the stratosphere-troposphere exchange processes on the longer timescale. This plays an important role in determining the atmospheric composition, particularly of tropospheric ozone, in the northern outer tropical central Pacific. It may lead to more ozone of stratospheric origin in the LT and even in the marine boundary, which may act as harmful pollutants and affect the radiative processes by changing the global budgets of atmospheric hydroxyl radicals.

Keywords: PV intrusion, westerly duct, ozone, Central Pacific

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689 Newly Designed Ecological Task to Assess Cognitive Map Reading Ability: Behavioral Neuro-Anatomic Correlates of Mental Navigation

Authors: Igor Faulmann, Arnaud Saj, Roland Maurer

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Spatial cognition consists in a plethora of high level cognitive abilities: among them, the ability to learn and to navigate in large scale environments is probably one of the most complex skills. Navigation is thought to rely on the ability to read a cognitive map, defined as an allocentric representation of ones environment. Those representations are of course intimately related to the two geometrical primitives of the environment: distance and direction. Also, many recent studies point to a predominant hippocampal and para-hippocampal role in spatial cognition, as well as in the more specific cluster of navigational skills. In a previous study in humans, we used a newly validated test assessing cognitive map processing by evaluating the ability to judge relative distances and directions: the CMRT (Cognitive Map Recall Test). This study identified in topographically disorientated patients (1) behavioral differences between the evaluation of distances and of directions, and (2) distinct causality patterns assessed via VLSM (i.e., distinct cerebral lesions cause distinct response patterns depending on the modality (distance vs direction questions). Thus, we hypothesized that: (1) if the CMRT really taps into the same resources as real navigation, there would be hippocampal, parahippocampal, and parietal activation, and (2) there exists underlying neuroanatomical and functional differences between the processing of this two modalities. Aiming toward a better understanding of the neuroanatomical correlates of the CMRT in humans, and more generally toward a better understanding of how the brain processes the cognitive map, we adapted the CMRT as an fMRI procedure. 23 healthy subjects (11 women, 12 men), all living in Geneva for at least 2 years, underwent the CMRT in fMRI. Results show, for distance and direction taken together, than the most active brain regions are the parietal, frontal and cerebellar parts. Additionally, and as expected, patterns of brain activation differ when comparing the two modalities. Furthermore, distance processing seems to rely more on parietal regions (compared to other brain regions in the same modality and also to direction). It is interesting to notice that no significant activity was observed in the hippocampal or parahippocampal areas. Direction processing seems to tap more into frontal and cerebellar brain regions (compared to other brain regions in the same modality and also to distance). Significant hippocampal and parahippocampal activity has been shown only in this modality. This results demonstrated a complex interaction of structures which are compatible with response patterns observed in other navigational tasks, thus showing that the CMRT taps at least partially into the same brain resources as real navigation. Additionally, differences between the processing of distances and directions leads to the conclusion that the human brain processes each modality distinctly. Further research should focus on the dynamics of this processing, allowing a clearer understanding between the two sub-processes.

Keywords: cognitive map, navigation, fMRI, spatial cognition

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688 Phage Display-Derived Vaccine Candidates for Control of Bovine Anaplasmosis

Authors: Itzel Amaro-Estrada, Eduardo Vergara-Rivera, Virginia Juarez-Flores, Mayra Cobaxin-Cardenas, Rosa Estela Quiroz, Jesus F. Preciado, Sergio Rodriguez-Camarillo

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Bovine anaplasmosis is an infectious, tick-borne disease caused mainly by Anaplasma marginale; typical signs include anemia, fever, abortion, weight loss, decreased milk production, jaundice, and potentially death. Sick bovine can recover when antibiotics are administered; however, it usually remains as carrier for life, being a risk of infection for susceptible cattle. Anaplasma marginale is an obligate intracellular Gram-negative bacterium with genetic composition highly diverse among geographical isolates. There are currently no vaccines fully effective against bovine anaplasmosis; therefore, the economic losses due to disease are present. Vaccine formulation became a hard task for several pathogens as Anaplasma marginale, but peptide-based vaccines are an interesting proposal way to induce specific responses. Phage-displayed peptide libraries have been proved one of the most powerful technologies for identifying specific ligands. Screening of these peptides libraries is also a tool for studying interactions between proteins or peptides. Thus, it has allowed the identification of ligands recognized by polyclonal antiserums, and it has been successful for the identification of relevant epitopes in chronic diseases and toxicological conditions. Protective immune response to bovine anaplasmosis includes high levels of immunoglobulins subclass G2 (IgG2) but not subclass IgG1. Therefore, IgG2 from the serum of protected bovine can be useful to identify ligands, which can be part of an immunogen for cattle. In this work, phage display random peptide library Ph.D. ™ -12 was incubating with IgG2 or blood sera of immunized bovines against A. marginale as targets. After three rounds of biopanning, several candidates were selected for additional analysis. Subsequently, their reactivity with sera immunized against A. marginale, as well as with positive and negative sera to A. marginale was evaluated by immunoassays. A collection of recognized peptides tested by ELISA was generated. More than three hundred phage-peptides were separately evaluated against molecules which were used during panning. At least ten different peptides sequences were determined from their nucleotide composition. In this approach, three phage-peptides were selected by their binding and affinity properties. In the case of the development of vaccines or diagnostic reagents, it is important to evaluate the immunogenic and antigenic properties of the peptides. Immunogenic in vitro and in vivo behavior of peptides will be assayed as synthetic and as phage-peptide for to determinate their vaccine potential. Acknowledgment: This work was supported by grant SEP-CONACYT 252577 given to I. Amaro-Estrada.

Keywords: bovine anaplasmosis, peptides, phage display, veterinary vaccines

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687 Lessons from Implementation of a Network-Wide Safety Huddle in Behavioral Health

Authors: Deborah Weidner, Melissa Morgera

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The model of care delivery in the Behavioral Health Network (BHN) is integrated across all five regions of Hartford Healthcare and thus spans the entirety of the state of Connecticut, with care provided in seven inpatient settings and over 30 ambulatory outpatient locations. While safety has been a core priority of the BHN in alignment with High Reliability practices, safety initiatives have historically been facilitated locally in each region or within each entity, with interventions implemented locally as opposed to throughout the network. To address this, the BHN introduced a network wide Safety Huddle during 2022. Launched in January, the BHN Safety Huddle brought together internal stakeholders, including medical and administrative leaders, along with executive institute leadership, quality, and risk management. By bringing leaders together and introducing a network-wide safety huddle into the way we work, the benefit has been an increase in awareness of safety events occurring in behavioral health areas as well as increased systemization of countermeasures to prevent future events. One significant discussion topic presented in huddles has pertained to environmental design and patient access to potentially dangerous items, addressing some of the most relevant factors resulting in harm to patients in inpatient and emergency settings for behavioral health patients. The safety huddle has improved visibility of potential environmental safety risks through the generation of over 15 safety alerts cascaded throughout the BHN and also spurred a rapid improvement project focused on standardization of patient belonging searches to reduce patient access to potentially dangerous items on inpatient units. Safety events pertaining to potentially dangerous items decreased by 31% as a result of standardized interventions implemented across the network and as a result of increased awareness. A second positive outcome originating from the BHN Safety Huddle was implementation of a recommendation to increase the emergency Narcan®(naloxone) supply on hand in ambulatory settings of the BHN after incidents involving accidental overdose resulted in higher doses of naloxone administration. By increasing the emergency supply of naloxone on hand in all ambulatory and residential settings, colleagues are better prepared to respond in an emergency situation should a patient experience an overdose while on site. Lastly, discussions in safety huddle spurred a new initiative within the BHN to improve responsiveness to assaultive incidents through a consultation service. This consult service, aligned with one of the network’s improvement priorities to reduce harm events related to assaultive incidents, was borne out of discussion in huddle in which it was identified that additional interventions may be needed in providing clinical care to patients who are experiencing multiple and/ or frequent safety events.

Keywords: quality, safety, behavioral health, risk management

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686 Subcutan Isosulfan Blue Administration May Interfere with Pulse Oximetry

Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya

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Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.

Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia

Procedia PDF Downloads 300
685 Measuring Organizational Resiliency for Flood Response in Thailand

Authors: Sudha Arlikatti, Laura Siebeneck, Simon A. Andrew

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The objective of this research is to measure organizational resiliency through five attributes namely, rapidity, redundancy, resourcefulness, and robustness and to provide recommendations for resiliency building in flood risk communities. The research was conducted in Thailand following the severe floods of 2011 triggered by Tropical Storm Nock-ten. The floods lasted over eight months starting in June 2011 affecting 65 of the country’s 76 provinces and over 12 million people. Funding from a US National Science Foundation grant was used to collect ephemeral data in rural (Ayutthaya), suburban (Pathum Thani), and urban (Bangkok) provinces of Thailand. Semi-structured face-to-face interviews were conducted in Thai with 44 contacts from public, private, and non-profit organizations including universities, schools, automobile companies, vendors, tourist agencies, monks from temples, faith based organizations, and government agencies. Multiple triangulations were used to analyze the data by identifying selective themes from the qualitative data, validated with quantitative data and news media reports. This helped to obtain a more comprehensive view of how organizations in different geographic settings varied in their understanding of what enhanced or hindered their resilience and consequently their speed and capacities to respond. The findings suggest that the urban province of Bangkok scored highest in resourcefulness, rapidity of response, robustness, and ability to rebound. This is not surprising considering that it is the country’s capital and the seat of government, economic, military and tourism sectors. However, contrary to expectations all 44 respondents noted that the rural province of Ayutthaya was the fastest to recover amongst the three. Its organizations scored high on redundancy and rapidity of response due to the strength of social networks, a flood disaster sub-culture due to annual flooding, and the help provided by monks from and faith based organizations. Organizations in the suburban community of Pathum Thani scored lowest on rapidity of response and resourcefulness due to limited and ambiguous warnings, lack of prior flood experience and controversies that government flood protection works like sandbagging favored the capital city of Bangkok over them. Such a micro-level examination of organizational resilience in rural, suburban and urban areas in a country through mixed methods studies has its merits in getting a nuanced understanding of the importance of disaster subcultures and religious norms for resilience. This can help refocus attention on the strengths of social networks and social capital, for flood mitigation.

Keywords: disaster subculture, flood response, organizational resilience, Thailand floods, religious beliefs and response, social capital and disasters

Procedia PDF Downloads 134
684 Decision-Making, Expectations and Life Project in Dependent Adults Due to Disability

Authors: Julia Córdoba

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People are not completely autonomous, as we live in society; therefore, people could be defined as relationally dependent. The lack, decrease or loss of physical, psychological and/or social interdependence due to a disability situation is known as dependence. This is related to the need for help from another person in order to carry out activities of daily living. This population group lives with major social limitations that significantly reduce their participation and autonomy. They have high levels of stigma and invisibility from private environments (family and close networks), as well as from the public order (environment, community). The importance of this study lies in the fact that the lack of support and adjustments leads to what authors call the circle of exclusion. This circle describes how not accessing services - due to the difficulties caused by the disability situation impacts biological, social and psychological levels. This situation produces higher levels of exclusion and vulnerability. This study will focus on the process of autonomy and dependence of adults with disability from the model of disability proposed by the International Classification of Functioning, Health and Disability (ICF). The objectives are: i) to write down the relationship between autonomy and dependence based on socio-health variables and ii) to determine the relationship between the situation of autonomy and dependence and the expectations and interests of the participants. We propose a study that will use a survey technique through a previously validated virtual questionnaire. The data obtained will be analyzed using quantitative and qualitative methods for the details of the profiles obtained. No less than 200 questionnaires will be administered to people between 18 and 64 years of age who self-identify as having some degree of dependency due to disability. For the analysis of the results, the two main variables of autonomy and dependence will be considered. Socio-demographic variables such as age, gender identity, area of residence and family composition will be used. In relation to the biological dimension of the situation, the diagnosis, if any, and the type of disability will be asked. For the description of these profiles of autonomy and dependence, the following variables will be used: self-perception, decision-making, interests, expectations and life project, care of their health condition, support and social network, and labor and educational inclusion. The relationship between the target population and the variables collected provides several guidelines that could form the basis for the analysis of other research of interest in terms of self-perception, autonomy and dependence. The areas and situations where people state that they have greater possibilities to decide and have a say will be obtained. It will identify social (networks and support, educational background), demographic (age, gender identity and residence) and health-related variables (diagnosis and type of disability, quality of care) that may have a greater relationship with situations of dependency or autonomy. It will be studied whether the level of autonomy and/or dependence has an impact on the type of expectations and interests of the people surveyed.

Keywords: life project, disability, inclusion, autonomy

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683 Piled Critical Size Bone-Biomimetic and Biominerizable Nanocomposites: Formation of Bioreactor-Induced Stem Cell Gradients under Perfusion and Compression

Authors: W. Baumgartner, M. Welti, N. Hild, S. C. Hess, W. J. Stark, G. Meier Bürgisser, P. Giovanoli, J. Buschmann

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Perfusion bioreactors are used to solve problems in tissue engineering in terms of sufficient nutrient and oxygen supply. Such problems especially occur in critical size grafts because vascularization is often too slow after implantation ending up in necrotic cores. Biominerizable and biocompatible nanocomposite materials are attractive and suitable scaffold materials for bone tissue engineering because they offer mineral components in organic carriers – mimicking natural bone tissue. In addition, human adipose derived stem cells (ASCs) can potentially be used to increase bone healing as they are capable of differentiating towards osteoblasts or endothelial cells among others. In the present study, electrospun nanocomposite disks of poly-lactic-co-glycolic acid and amorphous calcium phosphate nanoparticles (PLGA/a-CaP) were seeded with human ASCs and eight disks were stacked in a bioreactor running with normal culture medium (no differentiation supplements). Under continuous perfusion and uniaxial cyclic compression, load-displacement curves as a function of time were assessed. Stiffness and energy dissipation were recorded. Moreover, stem cell densities in the layers of the piled scaffold were determined as well as their morphologies and differentiation status (endothelial cell differentiation, chondrogenesis and osteogenesis). While the stiffness of the cell free constructs increased over time caused by the transformation of the a-CaP nanoparticles into flake-like apatite, ASC-seeded constructs showed a constant stiffness. Stem cell density gradients were histologically determined with a linear increase in the flow direction from the bottom to the top of the 3.5 mm high pile (r2 > 0.95). Cell morphology was influenced by the flow rate, with stem cells getting more roundish at higher flow rates. Less than 1 % osteogenesis was found upon osteopontin immunostaining at the end of the experiment (9 days), while no endothelial cell differentiation and no chondrogenesis was triggered under these conditions. All ASCs had mainly remained in their original pluripotent status within this time frame. In summary, we have fabricated a critical size bone graft based on a biominerizable bone-biomimetic nanocomposite with preserved stiffness when seeded with human ASCs. The special feature of this bone graft was that ASC densities inside the piled construct varied with a linear gradient, which is a good starting point for tissue engineering interfaces such as bone-cartilage where the bone tissue is cell rich while the cartilage exhibits low cell densities. As such, this tissue-engineered graft may act as a bone-cartilage interface after the corresponding differentiation of the ASCs.

Keywords: bioreactor, bone, cartilage, nanocomposite, stem cell gradient

Procedia PDF Downloads 288
682 Urban Seismic Risk Reduction in Algeria: Adaptation and Application of the RADIUS Methodology

Authors: Mehdi Boukri, Mohammed Naboussi Farsi, Mounir Naili, Omar Amellal, Mohamed Belazougui, Ahmed Mebarki, Nabila Guessoum, Brahim Mezazigh, Mounir Ait-Belkacem, Nacim Yousfi, Mohamed Bouaoud, Ikram Boukal, Aboubakr Fettar, Asma Souki

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The seismic risk to which the urban centres are more and more exposed became a world concern. A co-operation on an international scale is necessary for an exchange of information and experiments for the prevention and the installation of action plans in the countries prone to this phenomenon. For that, the 1990s was designated as 'International Decade for Natural Disaster Reduction (IDNDR)' by the United Nations, whose interest was to promote the capacity to resist the various natural, industrial and environmental disasters. Within this framework, it was launched in 1996, the RADIUS project (Risk Assessment Tools for Diagnosis of Urban Areas Against Seismic Disaster), whose the main objective is to mitigate seismic risk in developing countries, through the development of a simple and fast methodological and operational approach, allowing to evaluate the vulnerability as well as the socio-economic losses, by probable earthquake scenarios in the exposed urban areas. In this paper, we will present the adaptation and application of this methodology to the Algerian context for the seismic risk evaluation in urban areas potentially exposed to earthquakes. This application consists to perform an earthquake scenario in the urban centre of Constantine city, located at the North-East of Algeria, which will allow the building seismic damage estimation of this city. For that, an inventory of 30706 building units was carried out by the National Earthquake Engineering Research Centre (CGS). These buildings were digitized in a data base which comprises their technical information by using a Geographical Information system (GIS), and then they were classified according to the RADIUS methodology. The study area was subdivided into 228 meshes of 500m on side and Ten (10) sectors of which each one contains a group of meshes. The results of this earthquake scenario highlights that the ratio of likely damage is about 23%. This severe damage results from the high concentration of old buildings and unfavourable soil conditions. This simulation of the probable seismic damage of the building and the GIS damage maps generated provide a predictive evaluation of the damage which can occur by a potential earthquake near to Constantine city. These theoretical forecasts are important for decision makers in order to take the adequate preventive measures and to develop suitable strategies, prevention and emergency management plans to reduce these losses. They can also help to take the adequate emergency measures in the most impacted areas in the early hours and days after an earthquake occurrence.

Keywords: seismic risk, mitigation, RADIUS, urban areas, Algeria, earthquake scenario, Constantine

Procedia PDF Downloads 238
681 The Language of COVID-19: Psychological Effects of the Label 'Essential Worker' on Spanish-Speaking Adults

Authors: Natalia Alvarado, Myldred Hernandez-Gonzalez, Mary Laird, Madeline Phillips, Elizabeth Miller, Luis Mendez, Teresa Satterfield Linares

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Objectives: Focusing on the reported levels of depressive symptoms from Hispanic individuals in the U.S. during the ongoing COVID-19 pandemic, we analyze the psychological effects of being labeled an ‘essential worker/trabajador(a) esencial.’ We situate this attribute within the complex context of how an individual’s mental health is linked to work status and his/her community’s attitude toward such a status. Method: 336 Spanish-speaking adults (Mage = 34.90; SD = 11.00; 46% female) living in the U.S. participated in a mixed-method study. Participants completed a self-report Spanish-language survey consisting of COVID-19 prompts (e.g., Soy un trabajador esencial durante la pandemia. I am an ‘essential worker’ during the pandemic), civic engagement scale (CES) attitudes (e.g., Me siento responsable de mi comunidad. I feel responsible for my community) and behaviors (e.g., Ayudo a los miembros de mi comunidad. I help members of my community), and the Center for Epidemiological Studies Depression Scale (e.g., Me sentía deprimido/a. I felt depressed). The survey was conducted several months into the pandemic and before the vaccine distribution. Results: Regression analyses show that being labeled an essential worker was correlated to CES attitudes (b= .28, p < .001) and higher CES behaviors (b= .32, p < .001). Essential worker status also reported higher levels of depressive symptoms (b= .17, p < .05). In addition, we found that CES attitudes and CES behaviors were related to higher levels of depressive symptoms (b= .11, p <.05, b = .22, p < .001, respectively). These findings suggest that those who are on the frontlines during the COVID-19 pandemic suffer higher levels of depressive symptoms, despite their affirming community attitudes and behaviors. Discussion: Hispanics/Latinxs make up 53% of the high-proximity employees who must work in person and in close contact with others; this is the highest rate of any racial or ethnic category. Moreover, 31% of Hispanics are classified as essential workers. Our outcomes show that those labeled as trabajadores esenciales convey attitudes of remaining strong and resilient for COVID-19 victims. They also express community attitudes and behaviors reflecting a sense of responsibility to continue working to help others during these unprecedented times. However, we also find that the pressure of maintaining basic needs for others exacerbates mental health challenges and stressors, as many essential workers are anxious and stressed about their physical and economic security. As a result, community attitudes do not protect from depressive symptoms as Hispanic essential workers are failing to balance everyone’s needs, including their own (e.g., physical exhaustion and psychological distress). We conclude with a discussion on alternatives to the phrase ‘essential worker’ and of incremental steps that can be taken to address pandemic-related mental health issues targeting US Hispanic workers.

Keywords: COVID-19, essential worker, mental health, race and ethnicity

Procedia PDF Downloads 113
680 Music Genre Classification Based on Non-Negative Matrix Factorization Features

Authors: Soyon Kim, Edward Kim

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In order to retrieve information from the massive stream of songs in the music industry, music search by title, lyrics, artist, mood, and genre has become more important. Despite the subjectivity and controversy over the definition of music genres across different nations and cultures, automatic genre classification systems that facilitate the process of music categorization have been developed. Manual genre selection by music producers is being provided as statistical data for designing automatic genre classification systems. In this paper, an automatic music genre classification system utilizing non-negative matrix factorization (NMF) is proposed. Short-term characteristics of the music signal can be captured based on the timbre features such as mel-frequency cepstral coefficient (MFCC), decorrelated filter bank (DFB), octave-based spectral contrast (OSC), and octave band sum (OBS). Long-term time-varying characteristics of the music signal can be summarized with (1) the statistical features such as mean, variance, minimum, and maximum of the timbre features and (2) the modulation spectrum features such as spectral flatness measure, spectral crest measure, spectral peak, spectral valley, and spectral contrast of the timbre features. Not only these conventional basic long-term feature vectors, but also NMF based feature vectors are proposed to be used together for genre classification. In the training stage, NMF basis vectors were extracted for each genre class. The NMF features were calculated in the log spectral magnitude domain (NMF-LSM) as well as in the basic feature vector domain (NMF-BFV). For NMF-LSM, an entire full band spectrum was used. However, for NMF-BFV, only low band spectrum was used since high frequency modulation spectrum of the basic feature vectors did not contain important information for genre classification. In the test stage, using the set of pre-trained NMF basis vectors, the genre classification system extracted the NMF weighting values of each genre as the NMF feature vectors. A support vector machine (SVM) was used as a classifier. The GTZAN multi-genre music database was used for training and testing. It is composed of 10 genres and 100 songs for each genre. To increase the reliability of the experiments, 10-fold cross validation was used. For a given input song, an extracted NMF-LSM feature vector was composed of 10 weighting values that corresponded to the classification probabilities for 10 genres. An NMF-BFV feature vector also had a dimensionality of 10. Combined with the basic long-term features such as statistical features and modulation spectrum features, the NMF features provided the increased accuracy with a slight increase in feature dimensionality. The conventional basic features by themselves yielded 84.0% accuracy, but the basic features with NMF-LSM and NMF-BFV provided 85.1% and 84.2% accuracy, respectively. The basic features required dimensionality of 460, but NMF-LSM and NMF-BFV required dimensionalities of 10 and 10, respectively. Combining the basic features, NMF-LSM and NMF-BFV together with the SVM with a radial basis function (RBF) kernel produced the significantly higher classification accuracy of 88.3% with a feature dimensionality of 480.

Keywords: mel-frequency cepstral coefficient (MFCC), music genre classification, non-negative matrix factorization (NMF), support vector machine (SVM)

Procedia PDF Downloads 274
679 Exploring Nature and Pattern of Mentoring Practices: A Study on Mentees' Perspectives

Authors: Nahid Parween Anwar, Sadia Muzaffar Bhutta, Takbir Ali

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Mentoring is a structured activity which is designed to facilitate engagement between mentor and mentee to enhance mentee’s professional capability as an effective teacher. Both mentor and mentee are important elements of the ‘mentoring equation’ and play important roles in nourishing this dynamic, collaborative and reciprocal relationship. Cluster-Based Mentoring Programme (CBMP) provides an indigenous example of a project which focused on development of primary school teachers in selected clusters with a particular focus on their classroom practice. A study was designed to examine the efficacy of CBMP as part of Strengthening Teacher Education in Pakistan (STEP) project. This paper presents results of one of the components of this study. As part of the larger study, a cross-sectional survey was employed to explore nature and patterns of mentoring process from mentees’ perspectives in the selected districts of Sindh and Balochistan. This paper focuses on the results of the study related to the question: What are mentees’ perceptions of their mentors’ support for enhancing their classroom practice during mentoring process? Data were collected from mentees (n=1148) using a 5-point scale -‘Mentoring for Effective Primary Teaching’ (MEPT). MEPT focuses on seven factors of mentoring: personal attributes, pedagogical knowledge, modelling, feedback, system requirement, development and use of material, and gender equality. Data were analysed using SPSS 20. Mentees perceptions of mentoring practice of their mentors were summarized using mean and standard deviation. Results showed that mean scale scores on mentees’ perceptions of their mentors’ practices fell between 3.58 (system requirement) and 4.55 (personal attributes). Mentees’ perceives personal attribute of the mentor as the most significant factor (M=4.55) towards streamlining mentoring process by building good relationship between mentor and mentees. Furthermore, mentees have shared positive views about their mentors efforts towards promoting gender impartiality (M=4.54) during workshop and follow up visit. Contrary to this, mentees felt that more could have been done by their mentors in sharing knowledge about system requirement (e.g. school policies, national curriculum). Furthermore, some of the aspects in high scoring factors were highlighted by the mentees as areas for further improvement (e.g. assistance in timetabling, written feedback, encouragement to develop learning corners). Mentees’ perceptions of their mentors’ practices may assist in determining mentoring needs. The results may prove useful for the professional development programme for the mentors and mentees for specific mentoring programme in order to enhance practices in primary classrooms in Pakistan. Results would contribute into the body of much-needed knowledge from developing context.

Keywords: cluster-based mentoring programme, mentoring for effective primary teaching (MEPT), professional development, survey

Procedia PDF Downloads 212
678 Understanding the Impact of Out-of-Sequence Thrust Dynamics on Earthquake Mitigation: Implications for Hazard Assessment and Disaster Planning

Authors: Rajkumar Ghosh

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Earthquakes pose significant risks to human life and infrastructure, highlighting the importance of effective earthquake mitigation strategies. Traditional earthquake modelling and mitigation efforts have largely focused on the primary fault segments and their slip behaviour. However, earthquakes can exhibit complex rupture dynamics, including out-of-sequence thrust (OOST) events, which occur on secondary or subsidiary faults. This abstract examines the impact of OOST dynamics on earthquake mitigation strategies and their implications for hazard assessment and disaster planning. OOST events challenge conventional seismic hazard assessments by introducing additional fault segments and potential rupture scenarios that were previously unrecognized or underestimated. Consequently, these events may increase the overall seismic hazard in affected regions. The study reviews recent case studies and research findings that illustrate the occurrence and characteristics of OOST events. It explores the factors contributing to OOST dynamics, such as stress interactions between fault segments, fault geometry, and mechanical properties of fault materials. Moreover, it investigates the potential triggers and precursory signals associated with OOST events to enhance early warning systems and emergency response preparedness. The abstract also highlights the significance of incorporating OOST dynamics into seismic hazard assessment methodologies. It discusses the challenges associated with accurately modelling OOST events, including the need for improved understanding of fault interactions, stress transfer mechanisms, and rupture propagation patterns. Additionally, the abstract explores the potential for advanced geophysical techniques, such as high-resolution imaging and seismic monitoring networks, to detect and characterize OOST events. Furthermore, the abstract emphasizes the practical implications of OOST dynamics for earthquake mitigation strategies and urban planning. It addresses the need for revising building codes, land-use regulations, and infrastructure designs to account for the increased seismic hazard associated with OOST events. It also underscores the importance of public awareness campaigns to educate communities about the potential risks and safety measures specific to OOST-induced earthquakes. This sheds light on the impact of out-of-sequence thrust dynamics in earthquake mitigation. By recognizing and understanding OOST events, researchers, engineers, and policymakers can improve hazard assessment methodologies, enhance early warning systems, and implement effective mitigation measures. By integrating knowledge of OOST dynamics into urban planning and infrastructure development, societies can strive for greater resilience in the face of earthquakes, ultimately minimizing the potential for loss of life and infrastructure damage.

Keywords: earthquake mitigation, out-of-sequence thrust, seismic, satellite imagery

Procedia PDF Downloads 64
677 Role of ASHA in Utilizing Maternal Health Care Services India, Evidences from National Rural Health Mission (NRHM)

Authors: Dolly Kumari, H. Lhungdim

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Maternal health is one of the crucial health indicators for any country. 5th goal of Millennium Development Goals is also emphasising on improvement of maternal health. Soon after Independence government of India realizing the importance of maternal and child health care services, and took steps to strengthen in 1st and 2nd five year plans. In past decade the other health indicator which is life expectancy at birth has been observed remarkable improvement. But still maternal mortality is high in India and in some states it is observe much higher than national average. Government of India pour lots of fund and initiate National Rural Health Mission (NRHM) in 2005 to improve maternal health in country by providing affordable and accessible health care services. Accredited Social Heath Activist (ASHA) is one of the key components of the NRHM. Mainly ASHAs are selected female aged 25-45 years from village itself and accountable for the monitoring of maternal health care for the same village. ASHA are trained to works as an interface between the community and public health system. This study tries to assess the role of ASHA in utilizing maternal health care services and to see the level of awareness about benefits given under JSY scheme and utilization of those benefits by eligible women. For the study concurrent evaluation data from National Rural health Mission (NRHM), initiated by government of India in 2005 has been used. This study is based on 78205 currently married women from 70 different districts of India. Descriptive statistics, chi2 test and binary logistic regression have been used for analysis. The probability of institutional delivery increases by 2.03 times (p<0.001) while if ASHA arranged or helped in arranging transport facility the probability of institutional delivery is increased by 1.67 times (p<0.01) than if she is not arranging transport facility. Further if ASHA facilitated to get JSY card to the pregnant women probability of going for full ANC is increases by 1.36 times (p<0.05) than reference. However if ASHA discuses about institutional delivery and approaches to get register than probability of getting TT injection is 1.88 and 1.64 times (p<0.01) higher than that if she did not discus. Further, Probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 years. The probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 year of age than before 18 years, it is also 1.28 times (p<0.001) and 1.32 times (p<0.001) higher among women have 1 to 8 year of schooling and with 9 and above years of schooling respectively than the women who never attended school. Those women who are working have 1.13 times (p<0.001) higher probability of getting benefits from JSY scheme than not working women. Surprisingly women belongs to wealthiest quintile are .53times (P<0.001) less aware about JSY scheme. Results conclude that work done by ASHA has great influence on maternal health care utilization in India. But results also show that still substantial numbers of needed population are far from utilization of these services. Place of delivery is significantly influenced by referral and transport facility arranged by ASHA.

Keywords: institutional delivery, JSY beneficiaries, referral faculty, public health

Procedia PDF Downloads 309
676 The Role of Structural Poverty in the Know-How and Moral Economy of Doctors in Africa: An Anthropological Perspective

Authors: Isabelle Gobatto

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Based on an anthropological approach, this paper explores the medical profession and the construction of medical practices by considering the multiform articulations between structural poverty and the production of care from a low-resource francophone West African country, Burkina Faso. This country is considered in its exemplary dimension of culturally differentiated countries of the African continent that share the same situation of structural poverty. The objective is to expose the effects of structural poverty on the ways of constructing professional knowledge and thinking about the sense of the medical profession. If doctors are trained to have the same capacities in South and West countries, which are to treat and save lives whatever the cultural contexts of the practice of medicine, the ways of investing their role and of dealing with this context of action fracture the homogenization of the medical profession. In the line of anthropology of biomedicine, this paper outlines the complex effects of structural poverty on health care, care relations, and the moral economy of doctors. The materials analyzed are based on an ethnography including two temporalities located thirty years apart (1990-1994 and 2020-2021), based on long-term observations of care practices conducted in healthcare institutions, interviews coupled with the life histories of physicians. The findings reveal that disabilities faced by doctors to deliver care are interpreted as policy gaps, but they are also considered by physicians as constitutive of the social and cultural characteristics of patients, making their capacities and incapacities in terms of accompanying caregivers in the production of care. These perceptions have effects on know-how, structured around the need to act even when diagnoses are not made so as not to see patients desert health structures if the costs of care are too high for them. But these interpretations of highly individualizing dimensions of these difficulties place part of the blame on patients for the difficulties in using learned knowledge and delivering effective care. These situations challenge the ethics of caregivers but also of ethnologists. Firstly because the interpretations of disabilities prevent caregivers from considering vulnerabilities of care as constituting a common condition shared with their patients in these health systems, affecting them in an identical way although in different places in the production of care. Correlatively, these results underline that these professional conceptions prevent the emergence of a figure of victim, which could be shared between patients and caregivers who, together, undergo working and care conditions at the limit of the acceptable. This dimension directly involves politics. Secondly, structural poverty and its effects on care challenge the ethics of the anthropologist who observes caregivers producing, without intent to arm, experiences of care marked by an ordinary violence, by not giving them the care they need. It is worth asking how anthropologists could get doctors to think in this light in west-African societies.

Keywords: Africa, care, ethics, poverty

Procedia PDF Downloads 47
675 Temperature Dependence of the Optoelectronic Properties of InAs(Sb)-Based LED Heterostructures

Authors: Antonina Semakova, Karim Mynbaev, Nikolai Bazhenov, Anton Chernyaev, Sergei Kizhaev, Nikolai Stoyanov

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At present, heterostructures are used for fabrication of almost all types of optoelectronic devices. Our research focuses on the optoelectronic properties of InAs(Sb) solid solutions that are widely used in fabrication of light emitting diodes (LEDs) operating in middle wavelength infrared range (MWIR). This spectral range (2-6 μm) is relevant for laser diode spectroscopy of gases and molecules, for systems for the detection of explosive substances, medical applications, and for environmental monitoring. The fabrication of MWIR LEDs that operate efficiently at room temperature is mainly hindered by the predominance of non-radiative Auger recombination of charge carriers over the process of radiative recombination, which makes practical application of LEDs difficult. However, non-radiative recombination can be partly suppressed in quantum-well structures. In this regard, studies of such structures are quite topical. In this work, electroluminescence (EL) of LED heterostructures based on InAs(Sb) epitaxial films with the molar fraction of InSb ranging from 0 to 0.09 and multi quantum-well (MQW) structures was studied in the temperature range 4.2-300 K. The growth of the heterostructures was performed by metal-organic chemical vapour deposition on InAs substrates. On top of the active layer, a wide-bandgap InAsSb(Ga,P) barrier was formed. At low temperatures (4.2-100 K) stimulated emission was observed. As the temperature increased, the emission became spontaneous. The transition from stimulated emission to spontaneous one occurred at different temperatures for structures with different InSb contents in the active region. The temperature-dependent carrier lifetime, limited by radiative recombination and the most probable Auger processes (for the materials under consideration, CHHS and CHCC), were calculated within the framework of the Kane model. The effect of various recombination processes on the carrier lifetime was studied, and the dominant role of Auger processes was established. For MQW structures quantization energies for electrons, light and heavy holes were calculated. A characteristic feature of the experimental EL spectra of these structures was the presence of peaks with energy different from that of calculated optical transitions between the first quantization levels for electrons and heavy holes. The obtained results showed strong effect of the specific electronic structure of InAsSb on the energy and intensity of optical transitions in nanostructures based on this material. For the structure with MQWs in the active layer, a very weak temperature dependence of EL peak was observed at high temperatures (>150 K), which makes it attractive for fabricating temperature-resistant gas sensors operating in the middle-infrared range.

Keywords: Electroluminescence, InAsSb, light emitting diode, quantum wells

Procedia PDF Downloads 188
674 Cytotoxicity and Genotoxicity of Glyphosate and Its Two Impurities in Human Peripheral Blood Mononuclear Cells

Authors: Marta Kwiatkowska, Paweł Jarosiewicz, Bożena Bukowska

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Glyphosate (N-phosphonomethylglycine) is a non-selected broad spectrum ingredient in the herbicide (Roundup) used for over 35 years for the protection of agricultural and horticultural crops. Glyphosate was believed to be environmentally friendly but recently, a large body of evidence has revealed that glyphosate can negatively affect on environment and humans. It has been found that glyphosate is present in the soil and groundwater. It can also enter human body which results in its occurrence in blood in low concentrations of 73.6 ± 28.2 ng/ml. Research conducted for potential genotoxicity and cytotoxicity can be an important element in determining the toxic effect of glyphosate. Due to regulation of European Parliament 1107/2009 it is important to assess genotoxicity and cytotoxicity not only for the parent substance but also its impurities, which are formed at different stages of production of major substance – glyphosate. Moreover verifying, which of these compounds are more toxic is required. Understanding of the molecular pathways of action is extremely important in the context of the environmental risk assessment. In 2002, the European Union has decided that glyphosate is not genotoxic. Unfortunately, recently performed studies around the world achieved results which contest decision taken by the committee of the European Union. World Health Organization (WHO) in March 2015 has decided to change the classification of glyphosate to category 2A, which means that the compound is considered to "probably carcinogenic to humans". This category relates to compounds for which there is limited evidence of carcinogenicity to humans and sufficient evidence of carcinogenicity on experimental animals. That is why we have investigated genotoxicity and cytotoxicity effects of the most commonly used pesticide: glyphosate and its impurities: N-(phosphonomethyl)iminodiacetic acid (PMIDA) and bis-(phosphonomethyl)amine on human peripheral blood mononuclear cells (PBMCs), mostly lymphocytes. DNA damage (analysis of DNA strand-breaks) using the single cell gel electrophoresis (comet assay) and ATP level were assessed. Cells were incubated with glyphosate and its impurities: PMIDA and bis-(phosphonomethyl)amine at concentrations from 0.01 to 10 mM for 24 hours. Evaluating genotoxicity using the comet assay showed a concentration-dependent increase in DNA damage for all compounds studied. ATP level was decreased to zero as a result of using the highest concentration of two investigated impurities, like bis-(phosphonomethyl)amine and PMIDA. Changes were observed using the highest concentration at which a person can be exposed as a result of acute intoxication. Our survey leads to a conclusion that the investigated compounds exhibited genotoxic and cytotoxic potential but only in high concentrations, to which people are not exposed environmentally. Acknowledgments: This work was supported by the Polish National Science Centre (Contract-2013/11/N/NZ7/00371), MSc Marta Kwiatkowska, project manager.

Keywords: cell viability, DNA damage, glyphosate, impurities, peripheral blood mononuclear cells

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673 Fodder Production and Livestock Rearing in Relation to Climate Change and Possible Adaptation Measures in Manaslu Conservation Area, Nepal

Authors: Bhojan Dhakal, Naba Raj Devkota, Chet Raj Upreti, Maheshwar Sapkota

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A study was conducted to find out the production potential, nutrient composition, and the variability of the most commonly available fodder trees along with the varying altitude to help optimize the dry matter requirement during winter lean period. The study was carried out from March to June, 2012 in Lho and Prok Village Development Committee of Manaslu Conservation Area (MCA), located in Gorkha district of Nepal. The other objective of the research was to learn the impact of climate change on livestock production linking it with feed availability. The study was conducted in two parts: social and biological. Accordingly, a households (HHs) survey was conducted to collect primary data from 70 HHs, focusing on the perception of respondents on impacts of climatic variability on the feeding management. The next part consisted of understanding yield potential and nutrient composition of the four most commonly available fodder trees (M. azedirach, M. alba, F. roxburghii, F. nemoralis), within two altitudes range: (1500-2000 masl and 2000-2500 masl) by using a RCB design in 2*4 factorial combination of treatments, each replicated four times. Results revealed that majority of the farmers perceived the change in climatic phenomenon more severely within the past five years. Farmers were using different adaptation technologies such as collection of forage from jungle, reducing unproductive animals, fodder trees utilization, and crop by product feeding at feed scarcity period. Ranking of the different fodder trees on the basis of indigenous knowledge and experiences revealed that F. roxburghii was the best-preferred fodder tree species (index value 0.72) in terms overall preferability whereas M. azedirach had highest growth and productivity (index value 0.77), F. roxburghii had highest adoptability (index value 0.69) and palatability (index value 0.69) as well. Similarly, fresh yield and dry matter yield of the each fodder trees was significant (P < 0.01) between the altitude and within species. Fodder trees yield analysis revealed that the highest dry matter (DM) yield (28 kg/tree) was obtained for F. roxburghii but that remained statistically similar (P > 0.05) to the other treatment. On the other hand, most of the parameters: ether extract (EE), acid detergent lignin (ADL), acid detergent fibre (ADF), cell wall digestibility (CWD), relative digestibility (RD), digestible nutrient (TDN), and Calcium (Ca) among the treatments were highly significant (P < 0.01). This indicates the scope of introducing productive and nutritive fodder trees species even at the high altitude to help reduce fodder scarcity problem during winter. The finding also revealed the scope of promoting all available local fodder trees species as crude protein content of these species were similar.

Keywords: fodder trees, yield potential, climate change, nutrient composition

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672 In Silico Modeling of Drugs Milk/Plasma Ratio in Human Breast Milk Using Structures Descriptors

Authors: Navid Kaboudi, Ali Shayanfar

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Introduction: Feeding infants with safe milk from the beginning of their life is an important issue. Drugs which are used by mothers can affect the composition of milk in a way that is not only unsuitable, but also toxic for infants. Consuming permeable drugs during that sensitive period by mother could lead to serious side effects to the infant. Due to the ethical restrictions of drug testing on humans, especially women, during their lactation period, computational approaches based on structural parameters could be useful. The aim of this study is to develop mechanistic models to predict the M/P ratio of drugs during breastfeeding period based on their structural descriptors. Methods: Two hundred and nine different chemicals with their M/P ratio were used in this study. All drugs were categorized into two groups based on their M/P value as Malone classification: 1: Drugs with M/P>1, which are considered as high risk 2: Drugs with M/P>1, which are considered as low risk Thirty eight chemical descriptors were calculated by ACD/labs 6.00 and Data warrior software in order to assess the penetration during breastfeeding period. Later on, four specific models based on the number of hydrogen bond acceptors, polar surface area, total surface area, and number of acidic oxygen were established for the prediction. The mentioned descriptors can predict the penetration with an acceptable accuracy. For the remaining compounds (N= 147, 158, 160, and 174 for models 1 to 4, respectively) of each model binary regression with SPSS 21 was done in order to give us a model to predict the penetration ratio of compounds. Only structural descriptors with p-value<0.1 remained in the final model. Results and discussion: Four different models based on the number of hydrogen bond acceptors, polar surface area, and total surface area were obtained in order to predict the penetration of drugs into human milk during breastfeeding period About 3-4% of milk consists of lipids, and the amount of lipid after parturition increases. Lipid soluble drugs diffuse alongside with fats from plasma to mammary glands. lipophilicity plays a vital role in predicting the penetration class of drugs during lactation period. It was shown in the logistic regression models that compounds with number of hydrogen bond acceptors, PSA and TSA above 5, 90 and 25 respectively, are less permeable to milk because they are less soluble in the amount of fats in milk. The pH of milk is acidic and due to that, basic compounds tend to be concentrated in milk than plasma while acidic compounds may consist lower concentrations in milk than plasma. Conclusion: In this study, we developed four regression-based models to predict the penetration class of drugs during the lactation period. The obtained models can lead to a higher speed in drug development process, saving energy, and costs. Milk/plasma ratio assessment of drugs requires multiple steps of animal testing, which has its own ethical issues. QSAR modeling could help scientist to reduce the amount of animal testing, and our models are also eligible to do that.

Keywords: logistic regression, breastfeeding, descriptors, penetration

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671 The Dilemma of Translanguaging Pedagogy in a Multilingual University in South Africa

Authors: Zakhile Somlata

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In the context of international linguistic and cultural diversity, all languages can be used for all purposes. Africa in general and South Africa, in particular, is not an exception to multilingual and multicultural society. The multilingual and multicultural nature of South African society has a direct bearing to the heterogeneity of South African Universities in general. Universities as the centers of research, innovation, and transformation of the entire society should be at the forefront in leading multilingualism. The universities in South Africa had been using English and to a certain extent Afrikaans as the only academic languages during colonialism and apartheid regime. The democratic breakthrough of 1994 brought linguistic relief in South Africa. The Constitution of the Republic of South Africa recognizes 11 official languages that should enjoy parity of esteem for the realization of multilingualism. The elevation of the nine previously marginalized indigenous African languages as academic languages in higher education is central to multilingualism. It is high time that Afrocentric model instead of Eurocentric model should be the one which underpins education system in South Africa at all levels. Almost all South African universities have their language policies that seek to promote access and success of students through multilingualism, but the main dilemma is the implementation of language policies. This study is significant to respond to two objectives: (i) To evaluate how selected institutions use language policies for accessibility and success of students. (ii) To study how selected universities integrate African languages for both academic and administrative purposes. This paper reflects the language policy practices in one selected University of Technology (UoT) in South Africa. The UoT has its own language policy which depicts linguistic diversity of the institution and its commitment to promote multilingualism. Translanguaging pedagogy which accommodates minority languages' usage in the teaching and learning process plays a pivotal role in promoting multilingualism. This research paper employs mixed methods (quantitative and qualitative research) approach. Qualitative data has been collected from the key informants (insiders and experts), while quantitative data has been collected from a cohort of third-year students. A mixed methods approach with its convergent parallel design allows the data to be collected separately, analysed separately but with the comparison of the results. Language development initiatives have been discussed within the framework of language policy and policy implementation strategies. Theoretically, this paper is rooted in language as a problem, language as a right and language as a resource. The findings demonstrate that despite being a multilingual institution, there is a perpetuation of marginalization of African languages to be used as academic languages. Findings further display the hegemony of English. The promotion of status quo compromises the promotion of multilingualism, Africanization of Higher Education and intellectualization of indigenous African languages in South Africa under a democratic dispensation.

Keywords: afro-centric model, hegemony of English, language as a resource, translanguaging pedagogy

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670 Functional Switching of Serratia marcescens Transcriptional Regulator from Activator to Inhibitor of Quorum Sensing by Exogenous Addition

Authors: Norihiro Kato, Yuriko Takayama

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Some gram-negative bacteria enable the simultaneous activation of gene expression involved in N-acylhomoserine lactone (AHL) dependent cell-to-cell communication system. Such regulatory system for the bacterial group behavior is termed as quorum sensing (QS) because a diffusible AHL signal can accumulate around the cell during the increase of the cell density and trigger activation of the sequential QS process. By blocking the QS, the expression of diverse genes related to infection, antibiotic production, and biofilm formation is inhibited. Conditioning of QS by regulation of the DNA-receptor-AHL interaction is a potential target for enhancing host defenses against pathogenicity. We focused on engineered application of transcriptional regulator SpnR produced in opportunistic human pathogen Serratia marcescens. The SpnR can interact with AHL signals at an N-terminal domain and also with a promoter region of a QS target gene at a C-terminal domain. As the initial process of the QS activation, the SpnR forms a complex with the AHL to enhance the expression of pig cluster; the SpnR normally acts as an activator for the expression of the QS-dependent gene. In this research, we attempt to artificially control QS by changing the role of SpnR. The QS-dependent prodigiosin production is expected to inhibit by externally added SpnR in the culture broth of AS-1 strain because the AHL concentration was kept below the threshold by AHL-SpnR complex formation. Maltose-binding protein (MBP)-tagged SpnR (MBP-SpnR) was overexpressed in Escherichia coli and purified using an affinity chromatography equipped with an amylose resin column. The specific interaction between AHL and MBP-SpnR was demonstrated by quartz crystal microbalance (QCM) sensor. AHL with amino end-group was coupled with COOH-terminated self-assembled monolayer prepared on a gold electrode of 27-MHz quartz crystal sensor using water-soluble carbodiimide. After the injection of MBP-SpnR into a cup-type sensor cell filled with the buffer solution, time course of resonant frequency change (ΔFs) was determined. A decrease of ΔFs clearly showed the uptake of MBP-SpnR onto the AHL-immobilized electrode. Furthermore, no binding affinity was observed after the heat-inactivation of MBP-SpnR at 80ºC. These results suggest that MBP-SpnR possesses a specific affinity for AHL. MBP-SpnR was added to the culture medium as an AHL trap to study inhibitory effects on intracellularly accumulated prodigiosin. With approximately 2 µM MBP-SpnR, the amount of prodigiosin induced was half that of the control without any additives. In conclusion, the function of SpnR could be switched by adding it to the cell culture. Exogenously added MBP-SpnR possesses high affinity for AHL derived from cells and acts as an inhibitor of AHL-mediated QS.

Keywords: intracellular signaling, microbial biotechnology, quorum sensing, transcriptional regulator

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669 Development of a Novel Ankle-Foot Orthotic Using a User Centered Approach for Improved Satisfaction

Authors: Ahlad Neti, Elisa Arch, Martha Hall

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Studies have shown that individuals who use Ankle-Foot-Orthoses (AFOs) have a high level of dissatisfaction regarding their current AFOs. Studies point to the focus on technical design with little attention given to the user perspective as a source of AFO designs that leave users dissatisfied. To design a new AFO that satisfies users and thereby improves their quality of life, the reasons for their dissatisfaction and their wants and needs for an improved AFO design must be identified. There has been little research into the user perspective on AFO use and desired improvements, so the relationship between AFO design and satisfaction in daily use must be assessed to develop appropriate metrics and constraints prior to designing a novel AFO. To assess the user perspective on AFO design, structured interviews were conducted with 7 individuals (average age of 64.29±8.81 years) who use AFOs. All interviews were transcribed and coded to identify common themes using Grounded Theory Method in NVivo 12. Qualitative analysis of these results identified sources of user dissatisfaction such as heaviness, bulk, and uncomfortable material and overall needs and wants for an AFO. Beyond the user perspective, certain objective factors must be considered in the construction of metrics and constraints to ensure that the AFO fulfills its medical purpose. These more objective metrics are rooted in a common medical device market and technical standards. Given the large body of research concerning these standards, these objective metrics and constraints were derived through a literature review. Through these two methods, a comprehensive list of metrics and constraints accounting for both the user perspective on AFO design and the AFO’s medical purpose was compiled. These metrics and constraints will establish the framework for designing a new AFO that carries out its medical purpose while also improving the user experience. The metrics can be categorized into several overarching areas for AFO improvement. Categories of user perspective related metrics include comfort, discreteness, aesthetics, ease of use, and compatibility with clothing. Categories of medical purpose related metrics include biomechanical functionality, durability, and affordability. These metrics were used to guide an iterative prototyping process. Six concepts were ideated and compared using system-level analysis. From these six concepts, two concepts – the piano wire model and the segmented model – were selected to move forward into prototyping. Evaluation of non-functional prototypes of the piano wire and segmented models determined that the piano wire model better fulfilled the metrics by offering increased stability, longer durability, fewer points for failure, and a strong enough core component to allow a sock to cover over the AFO while maintaining the overall structure. As such, the piano wire AFO has moved forward into the functional prototyping phase, and healthy subject testing is being designed and recruited to conduct design validation and verification.

Keywords: ankle-foot orthotic, assistive technology, human centered design, medical devices

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