Search results for: Thomas Hoffmann
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 458

Search results for: Thomas Hoffmann

128 Rheumatoid Arthritis, Periodontitis and the Subgingival Microbiome: A Circular Relationship

Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

Abstract:

Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

Procedia PDF Downloads 108
127 Mindfulness in a Secular Age: Framing and Contextualising the Conversation in the Irish Context

Authors: Thomas P. Carroll

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The phenomenon of mindfulness has become ever more popular in an increasingly pluralist Western society. Mindfulness practice has penetrated secular contexts that would otherwise be closed to religious influence, including state schools, hospitals, and commerce. The contemporary understanding of mindfulness has its origins in Buddhist meditation. However, since Jon Kabat-Zinn’s pioneering work in Mindfulness-Based Interventions, the concept has developed and sometimes mutated into various forms of practice which are disembedded from their original spiritual philosophy. This project will explore the spiritual climate within which mindfulness is currently flourishing through dialogue with three interlocutors. The first interlocutor is the Canadian philosopher Charles Taylor whose seminal work, ‘A Secular Age’, outlines three distinct modes of secularity. Taylor examines how the conditions of belief have changed and how the self seeks meaning in an age where belief in the divine is no longer axiomatic. The next interlocutor is Czech theologian and psychotherapist Tomáš Halík who offers a unique perspective of a Catholic who belongs to a section of society outnumbered by secular counterparts, with a theological hermeneutic best described as 'Den Fremden verstehen- understanding the stranger'. Finally, Irish theologian Michael Paul Gallagher offers a theological perspective on how the Christian faith can be translated into dialogue with Irish secular culture, as well as addressing the crisis of imagination and culture rather than the crisis of faith in Ireland. These interlocutors will illustrate that there are sometimes striking differences in how to interpret the religious signs of the times. However, these approaches also reveal significant similarities in how they address and explore the meaning of religious belief and experience today. In this way, themes will emerge that will help to frame the conversation about mindfulness in the West. These themes will include; the failure of the secularization thesis to pass, the growth of a diverse marketplace of religions and beliefs and the growth of a demographic who identify as spiritual but not religious. Such research is paramount in enabling a richer dialogue between Christian faith and mindfulness in a fragmented, postmodern Western context.

Keywords: culture, mindfulness, secularism, spirituality

Procedia PDF Downloads 113
126 Automatic Processing of Trauma-Related Visual Stimuli in Female Patients Suffering From Post-Traumatic Stress Disorder after Interpersonal Traumatization

Authors: Theresa Slump, Paula Neumeister, Katharina Feldker, Carina Y. Heitmann, Thomas Straube

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A characteristic feature of post-traumatic stress disorder (PTSD) is the automatic processing of disorder-specific stimuli that expresses itself in intrusive symptoms such as intense physical and psychological reactions to trauma-associated stimuli. That automatic processing plays an essential role in the development and maintenance of symptoms. The aim of our study was, therefore, to investigate the behavioral and neural correlates of automatic processing of trauma-related stimuli in PTSD. Although interpersonal traumatization is a form of traumatization that often occurs, it has not yet been sufficiently studied. That is why, in our study, we focused on patients suffering from interpersonal traumatization. While previous imaging studies on PTSD mainly used faces, words, or generally negative visual stimuli, our study presented complex trauma-related and neutral visual scenes. We examined 19 female subjects suffering from PTSD and examined 19 healthy women as a control group. All subjects did a geometric comparison task while lying in a functional-magnetic-resonance-imaging (fMRI) scanner. Trauma-related scenes and neutral visual scenes that were not relevant to the task were presented while the subjects were doing the task. Regarding the behavioral level, there were not any significant differences between the task performance of the two groups. Regarding the neural level, the PTSD patients showed significant hyperactivation of the hippocampus for task-irrelevant trauma-related stimuli versus neutral stimuli when compared with healthy control subjects. Connectivity analyses revealed altered connectivity between the hippocampus and other anxiety-related areas in PTSD patients, too. Overall, those findings suggest that fear-related areas are involved in PTSD patients' processing of trauma-related stimuli even if the stimuli that were used in the study were task-irrelevant.

Keywords: post-traumatic stress disorder, automatic processing, hippocampus, functional magnetic resonance imaging

Procedia PDF Downloads 199
125 The Influence of Ecologically -Valid High- and Low-Volume Resistance Training on Muscle Strength and Size in Trained Men

Authors: Jason Dellatolla, Scott Thomas

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Much of the current literature pertaining to resistance training (RT) volume prescription lacks ecological validity, and very few studies investigate true high-volume ranges. Purpose: The present study sought to investigate the effects of ecologically-valid high- vs low-volume RT on muscular size and strength in trained men. Methods: This study systematically randomized trained, college-aged men into two groups: low-volume (LV; n = 4) and high-volume (HV; n = 5). The sample size was affected by COVID-19 limitations. Subjects followed an ecologically-valid 6-week RT program targeting both muscle size and strength. RT occurred 3x/week on non-consecutive days. Over the course of six weeks, LVR and HVR gradually progressed from 15 to 23 sets/week and 30 to 46 sets/week of lower-body RT, respectively. Muscle strength was assessed via 3RM tests in the squat, stiff-leg deadlift (SL DL), and leg press. Muscle hypertrophy was evaluated through a combination of DXA, BodPod, and ultrasound (US) measurements. Results: Two-way repeated-measures ANOVAs indicated that strength in all 3 compound lifts increased significantly among both groups (p < 0.01); between-group differences only occurred in the squat (p = 0.02) and SL DL (p = 0.03), both of which favored HVR. Significant pre-to-post-study increases in indicators of hypertrophy were discovered for lean body mass in the legs via DXA, overall fat-free mass via BodPod, and US measures of muscle thickness (MT) for the rectus femoris, vastus intermedius, vastus medialis, vastus lateralis, long-head of the biceps femoris, and total MT. Between-group differences were only found for MT of the vastus medialis – favoring HVR. Moreover, each additional weekly set of lower-body RT was associated with an average increase in MT of 0.39% in the thigh muscles. Conclusion: We conclude that ecologically-valid RT regimens significantly improve muscular strength and indicators of hypertrophy. When HVR is compared to LVR, HVR provides significantly greater gains in muscular strength but has no greater effect on hypertrophy over the course of 6 weeks in trained, college-aged men.

Keywords: ecological validity, hypertrophy, resistance training, strength

Procedia PDF Downloads 114
124 The Seeds of Limitlessness: Dambudzo Marechera's Utopian Thinking

Authors: Emily S. M. Chow

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The word ‘utopia’ was coined by Thomas More in Utopia (1516). Its Greek roots ‘ou’ means ‘not’ and ‘topos’ means ‘place.’ In other words, it literally refers to ‘no-place.’ However, the possibility of having an alternative and better future society has always been appealing. In fact, at the core of every utopianism is the search for a future alternative state with the anticipation of a better life. Nonetheless, the practicalities of such ideas have never ceased to be questioned. At times, building a utopia presents itself as a divisive act. In addition to the violence that must be employed to sweep away the old regime in order to make space for the new, all utopias carry within them the potential for bringing catastrophic consequences to human life. After all, every utopia seeks to remodel the individual in a very particular way for the benefit of the masses. In this sense, utopian thinking has the potential both to create and destroy the future. While writing during a traumatic transitional period in Zimbabwe’s history, Dambudzo Marechera witnessed an age of upheavals in which different parties battled for power over Zimbabwe. Being aware of the fact that all institutionalized narratives, be they originated from the governance of the UK, Ian Smith’s white minority regime or Zimbabwe’s revolutionary parties, revealed themselves to be nothing more than fiction, Marechera realized the impossibility of determining reality absolutely. As such, this thesis concerns the writing of the Zimbabwean maverick, Dambudzo Marechera. It argues that Marechera writes a unique vision of utopia. In short, for Marechera utopia is not a static entity but a moment of perpetual change. He rethinks utopia in the sense that he phrases it as an event that ceaselessly contests institutionalized and naturalized narratives of a post-colonial self and its relationship to society. Marechera writes towards a vision of an alternative future of the country. Yet, it is a vision that does not constitute a fully rounded sense of utopia. Being cautious about the world and the operation of power upon the people, rather than imposing his own utopian ideals, Marechera chooses to instead peeling away the narrative constitution of the self in relation to society in order to turn towards a truly radical utopian thinking that empowers the individual.

Keywords: African literature, Marechera, post-colonial literature, utopian studies

Procedia PDF Downloads 413
123 Community Involvement and Willingness To Pay for Municipal Solid Waste Management Activities in Rapid Urbanized Region: A Case Study of Mnadani and Madukani Wards-Dodoma Urban

Authors: Isabela Thomas Mkude

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This research was done to assess how the community is involved in waste management activities and their willingness to pay for services. Mnadani and Madukani are among the old wards in Dodoma urban. These two areas are similar and face numerous environmental problems, poor solid waste management practices being among them. People realize problems because they live with them daily but the study advice that the only way to stay off problems is to find appropriate measures. The findings recognized some problems that led to poor community involvement solid waste management the study areas. Lack of community education on how to deal with solid wastes, poor responsibility of ward leaders in issues concerning the environment and in active participation of communities in environmental meeting are among other major problems found during the research. The research also revealed that there is low willingness to pay for waste collection among communities and financial problems that make environmental committee inactive; that leading to a poor disposal and unavailable collection facilities in urban area. Although the municipal improves disposal activities by increasing amount of waste to be disposed off by 11% in three years, the amount of waste that collected is also increasing by 41% each day. It is advised that some corrective measures need to be put in place so that the communities are well involved in managing solid wastes as the best way to attain achievement in keeping the urban free from solid waste. Environmental education dissemination to the communities is needed so that they become responsible and dedicated citizen on the environment. There should be some incentives from government to the wards local government and CBOs so that they can practically implement solid waste management programs and to attract formation of more groups and motivate the present groups. Capacity building programs to the ward leaders need to be given priority so that leaders are well organized and able to plan, coordinate and cooperate with various governmental institutions, and NGOs responsible for development and environmental management.

Keywords: solid waste, waste management, public involvement, rapid urbanized region

Procedia PDF Downloads 352
122 The h3r Antagonist E159 Alleviates Neuroinflammation and Autistic-Like Phenotypes in BTBR T+ tf/J Mouse Model of Autism

Authors: Shilu Deepa Thomas, P. Jayaprakash, Dorota Łazewska, Katarzyna Kieć-Kononowicz, B. Sadek

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A large body of evidence suggests the involvement of cognitive impairment, increased levels of inflammation and oxidative stress in the pathogenesis of autism spectrum disorder (ASD). ASD commonly coexists with psychiatric conditions like anxiety and cognitive challenges, and individuals with ASD exhibit significant levels of inflammation and immune system dysregulation. Previous Studies have identified elevated levels of pro-inflammatory markers such as IL-1β, IL-6, IL-2 and TNF-α, particularly in young children with ASD. The current therapeutic options for ASD show limited effectiveness, signifying the importance of exploring an efficient drugs to address the core symptoms. The role of histamine H3 receptors (H3Rs) in memory and the prospective role of H3R antagonists in pharmacological control of neurodegenerative disorders, e.g., ASD, is well-accepted. Hence, the effects of chronic systemic administration of H3R antagonist E159 on autistic-like repetitive behaviors, social deficits, memory and anxiety parameters, as well as neuroinflammation in Black and Tan BRachyury (BTBR) mice, were evaluated using Y maze, Barnes maze, self-grooming, open field and three chamber social test. E159 (2.5, 5 and 10 mg/kg, i.p.) dose-dependently ameliorated repetitive and compulsive behaviors by reducing the increased time spent in self-grooming and improved reduced spontaneous alternation in BTBR mice. Moreover, treatment with E159 attenuated disturbed anxiety levels and social deficits in tested male BTBR mice. Furthermore, E159 attenuated oxidative stress by significantly increasing GSH, CAT, and SOD and decreasing the increased levels of MDA in the cerebellum as well as the hippocampus. In addition, E159 decreased the elevated levels of proinflammatory cytokines (tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), and IL-6). The observed results show that H3R antagonists like E159 may represent a promising novel pharmacological strategy for the future treatment of ASD.

Keywords: histamine H3 receptors, antagonist E159, autism, behaviors, mice

Procedia PDF Downloads 65
121 Introduction of an Approach of Complex Virtual Devices to Achieve Device Interoperability in Smart Building Systems

Authors: Thomas Meier

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One of the major challenges for sustainable smart building systems is to support device interoperability, i.e. connecting sensor or actuator devices from different vendors, and present their functionality to the external applications. Furthermore, smart building systems are supposed to connect with devices that are not available yet, i.e. devices that become available on the market sometime later. It is of vital importance that a sustainable smart building platform provides an appropriate external interface that can be leveraged by external applications and smart services. An external platform interface must be stable and independent of specific devices and should support flexible and scalable usage scenarios. A typical approach applied in smart home systems is based on a generic device interface used within the smart building platform. Device functions, even of rather complex devices, are mapped to that generic base type interface by means of specific device drivers. Our new approach, presented in this work, extends that approach by using the smart building system’s rule engine to create complex virtual devices that can represent the most diverse properties of real devices. We examined and evaluated both approaches by means of a practical case study using a smart building system that we have developed. We show that the solution we present allows the highest degree of flexibility without affecting external application interface stability and scalability. In contrast to other systems our approach supports complex virtual device configuration on application layer (e.g. by administration users) instead of device configuration at platform layer (e.g. platform operators). Based on our work, we can show that our approach supports almost arbitrarily flexible use case scenarios without affecting the external application interface stability. However, the cost of this approach is additional appropriate configuration overhead and additional resource consumption at the IoT platform level that must be considered by platform operators. We conclude that the concept of complex virtual devices presented in this work can be applied to improve the usability and device interoperability of sustainable intelligent building systems significantly.

Keywords: Internet of Things, smart building, device interoperability, device integration, smart home

Procedia PDF Downloads 271
120 Overcoming Barriers to Improve HIV Education and Public Health Outcomes in the Democratic Republic of Congo

Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

Procedia PDF Downloads 274
119 Metallic and Semiconductor Thin Film and Nanoparticles for Novel Applications

Authors: Hanan. Al Chaghouri, Mohammad Azad Malik, P. John Thomas, Paul O’Brien

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The process of assembling metal nanoparticles at the interface of two liquids has received a great interest over the past few years due to a wide range of important applications and their unusual properties compared to bulk materials. We present a low cost, simple and cheap synthesis of metal nanoparticles, core/shell structures and semiconductors followed by assembly of these particles between immiscible liquids. The aim of this talk is divided to three parts: firstly, to describe the achievement of a closed loop recycling for producing cadmium sulphide as powders and/or nanostructured thin films for solar cells or other optoelectronic devices applications by using a different chain length of commercially available secondary amines of dithiocarbamato complexes. The approach can be extended to other metal sulphides such as those of Zn, Pb, Cu, or Fe and many transition metals and oxides. Secondly, to synthesis significantly cheaper magnetic particles suited for the mass market. Ni/NiO nanoparticles with ferromagnetic properties at room temperature were among the smallest and strongest magnets (5 nm) were made in solution. The applications of this work can be applied to produce viable storage devices and the other possibility is to disperse these nanocrystals in solution and use it to make ferro-fluids which have a number of mature applications. The third part is about preparing and assembling of submicron silver, cobalt and nickel particles by using polyol methods and liquid/liquid interface, respectively. Noble metal like gold, copper and silver are suitable for plasmonic thin film solar cells because of their low resistivity and strong interactions with visible light waves. Silver is the best choice for solar cell application since it has low absorption losses and high radiative efficiency compared to gold and copper. Assembled cobalt and nickel as films are promising for spintronic, magnetic and magneto-electronic and biomedics.

Keywords: assembling nanoparticles, liquid/liquid interface, thin film, core/shell, solar cells, recording media

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118 Digital Transformation: Actionable Insights to Optimize the Building Performance

Authors: Jovian Cheung, Thomas Kwok, Victor Wong

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Buildings are entwined with smart city developments. Building performance relies heavily on electrical and mechanical (E&M) systems and services accounting for about 40 percent of global energy use. By cohering the advancement of technology as well as energy and operation-efficient initiatives into the buildings, people are enabled to raise building performance and enhance the sustainability of the built environment in their daily lives. Digital transformation in the buildings is the profound development of the city to leverage the changes and opportunities of digital technologies To optimize the building performance, intelligent power quality and energy management system is developed for transforming data into actions. The system is formed by interfacing and integrating legacy metering and internet of things technologies in the building and applying big data techniques. It provides operation and energy profile and actionable insights of a building, which enables to optimize the building performance through raising people awareness on E&M services and energy consumption, predicting the operation of E&M systems, benchmarking the building performance, and prioritizing assets and energy management opportunities. The intelligent power quality and energy management system comprises four elements, namely the Integrated Building Performance Map, Building Performance Dashboard, Power Quality Analysis, and Energy Performance Analysis. It provides predictive operation sequence of E&M systems response to the built environment and building activities. The system collects the live operating conditions of E&M systems over time to identify abnormal system performance, predict failure trends and alert users before anticipating system failure. The actionable insights collected can also be used for system design enhancement in future. This paper will illustrate how intelligent power quality and energy management system provides operation and energy profile to optimize the building performance and actionable insights to revitalize an existing building into a smart building. The system is driving building performance optimization and supporting in developing Hong Kong into a suitable smart city to be admired.

Keywords: intelligent buildings, internet of things technologies, big data analytics, predictive operation and maintenance, building performance

Procedia PDF Downloads 158
117 Spatial Distribution of Virus-Transmitting Aphids of Plants in Al Bahah Province, Saudi Arabia

Authors: Sabir Hussain, Muhammad Naeem, Yousif Aldryhim, Susan E. Halbert, Qingjun Wu

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Plant viruses annually cause severe economic losses in crop production and globally, different aphid species are responsible for the transmission of such viruses. Additionally, aphids are also serious pests of trees, and agricultural crops. Al Bahah Province, Kingdom of Saudi Arabia (KSA) has a high native and introduced plant species with a temperate climate that provides ample habitats for aphids. In this study, we surveyed virus-transmitting aphids from the Province to highlight their spatial distributions and hot spot areas for their target control strategies. During our fifteen month's survey in Al Bahah Province, three hundred and seventy samples of aphids were collected using both beating sheets and yellow water pan traps. Consequently, fifty-four aphid species representing 30 genera belonging to four families were recorded from Al Bahah Province. Alarmingly, 35 aphid species from our records are virus transmitting species. The most common virus transmitting aphid species based on number of collecting samples, were Macrosiphum euphorbiae (Thomas, 1878), Brachycaudus rumexicolens (Patch, 1917), Uroleucon sonchi (Linnaeus, 1767), Brachycaudus helichrysi (Kaltenbach, 1843), and Myzus persicae (Sulzer, 1776). The numbers of samples for the forementioned species were 66, 24, 23, 22, and 20, respectively. The widest range of plant hosts were found for M. euphorbiae (39 plant species), B. helichrysi (12 plant species), M. persicae (12 plant species), B. rumexicolens (10 plant species), and U. sonchi (9 plant species). The hottest spot areas were found in Al-Baha, Al Mekhwah and Biljarashi cities of the province on the basis of their abundance. This study indicated that Al Bahah Province has relatively rich aphid diversity due to the relatively high plant diversity in a favorable climatic condition. ArcGIS tools can be helpful for biologists to implement the target control strategies against these pests in the integrated pest management, and ultimately to save money and time.

Keywords: Al Bahah province, aphid-virus interaction, biodiversity, global information system

Procedia PDF Downloads 184
116 Using Unilateral Diplomatic Assurances to Evade Provisional Measures' Orders

Authors: William Thomas Worster

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This paper will highlight the failure of international adjudication to prevent a state from evading an order of provisional measures by simply issuing a diplomatic assurance to the court. This practice changes the positions of the litigants as equals before a court, prevents the court from inquiring into the reliability of the political pledge as it would with assurances from a state to an individual, and diminishes the court’s ability to control its own proceedings in the face of concerns over sovereignty. Both the European Court of Human Rights (ECtHR) and International Court of Justice (ICJ) will entertain these kinds of unilateral pledges, but they consider them differently when the declaration is made between states or between a state and an individual, and when made directly to the court. In short, diplomatic assurances issued between states or to individuals are usually considered not to be legally binding and are essentially questions of fact, but unilateral assurances issued directly to an international court are questions of law, and usually legally binding. At the same time, orders for provisional measures are now understood also to be legally binding, yet international courts will sometimes permit a state to substitute an assurance in place of an order for provisional measures. This emerging practice has brought the nature of a state as a sovereign capable of creating legal obligations into the forum of adjudication where the parties should have equality of arms and permitted states to create legal obligations that escape inquiry into the reliability of the outcome. While most recent practice has occurred at the ICJ in state-to-state litigation, there is some practice potentially extending the practice to human rights courts. Especially where the litigants are factually unequal – a state and an individual – this practice is problematic since states could more easily overcome factual failings in their pledges and evade the control of the court. Consider, for example, the potential for evading non-refoulement obligations by extending the current diplomatic assurances practice from the state-to-state context to the state-to-court context. The dual nature of assurances, as both legal and factual instruments, should be considered as addressed to distinct questions, each with its own considerations, and that we need to be more demanding about their precise legal and factual effects.

Keywords: unilateral, diplomacy, assurances, undertakings, provisional measures, interim measures

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115 Enhanced Tensor Tomographic Reconstruction: Integrating Absorption, Refraction and Temporal Effects

Authors: Lukas Vierus, Thomas Schuster

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A general framework is examined for dynamic tensor field tomography within an inhomogeneous medium characterized by refraction and absorption, treated as an inverse source problem concerning the associated transport equation. Guided by Fermat’s principle, the Riemannian metric within the specified domain is determined by the medium's refractive index. While considerable literature exists on the inverse problem of reconstructing a tensor field from its longitudinal ray transform within a static Euclidean environment, limited inversion formulas and algorithms are available for general Riemannian metrics and time-varying tensor fields. It is established that tensor field tomography, akin to an inverse source problem for a transport equation, persists in dynamic scenarios. Framing dynamic tensor tomography as an inverse source problem embodies a comprehensive perspective within this domain. Ensuring well-defined forward mappings necessitates establishing existence and uniqueness for the underlying transport equations. However, the bilinear forms of the associated weak formulations fail to meet the coercivity condition. Consequently, recourse to viscosity solutions is taken, demonstrating their unique existence within suitable Sobolev spaces (in the static case) and Sobolev-Bochner spaces (in the dynamic case), under a specific assumption restricting variations in the refractive index. Notably, the adjoint problem can also be reformulated as a transport equation, with analogous results regarding uniqueness. Analytical solutions are expressed as integrals over geodesics, facilitating more efficient evaluation of forward and adjoint operators compared to solving partial differential equations. Certainly, here's the revised sentence in English: Numerical experiments are conducted using a Nesterov-accelerated Landweber method, encompassing various fields, absorption coefficients, and refractive indices, thereby illustrating the enhanced reconstruction achieved through this holistic modeling approach.

Keywords: attenuated refractive dynamic ray transform of tensor fields, geodesics, transport equation, viscosity solutions

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114 Climate Change Adaptation in the U.S. Coastal Zone: Data, Policy, and Moving Away from Moral Hazard

Authors: Thomas Ruppert, Shana Jones, J. Scott Pippin

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State and federal government agencies within the United States have recently invested substantial resources into studies of future flood risk conditions associated with climate change and sea-level rise. A review of numerous case studies has uncovered several key themes that speak to an overall incoherence within current flood risk assessment procedures in the U.S. context. First, there are substantial local differences in the quality of available information about basic infrastructure, particularly with regard to local stormwater features and essential facilities that are fundamental components of effective flood hazard planning and mitigation. Second, there can be substantial mismatch between regulatory Flood Insurance Rate Maps (FIRMs) as produced by the National Flood Insurance Program (NFIP) and other 'current condition' flood assessment approaches. This is of particular concern in areas where FIRMs already seem to underestimate extant flood risk, which can only be expected to become a greater concern if future FIRMs do not appropriately account for changing climate conditions. Moreover, while there are incentives within the NFIP’s Community Rating System (CRS) to develop enhanced assessments that include future flood risk projections from climate change, the incentive structures seem to have counterintuitive implications that would tend to promote moral hazard. In particular, a technical finding of higher future risk seems to make it easier for a community to qualify for flood insurance savings, with much of these prospective savings applied to individual properties that have the most physical risk of flooding. However, there is at least some case study evidence to indicate that recognition of these issues is prompting broader discussion about the need to move beyond FIRMs as a standalone local flood planning standard. The paper concludes with approaches for developing climate adaptation and flood resilience strategies in the U.S. that move away from the social welfare model being applied through NFIP and toward more of an informed risk approach that transfers much of the investment responsibility over to individual private property owners.

Keywords: climate change adaptation, flood risk, moral hazard, sea-level rise

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113 Risk Factors for Severe Typhoid Fever in Children: A French Retrospective Study about 78 Cases from 2000-2017 in Six Parisian Hospitals

Authors: Jonathan Soliman, Thomas Cavasino, Virginie Pommelet, Lahouari Amor, Pierre Mornand, Simon Escoda, Nina Droz, Soraya Matczak, Julie Toubiana, François Angoulvant, Etienne Carbonnelle, Albert Faye, Loic de Pontual, Luu-Ly Pham

Abstract:

Background: Typhoid and paratyphoid fever are systemic infections caused by Salmonella enterica serovar Typhi or paratyphi (A, B, C). Children traveling to tropical areas are at risk to contract these diseases which can be complicated. Methods: Clinical, biological and bacteriological data were collected from 78 pediatric cases reported between 2000 and 2017 in six Parisian hospitals. Children aged 0 to 18 years old, with a diagnosis of typhoid or paratyphoid fever confirmed by bacteriological exams, were included. Epidemiologic, clinical, biological features and presence of multidrug-resistant (MDR) bacteria or intermediate susceptibility to ciprofloxacin (nalidixic acid resistant) were examined by univariate analysis and by logistic regression analysis to identify risk factors of severe typhoid in children. Results: 84,6% of the children were imported cases of typhoid fever (n=66/78) and 15,4% were autochthonous cases (n=12/78). 89,7% were caused by S.typhi (n=70/78) and 12,8% by S.paratyphi (n=10/78) including 2 co-infections. 19,2% were intrafamilial cases (n=15/78). Median age at diagnosis was 6,4 years-old [6 months-17,9 years]. 28,2% of the cases were complicated forms (n=22/78): digestive (n=8; 10,3%), neurological (n=7; 9%), pulmonary complications (n=4; 5,1%) and hemophagocytic syndrome (n=4; 5,1%). Only 5% of the children had prior immunization with typhoid non-conjugated vaccine (n=4/78). 28% of the cases (n=22/78) were caused by resistant bacteria. Thrombocytopenia and diagnosis delay was significantly associated with severe infection (p= 0.029 and p=0,01). Complicated forms were more common with MDR (p=0,1) and not statistically associated with a young age or sex in this study. Conclusions: Typhoid and paratyphoid fever are not rare in children back from tropical areas. This multicentric pediatric study seems to show that thrombocytopenia, diagnosis delay, and multidrug resistant bacteria are associated with severe typhoid fever and complicated forms in children.

Keywords: antimicrobial resistance, children, Salmonella enterica typhi and paratyphi, severe typhoid

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112 Unveiling the Reaction Mechanism of N-Nitroso Dimethyl Amine Formation from Substituted Hydrazine Derivatives During Ozonation: A Computational Study

Authors: Rehin Sulay, Anandhu Krishna, Jintumol Mathew, Vibin Ipe Thomas

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N-Nitrosodimethyl amine, the simplest member of the N-Nitrosoamine family, is a carcinogenic and mutagenic agent that has gained considerable research interest owing to its toxic nature. Ozonation of industrially important hydrazines such as unsymmetrical dimethylhydrazine (UDMH) or monomethylhydrazine (MMH) has been associated with NDMA formation and accumulation in the environment. UDMH/MMH - ozonation also leads to several other transformation products such as acetaldehyde dimethyl hydrazone (ADMH), tetramethyl tetra azene (TMT), diazomethane, methyl diazene, etc, which can be either precursors or competitors for NDMA formation.In this work, we explored the formation mechanism of ADMH and TMT from UDMH-ozonation and their further oxidation to NDMA using the second-order Moller Plesset perturbation theory employing the 6-311G(d) basis set. We have also investigated how MMH selectively forms methyl diazene and diazomethane under normal conditions and NDMA in the presence of excess ozone. Our calculations indicate that the reactions proceed via an initial H abstraction from the hydrazine –NH2 group followed by the oxidation of the generated N-radical species. The formation of ADMH from the UDMH-ozone reaction involves an acetaldehyde intermediate, which then reacts with a second UDMH molecule to generate ADMH. The preferable attack of ozone molecule on N=C bond of ADMH generates DMAN intermediate, which subsequently undergoes oxidation to form NDMA. Unlike other transformation products, TMT formation occurs via the dimerization of DMAN. Though there exist a N=N bonds in the TMT, which are preferable attacking sites for ozone, experimental studies show the lower yields of NDMA formation, which corroborates with the high activation barrier required for the process(42kcal/mol).Overall, our calculated results agree well with the experimental observations and rate constants. Computational calculations bring insights into the electronic nature and kinetics of the elementary reactions of this pathway, enabled by computed energies of structures that are not possible to access experimentally.

Keywords: reaction mechanism, ozonation, substituted hydrazine, transition state

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111 The Importance of Oral Mucosal Biopsy Selection Site in Areas of Field Change: A Case Report

Authors: Timmis W., Simms M., Thomas C.

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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.

Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco

Procedia PDF Downloads 112
110 Prognosis of Patients with COVID-19 and Hematologic Malignancies

Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

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Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

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109 Proteomic Evaluation of Sex Differences in the Plasma of Non-human Primates Exposed to Ionizing Radiation for Biomarker Discovery

Authors: Christina Williams, Mehari Weldemariam, Ann M. Farese, Thomas J. MacVittie, Maureen A. Kane

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Radiation exposure results in dose-dependent and time-dependent multi-organ damage. Drug development of medical countermeasures (MCM) for radiation-induced injury occurs under the FDA Animal Rule because human efficacy studies are not ethical or feasible. The FDA Animal Rule requires the representation of both sexes and describes several uses for biomarkers in MCM drug development studies. Currently, MCMs are limited and there is no FDA-approved biomarker for any radiation injury. Sex as a variable is essential to identifying biomarkers and developing effective MCMs for acute radiation exposure (ARS) and delayed effects of acute radiation exposure (DEARE). These studies aim to address the death of information on sex differences that have not been determined by studies that included only male, single-sex cohorts. Studies have reported differences in radiosensitivity according to sex. As such, biomarker discovery for radiation-induced damage must consider sex as a variable. This study evaluated the plasma proteomic profile of Rhesus macaque non-human primates after different exposures and doses, as well as time points after radiation. Exposures and doses included total body irradiation between 5-7.5 Gy and partial body irradiation with 5% bone marrow sparing at 9, 9.5 and 10 Gy. Timepoints after irradiation included days 1, 3, 60, and 180, which encompassed both acute radiation syndromes and delayed effects of acute radiation exposure. Bottom-up proteomic analyses of plasma included equal numbers of males and females. In the control animals, few proteomic differences are observed between the sexes. In the irradiated animals, there are a few sex differences, with changes mostly consisting of proteins upregulated in the female animals. Multiple canonical pathways were upregulated in irradiated animals relative to the control animals when subjected to pathway analysis, but differential responses between the sexes are limited. These data provide critical baseline differences according to sex and establish sex differences in non-human primate models relevant to drug development of MCM under the FDA Animal Rule.

Keywords: ionizing radiation, sex differences, plasma proteomics, biomarker discovery

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108 Predicting Wearable Technology Readiness in a South African Government Department: Exploring the Influence of Wearable Technology Acceptance and Positive Attitude

Authors: Henda J Thomas, Cornelia PJ Harmse, Cecile Schultz

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Wearables are one of the technologies that will flourish within the fourth industrial revolution and digital transformation arenas, allowing employers to integrate collected data into organisational information systems. The study aimed to investigate whether wearable technology readiness can predict employees’ acceptance to wear wearables in the workplace. The factors of technology readiness predisposition that predict acceptance and positive attitudes towards wearable use in the workplace were examined. A quantitative research approach was used. The population consisted of 8 081 South African Department of Employment and Labour employees (DEL). Census sampling was used, and questionnaires to collect data were sent electronically to all 8 081 employees, 351 questionnaires were received back. The measuring instrument called the Technology Readiness and Acceptance Model (TRAM) was used in this study. Four hypotheses were formulated to investigate the relationship between readiness and acceptance of wearables in the workplace. The results found consistent predictions of technology acceptance (TA) by eagerness, optimism, and discomfort in the technology readiness (TR) scales. The TR scales of optimism and eagerness were consistent positive predictors of the TA scales, while discomfort proved to be a negative predictor for two of the three TA scales. Insecurity was found not to be a predictor of TA. It was recommended that the digital transformation policy of the DEL should be revised. Wearables in the workplace should be embraced from the viewpoint of convenience, automation, and seamless integration with the DEL information systems. The empirical contribution of this study can be seen in the fact that positive attitude emerged as a factor that extends the TRAM. In this study, positive attitude is identified as a new dimension to the TRAM not found in the original TA model and subsequent studies of the TRAM. Furthermore, this study found that Perceived Usefulness (PU) and Behavioural Intention to Use and (BIU) could not be separated but formed one factor. The methodological contribution of this study can lead to the development of a Wearable Readiness and Acceptance Model (WRAM). To the best of our knowledge, no author has yet introduced the WRAM into the body of knowledge.

Keywords: technology acceptance model, technology readiness index, technology readiness and acceptance model, wearable devices, wearable technology, fourth industrial revolution

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107 Novel Routes to the Synthesis and Functionalization of Metallic and Semiconductor Thin Film and Nanoparticles

Authors: Hanan. Al Chaghouri, Mohammad Azad Malik, P. John Thomas, Paul O’Brien

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The process of assembling metal nanoparticles at the interface of two liquids has received a great deal of attention over the past few years due to a wide range of important applications and their unusual properties as compared to bulk materials. We present a low cost, simple and cheap synthesis of metal nanoparticles, core/shell structures and semiconductors followed by assembly of these particles between immiscible liquids. The aim of this talk is divided to three parts: Firstly, to describe the achievement of a closed loop recycling for producing cadmium sulfide as powders and/or nanostructured thin films for solar cells or other optoelectronic devices applications by using a different chain length of commercially available secondary amines of dithiocarbamato complexes. The approach can be extended to other metal sulfides such as those of Zn, Pb, Cu, or Fe and many transition metals and oxides. Secondly, to synthesis significantly cheaper magnetic particles suited for the mass market. Ni/NiO nanoparticles with ferromagnetic properties at room temperature were among the smallest and strongest magnets (5 nm) were made in solution. The applications of this work can be to produce viable storage devices and the other possibility is to disperse these nanocrystals in solution and use it to make ferrofluids which have a number of mature applications. The third part is about preparing and assembling of submicron silver, cobalt and nickel particles by using polyol methods and liquid/liquid interface, respectively. Coinage metals like gold, copper and silver are suitable for plasmonic thin film solar cells because of their low resistivity and strong interactions with visible light waves. Silver is the best choice for solar cell application since it has low absorption losses and high radiative efficiency compared to gold and copper. Assembled cobalt and nickel as films are promising for spintronic, magnetic and magneto-electronic and biomedics.

Keywords: metal nanoparticles, core/shell structures and semiconductors, ferromagnetic properties, closed loop recycling, liquid/liquid interface

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106 The Effects of Shift Work on Neurobehavioral Performance: A Meta Analysis

Authors: Thomas Vlasak, Tanja Dujlociv, Alfred Barth

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Shift work is an essential element of modern labor, ensuring ideal conditions of service for today’s economy and society. Despite the beneficial properties, its impact on the neurobehavioral performance of exposed subjects remains controversial. This meta-analysis aims to provide first summarizing the effects regarding the association between shift work exposure and different cognitive functions. A literature search was performed via the databases PubMed, PsyINFO, PsyARTICLES, MedLine, PsycNET and Scopus including eligible studies until December 2020 that compared shift workers with non-shift workers regarding neurobehavioral performance tests. A random-effects model was carried out using Hedge’s g as a meta-analytical effect size with a restricted likelihood estimator to summarize the mean differences between the exposure group and controls. The heterogeneity of effect sizes was addressed by a sensitivity analysis using funnel plots, egger’s tests, p-curve analysis, meta-regressions, and subgroup analysis. The meta-analysis included 18 studies resulting in a total sample of 18,802 participants and 37 effect sizes concerning six different neurobehavioral outcomes. The results showed significantly worse performance in shift workers compared to non-shift workers in the following cognitive functions with g (95% CI): processing speed 0.16 (0.02 - 0.30), working memory 0.28 (0.51 - 0.50), psychomotor vigilance 0.21 (0.05 - 0.37), cognitive control 0.86 (0.45 - 1.27) and visual attention 0.19 (0.11 - 0.26). Neither significant moderating effects of publication year or study quality nor significant subgroup differences regarding type of shift or type of profession were indicated for the cognitive outcomes. These are the first meta-analytical findings that associate shift work with decreased cognitive performance in processing speed, working memory, psychomotor vigilance, cognitive control, and visual attention. Further studies should focus on a more homogenous measurement of cognitive functions, a precise assessment of experience of shift work and occupation types which are underrepresented in the current literature (e.g., law enforcement). In occupations where shift work is fundamental (e.g., healthcare, industries, law enforcement), protective countermeasures should be promoted for workers.

Keywords: meta-analysis, neurobehavioral performance, occupational psychology, shift work

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105 Model Order Reduction of Complex Airframes Using Component Mode Synthesis for Dynamic Aeroelasticity Load Analysis

Authors: Paul V. Thomas, Mostafa S. A. Elsayed, Denis Walch

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Airframe structural optimization at different design stages results in new mass and stiffness distributions which modify the critical design loads envelop. Determination of aircraft critical loads is an extensive analysis procedure which involves simulating the aircraft at thousands of load cases as defined in the certification requirements. It is computationally prohibitive to use a Global Finite Element Model (GFEM) for the load analysis, hence reduced order structural models are required which closely represent the dynamic characteristics of the GFEM. This paper presents the implementation of Component Mode Synthesis (CMS) method for the generation of high fidelity Reduced Order Model (ROM) of complex airframes. Here, sub-structuring technique is used to divide the complex higher order airframe dynamical system into a set of subsystems. Each subsystem is reduced to fewer degrees of freedom using matrix projection onto a carefully chosen reduced order basis subspace. The reduced structural matrices are assembled for all the subsystems through interface coupling and the dynamic response of the total system is solved. The CMS method is employed to develop the ROM of a Bombardier Aerospace business jet which is coupled with an aerodynamic model for dynamic aeroelasticity loads analysis under gust turbulence. Another set of dynamic aeroelastic loads is also generated employing a stick model of the same aircraft. Stick model is the reduced order modelling methodology commonly used in the aerospace industry based on stiffness generation by unitary loading application. The extracted aeroelastic loads from both models are compared against those generated employing the GFEM. Critical loads Modal participation factors and modal characteristics of the different ROMs are investigated and compared against those of the GFEM. Results obtained show that the ROM generated using Craig Bampton CMS reduction process has a superior dynamic characteristics compared to the stick model.

Keywords: component mode synthesis, craig bampton reduction method, dynamic aeroelasticity analysis, model order reduction

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104 Emergency Physician Performance for Hydronephrosis Diagnosis and Grading Compared with Radiologist Assessment in Renal Colic: The EPHyDRA Study

Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron

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Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.

Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician

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103 Peer Support Groups as a Tool to Increase Chances of Passing General Practice UK Qualification Exams

Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

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102 Speaker Identification by Atomic Decomposition of Learned Features Using Computational Auditory Scene Analysis Principals in Noisy Environments

Authors: Thomas Bryan, Veton Kepuska, Ivica Kostanic

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Speaker recognition is performed in high Additive White Gaussian Noise (AWGN) environments using principals of Computational Auditory Scene Analysis (CASA). CASA methods often classify sounds from images in the time-frequency (T-F) plane using spectrograms or cochleargrams as the image. In this paper atomic decomposition implemented by matching pursuit performs a transform from time series speech signals to the T-F plane. The atomic decomposition creates a sparsely populated T-F vector in “weight space” where each populated T-F position contains an amplitude weight. The weight space vector along with the atomic dictionary represents a denoised, compressed version of the original signal. The arraignment or of the atomic indices in the T-F vector are used for classification. Unsupervised feature learning implemented by a sparse autoencoder learns a single dictionary of basis features from a collection of envelope samples from all speakers. The approach is demonstrated using pairs of speakers from the TIMIT data set. Pairs of speakers are selected randomly from a single district. Each speak has 10 sentences. Two are used for training and 8 for testing. Atomic index probabilities are created for each training sentence and also for each test sentence. Classification is performed by finding the lowest Euclidean distance between then probabilities from the training sentences and the test sentences. Training is done at a 30dB Signal-to-Noise Ratio (SNR). Testing is performed at SNR’s of 0 dB, 5 dB, 10 dB and 30dB. The algorithm has a baseline classification accuracy of ~93% averaged over 10 pairs of speakers from the TIMIT data set. The baseline accuracy is attributable to short sequences of training and test data as well as the overall simplicity of the classification algorithm. The accuracy is not affected by AWGN and produces ~93% accuracy at 0dB SNR.

Keywords: time-frequency plane, atomic decomposition, envelope sampling, Gabor atoms, matching pursuit, sparse dictionary learning, sparse autoencoder

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101 Development of Positron Emission Tomography (PET) Tracers for the in-Vivo Imaging of α-Synuclein Aggregates in α-Synucleinopathies

Authors: Bright Chukwunwike Uzuegbunam, Wojciech Paslawski, Hans Agren, Christer Halldin, Wolfgang Weber, Markus Luster, Thomas Arzberger, Behrooz Hooshyar Yousefi

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There is a need to develop a PET tracer that will enable to diagnosis and track the progression of Alpha-synucleinopathies (Parkinson’s disease [PD], dementia with Lewy bodies [DLB], multiple system atrophy [MSA]) in living subjects over time. Alpha-synuclein aggregates (a-syn), which are present in all the stages of disease progression, for instance, in PD, are a suitable target for in vivo PET imaging. For this reason, we have developed some promising a-syn tracers based on a disarylbisthiazole (DABTA) scaffold. The precursors are synthesized via a modified Hantzsch thiazole synthesis. The precursors were then radiolabeled via one- or two-step radiofluorination methods. The ligands were initially screened using a combination of molecular dynamics and quantum/molecular mechanics approaches in order to calculate the binding affinity to a-syn (in silico binding experiments). Experimental in vitro binding assays were also performed. The ligands were further screened in other experiments such as log D, in vitro plasma protein binding & plasma stability, biodistribution & brain metabolite analyses in healthy mice. Radiochemical yields were up to 30% - 72% in some cases. Molecular docking revealed possible binding sites in a-syn and also the free energy of binding to those sites (-28.9 - -66.9 kcal/mol), which correlated to the high binding affinity of the DABTAs to a-syn (Ki as low as 0.5 nM) and selectivity (> 100-fold) over Aβ and tau, which usually co-exist with a-synin some pathologies. The log D values range from 2.88 - 2.34, which correlated with free-protein fraction of 0.28% - 0.5%. Biodistribution experiments revealed that the tracers are taken up (5.6 %ID/g - 7.3 %ID/g) in the brain at 5 min (post-injection) p.i., and cleared out (values as low as 0.39 %ID/g were obtained at 120 min p.i. Analyses of the mice brain 20 min p.i. Revealed almost no radiometabolites in the brain in most cases. It can be concluded that in silico study presents a new venue for the rational development of radioligands with suitable features. The results obtained so far are promising and encourage us to further validate the DABTAs in autoradiography, immunohistochemistry, and in vivo imaging in non-human primates and humans.

Keywords: alpha-synuclein aggregates, alpha-synucleinopathies, PET imaging, tracer development

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100 Synthesis of Deformed Nuclei 260Rf, 261Rf and 262Rf in the Decay of 266Rf*Formed via Different Fusion Reactions: Entrance Channel Effects

Authors: Niyti, Aman Deep, Rajesh Kharab, Sahila Chopra, Raj. K. Gupta

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Relatively long-lived transactinide elements (i.e., elements with atomic number Z≥104) up to Z = 108 have been produced in nuclear reactions between low Z projectiles (C to Al) and actinide targets. Cross sections have been observed to decrease steeply with increasing Z. Recently, production cross sections of several picobarns have been reported for comparatively neutron-rich nuclides of 112 through 118 produced via hot fusion reactions with 48Ca and actinide targets. Some of those heavy nuclides are reported to have lifetimes on the order of seconds or longer. The relatively high cross sections in these hot fusion reactions are not fully understood and this has renewed interest in systematic studies of heavy-ion reactions with actinide targets. The main aim of this work is to understand the dynamics hot fusion reactions 18O+ 248Cm and 22Ne+244Pu (carried out at RIKEN and TASCA respectively) using the collective clusterization technique, carried out by undertaking the decay of the compound nucleus 266Rf∗ into 4n, 5n and 6n neutron evaporation channels. Here we extend our earlier study of the excitation functions (EFs) of 266Rf∗, formed in fusion reaction 18O+248Cm, based on Dynamical Cluster-decay Model (DCM) using the pocket formula for nuclear proximity potential, to the use of other nuclear interaction potentials derived from Skyrme energy density formalism (SEDF) based on semiclassical extended Thomas Fermi (ETF) approach and also study entrance channel effects by considering the synthesis of 266Rf* in 22Ne+244Pu reaction. The Skyrme forces used are the old force SIII, and new forces GSkI and KDE0(v1). Here, the EFs for the production of 260Rf, 261Rf and 262Rf isotope via 6n, 5n and 4n decay channel from the 266Rf∗ compound nucleus are studied at Elab = 88.2 to 125 MeV, including quadrupole deformations β2i and ‘hot-optimum’ orientations θi. The calculations are made within the DCM where the neck-length ∆R is the only parameter representing the relative separation distance between two fragments and/or clusters Ai which assimilates the neck formation effects.

Keywords: entrance channel effects, fusion reactions, skyrme force, superheavy nucleus

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99 An Object-Oriented Modelica Model of the Water Level Swell during Depressurization of the Reactor Pressure Vessel of the Boiling Water Reactor

Authors: Rafal Bryk, Holger Schmidt, Thomas Mull, Ingo Ganzmann, Oliver Herbst

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Prediction of the two-phase water mixture level during fast depressurization of the Reactor Pressure Vessel (RPV) resulting from an accident scenario is an important issue from the view point of the reactor safety. Since the level swell may influence the behavior of some passive safety systems, it has been recognized that an assumption which at the beginning may be considered as a conservative one, not necessary leads to a conservative result. This paper discusses outcomes obtained during simulations of the water dynamics and heat transfer during sudden depressurization of a vessel filled up to a certain level with liquid water under saturation conditions and with the rest of the vessel occupied by saturated steam. In case of the pressure decrease e.g. due to the main steam line break, the liquid water evaporates abruptly, being a reason thereby, of strong transients in the vessel. These transients and the sudden emergence of void in the region occupied at the beginning by liquid, cause elevation of the two-phase mixture. In this work, several models calculating the water collapse and swell levels are presented and validated against experimental data. Each of the models uses different approach to calculate void fraction. The object-oriented models were developed with the Modelica modelling language and the OpenModelica environment. The models represent the RPV of the Integral Test Facility Karlstein (INKA) – a dedicated test rig for simulation of KERENA – a new Boiling Water Reactor design of Framatome. The models are based on dynamic mass and energy equations. They are divided into several dynamic volumes in each of which, the fluid may be single-phase liquid, steam or a two-phase mixture. The heat transfer between the wall of the vessel and the fluid is taken into account. Additional heat flow rate may be applied to the first volume of the vessel in order to simulate the decay heat of the reactor core in a similar manner as it is simulated at INKA. The comparison of the simulations results against the reference data shows a good agreement.

Keywords: boiling water reactor, level swell, Modelica, RPV depressurization, thermal-hydraulics

Procedia PDF Downloads 210