Search results for: acoustic level
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13153

Search results for: acoustic level

9823 A Taxonomy of the Informational Content of Virtual Heritage Serious Games

Authors: Laurence C. Hanes, Robert J. Stone

Abstract:

Video games have reached a point of huge commercial success as well as wide familiarity with audiences both young and old. Much attention and research have also been directed towards serious games and their potential learning affordances. It is little surprise that the field of virtual heritage has taken a keen interest in using serious games to present cultural heritage information to users, with applications ranging from museums and cultural heritage institutions, to academia and research, to schools and education. Many researchers have already documented their efforts to develop and distribute virtual heritage serious games. Although attempts have been made to create classifications of the different types of virtual heritage games (somewhat akin to the idea of game genres), no formal taxonomy has yet been produced to define the different types of cultural heritage and historical information that can be presented through these games at a content level, and how the information can be manifested within the game. This study proposes such a taxonomy. First the informational content is categorized as heritage or historical, then further divided into tangible, intangible, natural, and analytical. Next, the characteristics of the manifestation within the game are covered. The means of manifestation, level of demonstration, tone, and focus are all defined and explained. Finally, the potential learning outcomes of the content are discussed. A demonstration of the taxonomy is then given by describing the informational content and corresponding manifestations within several examples of virtual heritage serious games as well as commercial games. It is anticipated that this taxonomy will help designers of virtual heritage serious games to think about and clearly define the information they are presenting through their games, and how they are presenting it. Another result of the taxonomy is that it will enable us to frame cultural heritage and historical information presented in commercial games with a critical lens, especially where there may not be explicit learning objectives. Finally, the results will also enable us to identify shared informational content and learning objectives between any virtual heritage serious and/or commercial games.

Keywords: informational content, serious games, taxonomy, virtual heritage

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9822 Harmonic Assessment and Mitigation in Medical Diagonesis Equipment

Authors: S. S. Adamu, H. S. Muhammad, D. S. Shuaibu

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Poor power quality in electrical power systems can lead to medical equipment at healthcare centres to malfunction and present wrong medical diagnosis. Equipment such as X-rays, computerized axial tomography, etc. can pollute the system due to their high level of harmonics production, which may cause a number of undesirable effects like heating, equipment damages and electromagnetic interferences. The conventional approach of mitigation uses passive inductor/capacitor (LC) filters, which has some drawbacks such as, large sizes, resonance problems and fixed compensation behaviours. The current trends of solutions generally employ active power filters using suitable control algorithms. This work focuses on assessing the level of Total Harmonic Distortion (THD) on medical facilities and various ways of mitigation, using radiology unit of an existing hospital as a case study. The measurement of the harmonics is conducted with a power quality analyzer at the point of common coupling (PCC). The levels of measured THD are found to be higher than the IEEE 519-1992 standard limits. The system is then modelled as a harmonic current source using MATLAB/SIMULINK. To mitigate the unwanted harmonic currents a shunt active filter is developed using synchronous detection algorithm to extract the fundamental component of the source currents. Fuzzy logic controller is then developed to control the filter. The THD without the active power filter are validated using the measured values. The THD with the developed filter show that the harmonics are now within the recommended limits.

Keywords: power quality, total harmonics distortion, shunt active filters, fuzzy logic

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9821 Harnessing Deep-Level Metagenomics to Explore the Three Dynamic One Health Areas: Healthcare, Domiciliary and Veterinary

Authors: Christina Killian, Katie Wall, Séamus Fanning, Guerrino Macori

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Deep-level metagenomics offers a useful technical approach to explore the three dynamic One Health axes: healthcare, domiciliary and veterinary. There is currently limited understanding of the composition of complex biofilms, natural abundance of AMR genes and gene transfer occurrence in these ecological niches. By using a newly established small-scale complex biofilm model, COMBAT has the potential to provide new information on microbial diversity, antimicrobial resistance (AMR)-encoding gene abundance, and their transfer in complex biofilms of importance to these three One Health axes. Shotgun metagenomics has been used to sample the genomes of all microbes comprising the complex communities found in each biofilm source. A comparative analysis between untreated and biocide-treated biofilms is described. The basic steps include the purification of genomic DNA, followed by library preparation, sequencing, and finally, data analysis. The use of long-read sequencing facilitates the completion of metagenome-assembled genomes (MAG). Samples were sequenced using a PromethION platform, and following quality checks, binning methods, and bespoke bioinformatics pipelines, we describe the recovery of individual MAGs to identify mobile gene elements (MGE) and the corresponding AMR genotypes that map to these structures. High-throughput sequencing strategies have been deployed to characterize these communities. Accurately defining the profiles of these niches is an essential step towards elucidating the impact of the microbiota on each niche biofilm environment and their evolution.

Keywords: COMBAT, biofilm, metagenomics, high-throughput sequencing

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9820 Gardening as a Contextual Scaffold for Learning: Connecting Community Wisdom for Science and Health Learning through Participatory Action Research

Authors: Kamal Prasad Acharya

Abstract:

The related literature suggests that teaching and learning science at the basic level community schools in Nepal is based on book recitation. Consequently, the achievement levels and the understanding of basic science concepts is much below the policy expectations. In this context, this study intended to gain perception in the implementation practices of school gardens ‘One Garden One School’ for science learning and to meet the target of sustainable development goals that connects community wisdom regarding school gardening activities (SGAs) for science learning. This Participatory Action Research (PAR) study was done at the action school located in Province 3, Chitwan of Federal Nepal, supported under the NORHED/Rupantaran project. The purpose of the study was to connect the community wisdom related to gardening activities as contextual scaffolds for science learning. For this, in-depth interviews and focus group discussions were applied to collect data which were analyzed using a thematic analysis. Basic level students, science teachers, and parents reported having wonderful experiences such as active and meaningful engagement in school gardening activities for science learning as well as science teachers’ motivation in activity-based science learning. Overall, teachers, students, and parents reported that the school gardening activities have been found to have had positive effects on students’ science learning as they develop basic scientific concepts by connecting community wisdom as a contextual scaffold. It is recommended that the establishment of a school garden is important for science learning in community schools throughout Nepal.

Keywords: contextual scaffold, community wisdom, science and health learning, school garden

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9819 Kinetic Study of Physical Quality Changes on Jumbo Squid (Dosidicus gigas) Slices during Application High-Pressure Impregnation

Authors: Mario Perez-Won, Roberto Lemus-Mondaca, Fernanda Marin, Constanza Olivares

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This study presents the simultaneous application of high hydrostatic pressure (HHP) and osmotic dehydration of jumbo squid (Dosidicus gigas) slice. Diffusion coefficients for both components water and solids were improved by the process pressure, being influenced by pressure level. The working conditions were different pressures such as 100, 250, 400 MPa and pressure atmospheric (0.1 MPa) for time intervals from 30 to 300 seconds and a 15% NaCl concentration. The mathematical expressions used for mass transfer simulations both water and salt were those corresponding to Newton, Henderson and Pabis, Page and Weibull models, where the Weibull and Henderson-Pabis models presented the best fitted to the water and salt experimental data, respectively. The values for water diffusivity coefficients varied from 1.62 to 8.10x10⁻⁹ m²/s whereas that for salt varied among 14.18 to 36.07x10⁻⁹ m²/s for selected conditions. Finally, as to quality parameters studied under the range of experimental conditions studied, the treatment at 250 MPa yielded on the samples a minimum hardness, whereas springiness, cohesiveness and chewiness at 100, 250 and 400 MPa treatments presented statistical differences regarding to unpressurized samples. The colour parameters L* (lightness) increased, however, but b* (yellowish) and a* (reddish) parameters decreased when increasing pressure level. This way, samples presented a brighter aspect and a mildly cooked appearance. The results presented in this study can support the enormous potential of hydrostatic pressure application as a technique important for compounds impregnation under high pressure.

Keywords: colour, diffusivity, high pressure, jumbo squid, modelling, texture

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9818 Data-Driven Simulations Tools for Der and Battery Rich Power Grids

Authors: Ali Moradiamani, Samaneh Sadat Sajjadi, Mahdi Jalili

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Power system analysis has been a major research topic in the generation and distribution sections, in both industry and academia, for a long time. Several load flow and fault analysis scenarios have been normally performed to study the performance of different parts of the grid in the context of, for example, voltage and frequency control. Software tools, such as PSCAD, PSSE, and PowerFactory DIgSILENT, have been developed to perform these analyses accurately. Distribution grid had been the passive part of the grid and had been known as the grid of consumers. However, a significant paradigm shift has happened with the emergence of Distributed Energy Resources (DERs) in the distribution level. It means that the concept of power system analysis needs to be extended to the distribution grid, especially considering self sufficient technologies such as microgrids. Compared to the generation and transmission levels, the distribution level includes significantly more generation/consumption nodes thanks to PV rooftop solar generation and battery energy storage systems. In addition, different consumption profile is expected from household residents resulting in a diverse set of scenarios. Emergence of electric vehicles will absolutely make the environment more complicated considering their charging (and possibly discharging) requirements. These complexities, as well as the large size of distribution grids, create challenges for the available power system analysis software. In this paper, we study the requirements of simulation tools in the distribution grid and how data-driven algorithms are required to increase the accuracy of the simulation results.

Keywords: smart grids, distributed energy resources, electric vehicles, battery storage systsms, simulation tools

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9817 Growth Performance, Survival Rate and Feed Efficacy of Climbing Perch, Anabas testudineus, Feed Experimental Diet with Several Dosages of Papain Enzyme

Authors: Zainal A. Muchlisin, Muhammad Iqbal, Abdullah A. Muhammadar

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The objective of the present study was to determine the optimum dose of papain enzyme in the diet for growing, survival rate and feed efficacy of climbing perch (Anabas testudineus). The study was conducted at the Laboratory of Aquatic of Faculty of Veterinary, Syiah Kuala University from January to March 2016. The completely randomized design was used in this study. Six dosages level of papain enzyme were tested with 4 replications i.e. 0 g kg-1 of feed, 20.0 g kg-1 feed, 22.5 g kg-1 of feed, 25.0 g kg-1 of feed, 27.5 g kg-1 of feed, and 30.0 g kg-1 of feed. The experimental fish fed twice a day at feeding level of 5% for 60 days. The results showed that weight gain ranged from 2.41g to 7.37g, total length gain ranged from 0.67cm to 3.17cm, specific growth rate ranged from 1.46 % day to 3.41% day, daily growth rate ranged from 0.04 g day to 0.13 g day, feed conversion ratio ranged from 1.94 to 3.59, feed efficiency ranged from 27.99% to 51.37%, protein retention ranged from 3.38% to 28.28%, protein digestibility ranged from 50.63% to 90.38%, and survival rate ranged from 88.89% to 100%. The highest rate for all parameters was found in the dosage of 3.00% papain enzyme kg feed. The ANOVA test showed that enzyme papain gave a significant effect on the weight gain, total length gain, daily growth rate, specific growth rate, feed conversion ratio, feed efficiency, protein retention, protein digestibility, and survival rate of the climbing perch (Anabas testudieus). The best enzyme papain dosage was 3.0%.

Keywords: betok, feed conversion ratio, freshwater fish, nutrition, feeding

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9816 COVID-19 Detection from Computed Tomography Images Using UNet Segmentation, Region Extraction, and Classification Pipeline

Authors: Kenan Morani, Esra Kaya Ayana

Abstract:

This study aimed to develop a novel pipeline for COVID-19 detection using a large and rigorously annotated database of computed tomography (CT) images. The pipeline consists of UNet-based segmentation, lung extraction, and a classification part, with the addition of optional slice removal techniques following the segmentation part. In this work, a batch normalization was added to the original UNet model to produce lighter and better localization, which is then utilized to build a full pipeline for COVID-19 diagnosis. To evaluate the effectiveness of the proposed pipeline, various segmentation methods were compared in terms of their performance and complexity. The proposed segmentation method with batch normalization outperformed traditional methods and other alternatives, resulting in a higher dice score on a publicly available dataset. Moreover, at the slice level, the proposed pipeline demonstrated high validation accuracy, indicating the efficiency of predicting 2D slices. At the patient level, the full approach exhibited higher validation accuracy and macro F1 score compared to other alternatives, surpassing the baseline. The classification component of the proposed pipeline utilizes a convolutional neural network (CNN) to make final diagnosis decisions. The COV19-CT-DB dataset, which contains a large number of CT scans with various types of slices and rigorously annotated for COVID-19 detection, was utilized for classification. The proposed pipeline outperformed many other alternatives on the dataset.

Keywords: classification, computed tomography, lung extraction, macro F1 score, UNet segmentation

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9815 Hydro-Climatological, Geological, Hydrogeological and Geochemical Study of the Coastal Aquifer System of Chiba Watershed (Cape Bon Peninsula)

Authors: Khawla Askri, Mohamed Haythem Msaddek, AbdelAziz Sebei

Abstract:

Climate change combined with the increase in anthropogenic activities will affect coastal groundwater systems around the world and, more particularly, the Cap Bon region in the North East of Tunisia. This study aims to study the impact of climate change and human stress on the salinization and quantification of groundwater in the Wadi Chiba watershed. In this regard, a hydro-climatological study and a hydrogeological study were carried out based on the characterization of the aquifer system of the eastern coast at the level of the watershed of Wadi Chiba in order to seek to identify, first of all, the degradation of the state of the aquifer on the quantitative level by the study of the piezometric and its evolution over time. Secondly, we sought to identify the degradation of the state of the aquifer qualitatively by using the geochemical method, in particular the major elements, to assess the mineralization of the aquifer water and understand its hydrogeochemical functioning. The study of the Na + / Cl- and Ca2 + / Mg2 + chemical relationships confirmed the presence of a marine intrusion downstream of the Wadi Chiba watershed northeast of Cap-Bon accompanied by a piezometric depression. For this purpose, we proceeded to: 1) Mapping of both piezometric data and salinity. 2) The interpretation of the mapping results. 3)Identification of the origin of the localized deterioration in the quality of the aquifer water. Finally, the analysis of the results showed that the scarcity of water is already forcing human actions in the Chiba watershed due to the irrigation of agricultural lands and the overexploitation of the water table in the study area.

Keywords: climate change, human activities, water table, Wadi Chiba watershed, piezometric depression, marine intrusion

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9814 Low-Cost Monitoring System for Hydroponic Urban Vertical Farms

Authors: Francesco Ruscio, Paolo Paoletti, Jens Thomas, Paul Myers, Sebastiano Fichera

Abstract:

This paper presents the development of a low-cost monitoring system for a hydroponic urban vertical farm, enabling its automation and a quantitative assessment of the farm performance. Urban farming has seen increasing interest in the last decade thanks to the development of energy efficient and affordable LED lights; however, the optimal configuration of such systems (i.e. amount of nutrients, light-on time, ambient temperature etc.) is mostly based on the farmers’ experience and empirical guidelines. Moreover, even if simple, the maintenance of such systems is labor intensive as it requires water to be topped-up periodically, mixing of the nutrients etc. To unlock the full potential of urban farming, a quantitative understanding of the role that each variable plays in the growth of the plants is needed, together with a higher degree of automation. The low-cost monitoring system proposed in this paper is a step toward filling this knowledge and technological gap, as it enables collection of sensor data related to water and air temperature, water level, humidity, pressure, light intensity, pH and electric conductivity without requiring any human intervention. More sensors and actuators can also easily be added thanks to the modular design of the proposed platform. Data can be accessed remotely via a simple web interface. The proposed platform can be used both for quantitatively optimizing the setup of the farms and for automating some of the most labor-intensive maintenance activities. Moreover, such monitoring system can also potentially be used for high-level decision making, once enough data are collected.

Keywords: automation, hydroponics, internet of things, monitoring system, urban farming

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9813 Design an Assessment Model of Research and Development Capabilities with the New Product Development Approach: A Case Study of Iran Khodro Company

Authors: Hamid Hanifi, Adel Azar, Alireza Booshehri

Abstract:

In order to know about the capability level of R & D units in automotive industry, it is essential that organizations always compare themselves with standard level and higher than themselves so that to be improved continuously. In this research, with respect to the importance of this issue, we have tried to present an assessment model for R & D capabilities having reviewed on new products development in automotive industry of Iran. Iran Khodro Company was selected for the case study. To this purpose, first, having a review on the literature, about 200 indicators effective in R & D capabilities and new products development were extracted. Then, of these numbers, 29 indicators which were more important were selected by industry and academia experts and the questionnaire was distributed among statistical population. Statistical population was consisted of 410 individuals in Iran Khodro Company. We used the 410 questionnaires for exploratory factor analysis and then used the data of 308 questionnaires from the same population randomly for confirmatory factor analysis. The results of exploratory factor analysis led to categorization of dimensions in 9 secondary dimensions. Naming the dimensions was done according to a literature review and the professors’ opinion. Using structural equation modeling and AMOS software, confirmatory factor analysis was conducted and ultimate model with 9 secondary dimensions was confirmed. Meanwhile, 9 secondary dimensions of this research are as follows: 1) Research and design capability, 2) Customer and market capability, 3) Technology capability, 4) Financial resources capability, 5) Organizational chart, 6) Intellectual capital capability, 7) NPD process capability, 8) Managerial capability and 9) Strategy capability.

Keywords: research and development, new products development, structural equations, exploratory factor analysis, confirmatory factor analysis

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9812 Experimental Investigation of Mechanical Friction Influence in Semi-Hydraulic Clutch Actuation System Over Mileage

Authors: Abdul Azarrudin M. A., Pothiraj K., Kandasamy Satish

Abstract:

In the current automobile scenario, there comes a demand on more sophistication and comfort drive feel on passenger segments. The clutch pedal effort is one such customer touch feels in manual transmission vehicles, where the driver continuous to operate the clutch pedal in his entire the driving maneuvers. Hence optimum pedal efforts at green condition and over mileage to be ensured for fatigue free the driving. As friction is one the predominant factor and its tendency to challenge the technicality by causing the function degradation. One such semi-hydraulic systems shows load efficiency of about 70-75% over lifetime only due to the increase in friction which leads to the increase in pedal effort and cause fatigue to the vehicle driver. This work deals with the study of friction with different interfaces and its influence in the fulcrum points over mileage, with the objective of understanding the trend over mileage and determining the alternative ways of resolving it. In that one way of methodology is the reduction of friction by experimental investigation of various friction reduction interfaces like metal-to-metal interface and it has been tried out and is detailed further. Also, the specific attention has been put up considering the fulcrum load and its contact interfaces to move on with this study. The main results of the experimental data with the influence of three different contact interfaces are being presented with an ultimate intention of ending up into less fatigue with longer consistent pedal effort, thus smoothens the operation of the end user. The Experimental validation also has been done through rig-level test setup to depict the performance at static condition and in-parallel vehicle level test has also been performed to record the additional influences if any.

Keywords: automobile, clutch, friction, fork

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9811 The Effect of Melatonin on Acute Liver Injury: Implication to Shift Work Related Sleep Deprivation

Authors: Bing-Fang Lee, Srinivasan Periasamy, Ming-Yie Liu

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Shift work sleep disorder is a common problem in industrialized world. It is a type of circadian rhythmic sleep disorders characterized by insomnia and sleep deprivation. Lack of sleep in workers may lead to poor health conditions such as hepatic dysfunction. Melatonin is a hormone secreted by the pineal gland to alleviate insomnia. Moreover, it is a powerful antioxidant and may prevent acute liver injury. Therefore, workers take in melatonin to deal with sleep-related health is an important issue. The aim of this study was to investigate the effect of melatonin on an acute hepatic injury model sinusoidal obstruction syndrome (SOS) in mice. Male C57BL/6 mice were injected with a single dose (500 mg/kg) of monocrotaline (MCT) to induce SOS. Melatonin (1, 3, 10 and 30 mg/kg) was injected 1 h before MCT treatment. After 24 h of MCT treatment, mice were sacrificed. The blood and liver were collected. Organ damage was evaluated by serum biochemistry, hematology analyzer, and histological examination. Low doses of melatonin (1 and 3 mg/kg) had no protective effect on SOS. However, high doses (10 and 30 mg/kg) exacerbated SOS. In addition, it not only increased serum glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT) and extended liver damage indicated by histological examination but also decreased platelet levels, lymphocyte ratio, and glutathione level; it had no effect on malondialdehyde and nitric oxide level in SOS mice. To conclude, melatonin may exacerbate MCT-induced SOS in mice. Furthermore, melatonin might have a synergistic action with SOS. Usage of melatonin for insomnia by people working in long shift must be cautioned; it might cause acute hepatic injury.

Keywords: acute liver injury, melatonin, shift work, sleep deprivation

Procedia PDF Downloads 195
9810 Examining the Relations among Autobiographical Memory Recall Types, Quality of Descriptions, and Emotional Arousal in Psychotherapy for Depression

Authors: Jinny Hong, Jeanne C. Watson

Abstract:

Three types of autobiographical memory recall -specific, episodic, and generic- were examined in relation to the quality of descriptions and in-session levels of emotional arousal. Correlational analyses and general estimating equation were conducted to test the relationships between 1) quality of descriptions and type of memory, 2) type of memory and emotional arousal, and 3) quality of descriptions and emotional arousal. The data was transcripts drawn from an archival randomized-control study comparing cognitive-behavioral therapy and emotion-focused therapy in a 16-week treatment for depression. Autobiographical memory recall segments were identified and sorted into three categories: specific, episodic, and generic. Quality of descriptions of these segments was then operationalized and measured using the Referential Activity Scale, and each memory segment was rated on four dimensions: concreteness, specificity, clarity, and overall imagery. Clients’ level of emotional arousal for each recall was measured using the Client’s Expression Emotion Scale. Contrary to the predictions, generic memories are associated with higher emotional arousal ratings and descriptive language ratings compared to specific memories. However, a positive relationship emerged between the quality of descriptions and expressed emotional arousal, indicating that the quality of descriptions in which memories are described in sessions is more important than the type of memory recalled in predicting clients’ level of emotional arousal. The results from this study provide a clearer understanding of the role of memory recall types and use of language in activating emotional arousal in psychotherapy sessions in a depressed sample.

Keywords: autobiographical memory recall, emotional arousal, psychotherapy for depression, quality of descriptions, referential activity

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9809 Radiation Annealing of Radiation Embrittlement of the Reactor Pressure Vessel

Authors: E. A. Krasikov

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Influence of neutron irradiation on RPV steel degradation are examined with reference to the possible reasons of the substantial experimental data scatter and furthermore – nonstandard (non-monotonous) and oscillatory embrittlement behavior. In our glance, this phenomenon may be explained by presence of the wavelike component in the embrittlement kinetics. We suppose that the main factor affecting steel anomalous embrittlement is fast neutron intensity (dose rate or flux), flux effect manifestation depends on state-of-the-art fluence level. At low fluencies, radiation degradation has to exceed normative value, then approaches to normative meaning and finally became sub normative. Data on radiation damage change including through the ex-service RPVs taking into account chemical factor, fast neutron fluence and neutron flux were obtained and analyzed. In our opinion, controversy in the estimation on neutron flux on radiation degradation impact may be explained by presence of the wavelike component in the embrittlement kinetics. Therefore, flux effect manifestation depends on fluence level. At low fluencies, radiation degradation has to exceed normative value, then approaches to normative meaning and finally became sub normative. Moreover as a hypothesis we suppose that at some stages of irradiation damaged metal have to be partially restored by irradiation i.e. neutron bombardment. Nascent during irradiation structure undergo occurring once or periodically transformation in a direction both degradation and recovery of the initial properties. According to our hypothesis, at some stage(s) of metal structure degradation neutron bombardment became recovering factor. As a result, oscillation arises that in turn leads to enhanced data scatter.

Keywords: annealing, embrittlement, radiation, RPV steel

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9808 Reception Class Practitioners' Understandings on the Role of Teaching Assistants, in Particular Supporting Children in Mathematics

Authors: Nursel Bektas

Abstract:

The purpose of this study is to investigate the roles of teaching assistants (TAs) working in reception classes through practitioners’ perspectives. The study has two major purposes; firstly to explore the general roles of TAs, and secondly to identify their roles in supporting children for mathematics. A small-scale case study approach was adopted for this study. The research was carried out in two reception classes within a primary school in London. The qualitative data were gathered through observations and semi-structured interviews with four reception class practitioners, comprising two teachers and two TAs. The results show that TAs consider their role to be more like a teacher, whereas classroom teachers do not corroborate this and they generally believe that the role of TAs depends on their personal characteristics and skills. In regard to the general role of TAs, the study suggests that reception class TAs are deployed both at the classroom level to provide academic support for children’s learning and development, and at the school level they are deployed as support staff such as Midday Meal Supervisor or assistants. In terms of the pedagogical roles of TAs, it was found that TAs have a strong teaching role in literacy development, with notable autonomy if conducting their own phonics sessions without teacher direction, but a negligible influence in numeracy/ math’s. In addition, the results show that the TA role is perceived to be quite limited in planning and assessment processes. Linked to their limited roles in such processes, all participants agree that all the responsibility regarding the children’s learning and development, planning and assessment lies with the teacher. Therefore, data suggest that TAs’ roles in these areas depend on TAs’ their own initiatives.

Keywords: early years education, reception classes, roles, teaching assistants

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9807 Potential Therapeutic Effect of Obestatin in Oral Mucositis

Authors: Agnieszka Stempniewicz, Piotr Ceranowicz, Wojciech Macyk, Jakub Cieszkowski, Beata Kuśnierz-Cabała, Katarzyna Gałązka, Zygmunt Warzecha

Abstract:

Objectives: There are numerous strategies for the prevention or treatment of oral mucositis. However, their effectiveness is limited and does not correspond to expectations. Recent studies have shown that obestatin exhibits a protective effect and accelerates the healing of gastrointestinal mucosa. The aim of the present study was to examine the influence of obestatin administration on oral ulcers in rats. Methods: lingual ulcers were induced by the use of acetic acid. Rats were treated twice a day intraperitoneally with saline or obestatin(4, 8, or 16 nmol/kg/dose) for five days. The study determined: lingual mucosa morphology, cell proliferation, mucosal blood flow, and mucosal pro-inflammatory interleukin-1β level(IL-1β). Results: In animals without induction of oral ulcers, treatment with obestatin was without any effect. Obestatin administration in rats with lingual ulcers increased the healing rate of these ulcers. Obestatin given at the dose of 8 or 16 nmol/kg/dose caused the strongest and similar therapeutic effect. This result was associated with a significant increase in blood flow and cell proliferation in gingival mucosa, as well as a significant decrease in IL-1β level. Conclusions: Obestatin accelerates the healing of lingual ulcers in rats. This therapeutic effect is well-correlated with an increase in blood flow and cell proliferation in oral mucosa, as well as a decrease in pro-inflammatory IL-1β levels. Obestatin is a potentially useful candidate for the prevention and treatment of oral mucositis. Acknowledgment: Agnieszka Stempniewicz acknowledges the support of InterDokMed project no. POWR.03.02.00- 00-I013/16.

Keywords: oral mucositis, ulcers, obestatin, lingual mucosa

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9806 Downtime Modelling for the Post-Earthquake Building Assessment Phase

Authors: S. Khakurel, R. P. Dhakal, T. Z. Yeow

Abstract:

Downtime is one of the major sources (alongside damage and injury/death) of financial loss incurred by a structure in an earthquake. The length of downtime associated with a building after an earthquake varies depending on the time taken for the reaction (to the earthquake), decision (on the future course of action) and execution (of the decided course of action) phases. Post-earthquake assessment of buildings is a key step in the decision making process to decide the appropriate safety placarding as well as to decide whether a damaged building is to be repaired or demolished. The aim of the present study is to develop a model to quantify downtime associated with the post-earthquake building-assessment phase in terms of two parameters; i) duration of the different assessment phase; and ii) probability of different colour tagging. Post-earthquake assessment of buildings includes three stages; Level 1 Rapid Assessment including a fast external inspection shortly after the earthquake, Level 2 Rapid Assessment including a visit inside the building and Detailed Engineering Evaluation (if needed). In this study, the durations of all three assessment phases are first estimated from the total number of damaged buildings, total number of available engineers and the average time needed for assessing each building. Then, probability of different tag colours is computed from the 2010-11 Canterbury earthquake Sequence database. Finally, a downtime model for the post-earthquake building inspection phase is proposed based on the estimated phase length and probability of tag colours. This model is expected to be used for rapid estimation of seismic downtime within the Loss Optimisation Seismic Design (LOSD) framework.

Keywords: assessment, downtime, LOSD, Loss Optimisation Seismic Design, phase length, tag color

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9805 The Relationship between Land Use Factors and Feeling of Happiness at the Neighbourhood Level

Authors: M. Moeinaddini, Z. Asadi-Shekari, Z. Sultan, M. Zaly Shah

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Happiness can be related to everything that can provide a feeling of satisfaction or pleasure. This study tries to consider the relationship between land use factors and feeling of happiness at the neighbourhood level. Land use variables (beautiful and attractive neighbourhood design, availability and quality of shopping centres, sufficient recreational spaces and facilities, and sufficient daily service centres) are used as independent variables and the happiness score is used as the dependent variable in this study. In addition to the land use variables, socio-economic factors (gender, race, marital status, employment status, education, and income) are also considered as independent variables. This study uses the Oxford happiness questionnaire to estimate happiness score of more than 300 people living in six neighbourhoods. The neighbourhoods are selected randomly from Skudai neighbourhoods in Johor, Malaysia. The land use data were obtained by adding related questions to the Oxford happiness questionnaire. The strength of the relationship in this study is found using generalised linear modelling (GLM). The findings of this research indicate that increase in happiness feeling is correlated with an increasing income, more beautiful and attractive neighbourhood design, sufficient shopping centres, recreational spaces, and daily service centres. The results show that all land use factors in this study have significant relationship with happiness but only income, among socio-economic factors, can affect happiness significantly. Therefore, land use factors can affect happiness in Skudai more than socio-economic factors.

Keywords: neighbourhood land use, neighbourhood design, happiness, socio-economic factors, generalised linear modelling

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9804 Serum Neurotrophins in Different Metabolic Types of Obesity

Authors: Irina M. Kolesnikova, Andrey M. Gaponov, Sergey A. Roumiantsev, Tatiana V. Grigoryeva, Alexander V. Laikov, Alexander V. Shestopalov

Abstract:

Background. Neuropathy is a common complication of obesity. In this regard, the content of neurotrophins in such patients is of particular interest. Neurotrophins are the proteins that regulate neuron survival and neuroplasticity and include brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). However, the risk of complications depends on the metabolic type of obesity. Metabolically unhealthy obesity (MUHO) is associated with a high risk of complications, while this is not the case with metabolically healthy obesity (MHO). Therefore, the aim of our work was to study the effect of the obesity metabolic type on serum neurotrophins levels. Patients, materials, methods. The study included 134 healthy donors and 104 obese patients. Depending on the metabolic type of obesity, the obese patients were divided into subgroups with MHO (n=40) and MUHO (n=55). In the blood serum, the concentration of BDNF and NGF was determined. In addition, the content of adipokines (leptin, asprosin, resistin, adiponectin), myokines (irisin, myostatin, osteocrin), indicators of carbohydrate, and lipid metabolism were measured. Correlation analysis revealed the relationship between the studied parameters. Results. We found that serum BDNF concentration was not different between obese patients and healthy donors, regardless of obesity metabolic type. At the same time, in obese patients, there was a decrease in serum NGF level versus control. A similar trend was characteristic of both MHO and MUHO. However, MUHO patients had a higher NGF level than MHO patients. The literature indicates that obesity is associated with an increase in the plasma concentration of NGF. It can be assumed that in obesity, there is a violation of NGF storage in platelets, which accelerates neurotrophin degradation. We found that BDNF concentration correlated with irisin levels in MUHO patients. Healthy donors had a weak association between NGF and VEGF levels. No such association was found in obese patients, but there was an association between NGF and leptin concentrations. In MHO, the concentration of NHF correlated with the content of leptin, irisin, osteocrin, insulin, and the HOMA-IR index. But in MUHO patients, we found only the relationship between NGF and adipokines (leptin, asprosin). It can be assumed that in patients with MHO, the replenishment of serum NGF occurs under the influence of muscle and adipose tissue. In the MUHO patients only the effect of adipose tissue on NGF was observed. Conclusion. Obesity, regardless of metabolic type, is associated with a decrease in serum NGF concentration. We showed that muscle and adipose tissues make a significant contribution to the serum NGF pool in the MHO patients. In MUHO there is no effect of muscle on the NGF level, but the effect of adipose tissue remains.

Keywords: neurotrophins, nerve growth factor, NGF, brain-derived neurotrophic factor, BDNF, obesity, metabolically healthy obesity, metabolically unhealthy obesity

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9803 Non-Melanoma Skin Cancer of Cephalic Extremity – Clinical and Histological Aspects

Authors: Razvan Mercut, Mihaela Ionescu, Vlad Parvanescu, Razvan Ghita, Tudor-Gabriel Caragea, Cristina Simionescu, Marius-Eugen Ciurea

Abstract:

Introduction: Over the past years, the incidence of non-melanoma skin cancer (NMSC) has continuously increased, being one of the most commonly diagnosed carcinomasofthe cephalic extremity. NMSC regroups basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Merkel cell carcinoma, cutaneous lymphoma, and sarcoma. The most common forms are BCC and SCC, both still implying a significant level of morbidity due to local invasion (especially BCC), even if the overall death rates are declining. The objective of our study was the evaluation of clinical and histological aspects of NMSC for a group of patients with BCC and SCC, from Craiova, a south-western major city in Romania. Materialand method: Our study lot comprised 65 patients, with an almost equal distribution of sexes, and ages between 23-91 years old (mean value±standard deviation62.61±16.67), all treated within the Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency County Hospital Craiova, Romania, between 2019-2020. In order to determine the main morphological characteristics of both studied cancers, we used paraffin embedding techniques, with various staining methods:hematoxylin-eosin, Masson's trichrome stain with aniline blue, and Periodic acid-schiffAlcian Blue. The statistical study was completed using Microsoft Excel (Microsoft Corp., Redmond, WA, USA), with XLSTAT (Addinsoft SARL, Paris, France). Results: The overall results of our study indicate that BCC accounts for 67.69% of all NMSC forms; SCC covers 27.69%, while 4.62% are representedby other forms. The most frequent site is the nose for BCC (27.69%, 18 patients), being followed by preauricular regions, forehead, and periorbital areas. For patients with SCC, tumors were mainly located at lips level (66.67%, 12 patients). The analysis of NMSC histological forms indicated that nodular BCC is predominant (45.45%, 20 patients), as well as ulcero-vegetant SCC (38.89%, 7 patients). We have not identified any topographic characteristics or NMSC forms significantly related to age or sex. Conclusions: The most frequent NMSC form identified for our study lot was BCC. The preferred location was the nose for BCC. For SCC, the oral cavity is the most frequent anatomical site, especially the lips level. Nodular BCC and ulcero-vegetant SCC were the most commonly identified histological types. Our findings emphasize the need for periodic screening, in order to improve prevention and early treatment for these malignancies.

Keywords: non-melanoma skin cancer, basal cell carcinoma, squamous cell carcinoma, histological

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9802 Spatio-Temporal Dynamic of Woody Vegetation Assessment Using Oblique Landscape Photographs

Authors: V. V. Fomin, A. P. Mikhailovich, E. M. Agapitov, V. E. Rogachev, E. A. Kostousova, E. S. Perekhodova

Abstract:

Ground-level landscape photos can be used as a source of objective data on woody vegetation and vegetation dynamics. We proposed a method for processing, analyzing, and presenting ground photographs, which has the following advantages: 1) researcher has to form holistic representation of the study area in form of a set of interlapping ground-level landscape photographs; 2) it is necessary to define or obtain characteristics of the landscape, objects, and phenomena present on the photographs; 3) it is necessary to create new or supplement existing textual descriptions and annotations for the ground-level landscape photographs; 4) single or multiple ground-level landscape photographs can be used to develop specialized geoinformation layers, schematic maps or thematic maps; 5) it is necessary to determine quantitative data that describes both images as a whole, and displayed objects and phenomena, using algorithms for automated image analysis. It is suggested to match each photo with a polygonal geoinformation layer, which is a sector consisting of areas corresponding with parts of the landscape visible in the photos. Calculation of visibility areas is performed in a geoinformation system within a sector using a digital model of a study area relief and visibility analysis functions. Superposition of the visibility sectors corresponding with various camera viewpoints allows matching landscape photos with each other to create a complete and wholesome representation of the space in question. It is suggested to user-defined data or phenomenons on the images with the following superposition over the visibility sector in the form of map symbols. The technology of geoinformation layers’ spatial superposition over the visibility sector creates opportunities for image geotagging using quantitative data obtained from raster or vector layers within the sector with the ability to generate annotations in natural language. The proposed method has proven itself well for relatively open and clearly visible areas with well-defined relief, for example, in mountainous areas in the treeline ecotone. When the polygonal layers of visibility sectors for a large number of different points of photography are topologically superimposed, a layer of visibility of sections of the entire study area is formed, which is displayed in the photographs. Also, as a result of this overlapping of sectors, areas that did not appear in the photo will be assessed as gaps. According to the results of this procedure, it becomes possible to obtain information about the photos that display a specific area and from which points of photography it is visible. This information may be obtained either as a query on the map or as a query for the attribute table of the layer. The method was tested using repeated photos taken from forty camera viewpoints located on Ray-Iz mountain massif (Polar Urals, Russia) from 1960 until 2023. It has been successfully used in combination with other ground-based and remote sensing methods of studying the climate-driven dynamics of woody vegetation in the Polar Urals. Acknowledgment: This research was collaboratively funded by the Russian Ministry for Science and Education project No. FEUG-2023-0002 (image representation) and Russian Science Foundation project No. 24-24-00235 (automated textual description).

Keywords: woody, vegetation, repeated, photographs

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9801 Relationship Between Upper Extremity Erectile Abnormalities with Quality of Life Factors and Physical Self-concept in Boy Students 7 to 10 Years

Authors: Nadiya Zahra Karimi, Amir Ghiami Rad

Abstract:

The physical health of students from an early age and the proper formation of the musculoskeletal system of their body is part of the overall health of these people. Most chronic musculoskeletal problems and pains can be controlled and reduced with education at an early age. Therefore, with the correct and timely diagnosis of these abnormalities, we can play an important role in their proper treatment and control, and in a way, raise the level of quality of life and positive self-concept in students. The aim of this study was to investigate the relationship between erectile dysfunctions of the upper limbs (head and neck, shoulder, thoracic and lumbar) and the quality of life and self-concept of male students aged 7 to 10 years. The statical population of the study consists of 227 students of shahadat boys’ primary school in khajeh city. Due to the corona pandemic conditions, the research samples were identified after screening and available according to the entrance criteria of the study. To validate the quality of life, the valid WHOQOL-BREF questionnaire will be used for self-concept variables, Dolatabadi, Fatemeh (2007) questionnaire, and for physical screening, a checkerboard, plumb line, and flexible ruler will be used. There is a negative and significant relationship between the dimensions of upper limb anomalies and quality of life factors, and also there is a negative and significant relationship between the dimensions of upper limb anomalies and self-concept factors. The results showed that there is a negative and significant relationship between head and neck abnormalities with quality of life and self-concept factors, with a significance level of less than 0.05 in male students aged 7 to 10 years.

Keywords: upper limb erectile dysfunction, quality of life, self-concept, erectile abnormalities

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9800 Sexual Behaviors and Its Predictors among Iranian Women in Iran: A Cross-Sectional Study

Authors: Zahra Karimian, Effat Merghati Khoei, Raziyeh Maasoumi

Abstract:

Background: Women's sexual well-being is center of focus in the field of sexology. Study of sexual behavior and investigating its predictors is important in women's health promotion. Objectives: This study aimed to explore the components of sexual behaviors and their possible associations with the women's demographic. Methods: A National Sexual Behavior Assessment Questionnaire was administered to 500 women ages 15 to 45 who referred to the public health centers seeking for health care services. The associations with demographic were examined. Results: From all participant, 31.8% of women obtain high score in the sexual capacity 21.2% in sexual motivation and 0.2% in sexual function. In sexual script component, 86.2% of women were holding traditional beliefs toward sexual behaviors; the majority (91.5%) of women believed in mutual and relational sexuality, 83.4% believed in androcentricity (male-dominated sexuality). Pearson correlation test showed significant positive correlations between sexual capacity, motivation, function and sexual script (p < 0.05). Regression model showed that sexual capacity is associated with women's education, age of her spouse. Sexual function and sexual motivation were significantly associated with the age of subjects' spouses. Conclusion: In this study, lower score was found in sexual performance while women were scored higher in the sexual capacity and motivation. We argue that these lower score in sexual performance more likely is due to the level of participants' religiosity and formation of their sexuality through an androcentric culture. Women's level of education and the spouse age appear to be predicting factors in the scores the subjects gained. We suggest that gender-specific and culturally sensitive sexuality education should be focus of women's health programs in Iran.

Keywords: sexual behaviors, women, health, Iran

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9799 Foreign Direct Investment on Economic Growth by Industries in Central and Eastern European Countries

Authors: Shorena Pharjiani

Abstract:

The Present empirical paper investigates the relationship between FDI and economic growth by 10 selected industries in 10 Central and Eastern European countries from the period 1995 to 2012. Different estimation approaches were used to explore the connection between FDI and economic growth, for example OLS, RE, FE with and without time dummies. Obtained empirical results leads to some main consequences: First, the Central and East European countries (CEEC) attracted foreign direct investment, which raised the productivity of industries they entered in. It should be concluded that the linkage between FDI and output growth by industries is positive and significant enough to suggest that foreign firm’s participation enhanced the productivity of the industries they occupied. There had been an endogeneity problem in the regression and fixed effects estimation approach was used which partially corrected the regression analysis in order to make the results less biased. Second, it should be stressed that the results show that time has an important role in making FDI operational for enhancing output growth by industries via total factor productivity. Third, R&D positively affected economic growth and at the same time, it should take some time for research and development to influence economic growth. Fourth, the general trends masked crucial differences at the country level: over the last 20 years, the analysis of the tables and figures at the country level show that the main recipients of FDI of the 11 Central and Eastern European countries were Hungary, Poland and the Czech Republic. The main reason was that these countries had more open door policies for attracting the FDI. Fifth, according to the graphical analysis, while Hungary had the highest FDI inflow in this region, it was not reflected in the GDP growth as much as in other Central and Eastern European countries.

Keywords: central and East European countries (CEEC), economic growth, FDI, panel data

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9798 Function Study of IrMYB55 in Regulating Synthesis of Terpenoids in Isodon Rubescens

Authors: Qingfang Guo

Abstract:

Isodon rubescens is rich in a variety of terpenes such as oridonin. It has important medicinal value. MYB transcription factors are involved in the regulation of plant secondary metabolic pathways. The combined transcriptomics and metabolomics analysis revealed that IrMYB55 might be involved in the regulation of the synthesis of terpenes. The function of IrMYB55 was further verified by establishing of a genetic transformation system by CRISPR/Cas9. Obtaining a virus-mediated Isodon rubescens gene silencing material. The main research results are as follows: (1) Screening IrMYB which can regulate the synthesis of terpenes. Metabolomics and transcriptomics analyses of materials with high (TJ)-and low (FL)-content populations which revealed significant differences in terpene content and IrMYB55 expression. Correlation analysis showed that the expression level of IrMYB55 had a significant correlation with the content of terpenes. (2) Establishment of a genetic transformation system of Isodon rubescens. The IrPDS gene could be knocked out by injection of Isodon rubescens cotyledon, and the transformed material showed obvious albino phenotype. Subsequently, IrMYB55 conversion material was obtained by this method. (3) The IrMYB55 silencing material was obtained. Subcellular localization indicated that IrMYB55 was located in the nucleus, indicating that it might regulate the synthesis of terpenoids through transcription. In summary, IrMYB55 that may regulate the synthesis of oridonin was dug out from the transcriptome and metabolome data. In this study, a genetic transformation system of Isodon rubescens was successfully established. Further studies showed that IrMYB55 regulated the transcription level of genes related to the synthesis of terpenoids, thereby promoting the accumulation of oridonin.

Keywords: isodon rubescens, MYB, oridonin, CRISPR/Cas9

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9797 Simultaneous Detection of Dopamine and Uric Acid in the Presence of Ascorbic Acid at Physiological Level Using Anodized Multiwalled Carbon Nanotube–Poldimethylsiloxane Paste Electrode

Authors: Angelo Gabriel Buenaventura, Allan Christopher Yago

Abstract:

A carbon paste electrode (CPE) composed of Multiwalled Carbon Nanotube (MWCNT) conducting particle and Polydimethylsiloxane (PDMS) binder was used for simultaneous detection of Dopamine (DA) and Uric Acid (UA) in the presence of Ascorbic Acid (AA) at physiological level. The MWCNT-PDMS CPE was initially activated via potentiodynamic cycling in a basic (NaOH) solution, which resulted in enhanced electrochemical properties. Electrochemical Impedance Spectroscopy measurements revealed a significantly lower charge transfer resistance (Rct) for the OH--activated MWCNT-PDMS CPE (Rct = 5.08kΩ) as compared to buffer (pH 7)-activated MWCNT-PDMS CPE (Rct = 25.9kΩ). Reversibility analysis of Fe(CN)63-/4- redox couple of both Buffer-Activated CPE and OH--Activated CPE showed that the OH—Activated CPE have peak current ratio (Ia/Ic) of 1.11 at 100mV/s while 2.12 for the Buffer-Activated CPE; this showed an electrochemically reversible behavior for Fe(CN)63-/4- redox couple even at relatively fast scan rate using the OH--activated CPE. Enhanced voltammetric signal for DA and significant peak separation between DA and UA was obtained using the OH--activated MWCNT-PDMS CPE in the presence of 50 μM AA via Differential Pulse Voltammetry technique. The anodic peak currents which appeared at 0.263V and 0.414 V were linearly increasing with increasing concentrations of DA and UA, respectively. The linear ranges were obtained at 25 μM – 100 μM for both DA and UA. The detection limit was determined to be 3.86 μM for DA and 5.61 μM for UA. These results indicate a practical approach in the simultaneous detection of important bio-organic molecules using a simple CPE composed of MWCNT and PDMS with base anodization as activation technique.

Keywords: anodization, ascorbic acid, carbon paste electrodes, dopamine, uric acid

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9796 Polarisation in Latin America: Examining the Role of Social Media in Ideological Positioning Based on 2018 Census Data

Authors: Sarah Ledoux

Abstract:

This paper analyses the quantitative effects of political content consumption in social media platforms on self-reported ideological preference across the Latin American region. Initially praising the democratic potential of the internet and its social networking websites, digital politics scholars have transitioned their discourse to warning against the undemocratic side-effects it cultivates, such as hate speech, filter bubbles, and ideological polarisation. Holding technology solely responsible for political trends worldwide is an oversimplification of the factors influencing social change. Nonetheless, widespread use of social media in new democracies raises questions on the reproduction of recent trends that have been observed in the US and Western Europe. Through the analysis of ordered logistic regressions on data from the 2018 AmericasBarometer survey, this study examines the extent to which the relationship between the consumption of political content on social media is related to ideological polarisation in Latin America. The findings indicate that there is a close link between consumption of political information on social media, specifically on Facebook and WhatsApp, and ideological positioning on the extremes of the political left- and right-wings. This relation holds when controlling for individual-level demographic and attitudinal factors, as well as country-level effects. These results demonstrate with empirical evidence that viewing political content on social media has a significant positive effect on the likelihood that citizens position themselves on the extreme ends of the left-right ideological spectrum and implies that political polarisation is a phenomenon that accompanies politically driven social media use.

Keywords: Latin America, polarisation, political consumption, political ideology, social media, survey

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9795 School Partners in Initial Teacher Education: An Including or Excluding Approach When Engaging Schools

Authors: Laila Niklasson

Abstract:

The aim of the study is to critically discuss how partner schools are engaged during Initial teacher education, ITE. The background is an experiment in Sweden where the practicum organization is reorganized due to a need to enhance quality during practicum. It is a national initiative from the government, supported by the National Agency of Education and lasts 2014-2019. The main features are concentration of students to school with a certain amount of mentors, mentors who have a mentor education and teachers with relevant subject areas and where there could be a mentor team with a leader at the school. An expected outcome is for example that the student teachers should be engaged in peer-learning. The schools should be supported by extra lectures from university teachers during practicum and also extra research projects where the schools should be engaged. A case study of one university based ITE was carried out to explore the consequences for the schools not selected. The result showed that from engaging x schools in a region, x was engaged. The schools are both in urban and rural areas, mainly in the latter. There is also a tendency that private schools are not engaged. On a unit level recruitment is perceived as harder for schools not engaged. In addition they cannot market themselves as ´selected school´ which can affect parent´s selection of school for their children. Also, on unit level, but with consequences for professional development, they are not selected for research project and thereby are not fully supported during school development. The conclusion is that from an earlier inclusive approach concerning professions where all teachers were perceived as possible mentors, there is a change to an exclusive approach where selected schools and selected teachers should be engaged. The change could be perceived as a change in governance mentality, but also in how professions are perceived, and development work is pursued.

Keywords: initial teacher education, practicum schools, profession, quality development

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9794 A Randomised Simulation Study to Assess the Impact of a Focussed Crew Resource Management Course on UK Medical Students

Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

Abstract:

Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

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