Search results for: TS patient selection
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5355

Search results for: TS patient selection

825 Apathetic Place, Hostile Space: A Qualitative Study on the Ability of Immigration Detention in the UK to Promote the Health and Dignity of Detainees

Authors: P. Dhesi, R. Burns

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Background: The UK has one of the largest immigration detention estates in Europe and is under increasing scrutiny, particularly regarding the lack of transparency over the use of detention and the conditions. Therefore, this research seeks to explore the professional perceptions of the ability of immigration detention in the UK to promote health and dignity. Methods: A phenomenological approach to qualitative methods were used, with social constructivist theorisations of health and dignity. Seven semi-structured interviews were conducted using Microsoft Teams. Participants included a range of immigration detention stakeholders who have visited closed immigration detention centres in the UK in a professional capacity. Recorded interviews were transcribed verbatim, and analysis was data-driven through inductive reflexive thematic analysis of the entire data set to account for the small sample size. This study received ethical approval from University College London Research Ethics Committee. Results: Two global themes were created through analysis: apathetic place and hostile space. Apathetic place discusses the lack of concern for detainees' daily living and healthcare needs within immigration detention in the UK. This is explored through participants' perceptions of the lack of ability of monitoring and evaluation processes to ensure detainees are able to live with dignity and understand the unfulfilled duty of care that exists in detention. Hostile space discusses immigration detention in the UK as a wider system of hostility. This is explored through the disempowering impact on detainees, the perception of a failing system as a result of inadequate safeguarding procedures, and a belief that the intention of immigration detention is misaligned with its described purpose. Conclusion: This research explains why the current immigration detention system in the UK is unable to promote health and dignity, offering a social justice and action-orientated approach to research in this sphere. The findings strengthen the discourse against the use of detention as an immigration control tool in the UK. Implications for further research include a stronger emphasis on investigating alternatives to detention and culturally considerate opportunities for patient-centred healthcare.

Keywords: access to healthcare, dignity, health, immigration detention, migrant, refugee, UK

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824 A Semiotic Analysis of the Changes in the Visual Sign System of International Advertisements in the Arab World

Authors: Nabil Mohammed Nasser Salem

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International advertisements targeting the Arab world are usually modified to be compatible with the conservative culture in many Arab countries. The portrayal of female models in international advertisements in Arab magazines avoids direct sexual representation. Arab culture is guided by religious teachings and social restrictions that prohibit the display of many parts of the female body. Exposure of shoulders, arms, armpits, cleavage, legs, thighs, etc., of the female body is usually avoided in international advertisements published in Arab magazines. Exposure to parts of the female body other than the face and hands may be considered offensive in many parts of Arab countries. Although extensive research has been conducted on Arabic advertisements, to our best knowledge, there are no publications in the literature that address the recent changes in the visual sign system in international advertisements in Arab magazines using semiotics as a research method. The present study aims to analyze the changes in the visual sign system of international advertisements published in Arab magazines that promote female fragrances. It tries to analyze the differences in the sexual representations of the same female models in some selected advertisements during different periods. The magazines are randomly selected from the period between 2000 and 2019. The selection of magazines is based on their availability and popularity. The study focuses on the Dior Jadore ads because they reflect important changes in the appearance of the same female model between 2000 to 2019. The result of the study shows important changes in the sexual representation of the same female body. The Dior Jadore advertisement in 2000 shows only the head of the female model. The model is modestly portrayed and shows clear cultural and religious restrictions on the sexual representation of the female body. The result shows that the same female model is portrayed differently in the Dior Jadore advertisement from the period 2005 to 2019. These versions of advertisements show more parts of the female body that are covered in the older versions and show stronger sexual representations. The study is an important contribution as it fills an important gap in the literature by extending semiotic research to the study of recent visual changes in the sign system of international advertisements published in Arab magazines during an important period in the history of international advertisement targeting the Arab world, as they reflect changes in the sexual representation of female models.

Keywords: Arab magazine, female body, international advertisements, semiotics, sexual representation

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823 Postmortem Genetic Testing to Sudden and Unexpected Deaths Using the Next Generation Sequencing

Authors: Eriko Ochiai, Fumiko Satoh, Keiko Miyashita, Yu Kakimoto, Motoki Osawa

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Sudden and unexpected deaths from unknown causes occur in infants and youths. Recently, molecular links between a part of these deaths and several genetic diseases are examined in the postmortem. For instance, hereditary long QT syndrome and Burgada syndrome are occasionally fatal through critical ventricular tachyarrhythmia. There are a large number of target genes responsible for such diseases, the conventional analysis using the Sanger’s method has been laborious. In this report, we attempted to analyze sudden deaths comprehensively using the next generation sequencing (NGS) technique. Multiplex PCR to subject’s DNA was performed using Ion AmpliSeq Library Kits 2.0 and Ion AmpliSeq Inherited Disease Panel (Life Technologies). After the library was constructed by emulsion PCR, the amplicons were sequenced 500 flows on Ion Personal Genome Machine System (Life Technologies) according to the manufacture instruction. SNPs and indels were analyzed to the sequence reads that were mapped on hg19 of reference sequences. This project has been approved by the ethical committee of Tokai University School of Medicine. As a representative case, the molecular analysis to a 40 years old male who received a diagnosis of Brugada syndrome demonstrated a total of 584 SNPs or indels. Non-synonymous and frameshift nucleotide substitutions were selected in the coding region of heart disease related genes of ANK2, AKAP9, CACNA1C, DSC2, KCNQ1, MYLK, SCN1B, and STARD3. In particular, c.629T-C transition in exon 3 of the SCN1B gene, resulting in a leu210-to-pro (L210P) substitution is predicted “damaging” by the SIFT program. Because the mutation has not been reported, it was unclear if the substitution was pathogenic. Sudden death that failed in determining the cause of death constitutes one of the most important unsolved subjects in forensic pathology. The Ion AmpliSeq Inherited Disease Panel can amplify the exons of 328 genes at one time. We realized the difficulty in selection of the true source from a number of candidates, but postmortem genetic testing using NGS analysis deserves of a diagnostic to date. We now extend this analysis to SIDS suspected subjects and young sudden death victims.

Keywords: postmortem genetic testing, sudden death, SIDS, next generation sequencing

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822 Creating a Rehabilitation Product as an Example of Design Management

Authors: K. Caban-Piaskowska

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The aim of the article is to show how the role of a designer has changed, from the point of view of human resources management and thanks to the increased importance of design management, and is to present how a rehabilitation product, through technology approach to designing, becomes a universal product. Designing for the disabled is a very undiscovered area on the pattern-designing market, most often because it is associated with devices which support rehabilitation. In consequence, it means that the realizations have a limited group of receivers and are not that attractive for designers. The relation between using modern design in building rehabilitation devices and increasing the efficiency of treatment and physiotherapy. Using modern technology can have marketing significance. Rehabilitation products designed and produced in a modern way makes an impression that experts and professionals are involved in the lives of the user – patient. In order to illustrate the problem presented above i.e. Creating a rehabilitation product as an example of design management, the case study method was used in the research. The analysis of the case was created on the basis of an interview conducted by the author with a designer who took part in meetings with people who use rehabilitation and their physiotherapists, and created universal products in Poland in the years of 2012 to 2017. Usually, engineers and constructors deal with creating products which remind us of old torture devices, however, they are indestructible in construction. Such image of those products for the disabled clearly indicates that it is a wonderful niche for designers and emphasizes the need to make those products more attractive and innovative. Products for the disabled cannot be limited to rehabilitation equipment only e.g. wheelchairs or standing frames. Introducing the idea of universal designing can significantly broaden the circle of pattern-designing receivers – everyday-use items – with the disabled people. Fulfilling these criteria will decide about the advantage on the competitive market. It is possible due to the usage of the design management concept in the functioning of an organization. Using modern technology and materials in the production of equipment, and changing the role of a designer broadening the circle of receivers by designing a wide use process which makes it possible to use the product by people with various needs. What is more, introducing rehabilitation functions in everyday-use items can also become an innovative accent in designing. In the reality of the market, each group of users can and should be treated as a problem and a realization task.

Keywords: design management, innovation, rehabilitation product, universal product

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821 Opinions and Perceptions of Clinical Staff towards Caring for Obese Patients: A Qualitative Research Study in a Cardiac Centre in Bahrain

Authors: Catherine Mary Abou-Zaid, Sandra Goodwin

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This study was conducted in a cardiac center in Bahrain. The rise in the amount of obese patients’ both men and women, being admitted for surgical procedures has become an issue to the nurses and doctors as these patients pose a high risk of major complications arising from their problem. The cessation of obesity in the country is very high and obesity-related diseases has been the cause of concern among men and women, also related individual diseases such as cardiovascular, diabetes and chronic respiratory diseases are rising dramatically within Bahrain in the last 10 years. Rationale for the Study: The ontological approach will help to understand and assess the true nature of the social world and how the world looks at obesity. Obesity has to be looked at as being a realistic ongoing issue. The epistemological approach will look at the theory of the origins of the nature of knowledge, set the rule of validating and learning in the social world of what can be done to curb this concept and how this can help prevent otherwise preventable diseases. Design Methodology: The qualitative design methodology took the form of an ontological/epistemological approach using phenomenology as a framework. The study was based on a social research issue, therefore, ontological ‘realism and idealism’ will feature as the nature of the world from a social and natural context. Epistemological positions of the study will be how we as researchers will find the actual social world and the limiting of that knowledge. The one-to-one interviews will be transcribed and the taped verbatim will be coded and charted giving the thematic analytic results. Recommendations: The significance of the research brought many recommendations. These recommendations were taken from the themes and sub-themes and were presented to the centers management and the necessary arrangements for updating knowledge and attitudes towards obesity in cardiac patients was then presented to the in-service education department. Workshops and training sessions on promoting health education were organized and put into the educational calendar for the next academic year. These sessions would look at patient autonomy, the patients’ rights, healthy eating for patients and families and the risks associated with obesity in cardiac disease processes.

Keywords: cardiac patients, diabetes, education & training, obesity cessation, qualitative

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820 Pressures of a Pandemic on the Perinatal Women: Experiences of Welsh Women

Authors: Filiz Celik, Rachel Harrad, Rob Keasley, Paul Bennett

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The COVID-19 pandemic has posed a significant challenge to many, with some groups with particular vulnerability to adverse psychological impacts. These include those disadvantaged by mental ill health, either pre-existing or occurring during pregnancy or post-partum. Using a qualitative approach, the research aimed to identify the challenges posed by COVID-19 to women, their infants and families during the perinatal period and to suggest what further support can help alleviate the adverse mental health impact of COVID-19. 21 expectant and new mothers who were currently receiving support via a peri-natal mental health service participated in semi-structured interviews. In these interviews, participants explored the impact of changes in social circumstances and healthcare providers as a result of COVID-19 restrictions, with the resultant audio recordings transcribed and analyzed using Reflexive Thematic Analysis (RTA). Based on these accounts, it was concluded that women, their partners and potentially their infants experienced heightened peri-natal distress, and their experience at this time increased their risk for future mental health problems. Women described emerging as more vulnerable, owing to their role as primary caregivers during the perinatal period and also explained how social isolation and limited access to services meant protective buffers against mental health deterioration were reduced and the resources they needed in order to develop resilience were weakened. Although partners were invited to take part in the research, a sizeable volume of data could not be generated to fully assess the impact of the pandemic on a partner’s mental well-being. However, women expressed concerns about the paternal mental health of partners and husbands which invites us to be further vigilant to paternal mental health and associated experiences. Overall, these interviews serve to highlight and provide a voice to these women and their families who describe experiencing disadvantage at an already vulnerable time in their lives, as well as illustrating the need for services to prioritize the needs of this population when acute events strike, be those future pandemics or other disasters.

Keywords: patient experience, perinatal mental health, covid-19 pandemic, heightened anxiety, birth trauma, post-natal well-being

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819 Trends in Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome in Rheumatoid Arthritis Patients

Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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818 Rangeland Monitoring by Computerized Technologies

Authors: H. Arzani, Z. Arzani

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Every piece of rangeland has a different set of physical and biological characteristics. This requires the manager to synthesis various information for regular monitoring to define changes trend to get wright decision for sustainable management. So range managers need to use computerized technologies to monitor rangeland, and select. The best management practices. There are four examples of computerized technologies that can benefit sustainable management: (1) Photographic method for cover measurement: The method was tested in different vegetation communities in semi humid and arid regions. Interpretation of pictures of quadrats was done using Arc View software. Data analysis was done by SPSS software using paired t test. Based on the results, generally, photographic method can be used to measure ground cover in most vegetation communities. (2) GPS application for corresponding ground samples and satellite pixels: In two provinces of Tehran and Markazi, six reference points were selected and in each point, eight GPS models were tested. Significant relation among GPS model, time and location with accuracy of estimated coordinates was found. After selection of suitable method, in Markazi province coordinates of plots along four transects in each 6 sites of rangelands was recorded. The best time of GPS application was in the morning hours, Etrex Vista had less error than other models, and a significant relation among GPS model, time and location with accuracy of estimated coordinates was found. (3) Application of satellite data for rangeland monitoring: Focusing on the long term variation of vegetation parameters such as vegetation cover and production is essential. Our study in grass and shrub lands showed that there were significant correlations between quantitative vegetation characteristics and satellite data. So it is possible to monitor rangeland vegetation using digital data for sustainable utilization. (4) Rangeland suitability classification with GIS: Range suitability assessment can facilitate sustainable management planning. Three sub-models of sensitivity to erosion, water suitability and forage production out puts were entered to final range suitability classification model. GIS was facilitate classification of range suitability and produced suitability maps for sheep grazing. Generally digital computers assist range managers to interpret, modify, calibrate or integrating information for correct management.

Keywords: computer, GPS, GIS, remote sensing, photographic method, monitoring, rangeland ecosystem, management, suitability, sheep grazing

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817 Computational Study on Traumatic Brain Injury Using Magnetic Resonance Imaging-Based 3D Viscoelastic Model

Authors: Tanu Khanuja, Harikrishnan N. Unni

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Head is the most vulnerable part of human body and may cause severe life threatening injuries. As the in vivo brain response cannot be recorded during injury, computational investigation of the head model could be really helpful to understand the injury mechanism. Majority of the physical damage to living tissues are caused by relative motion within the tissue due to tensile and shearing structural failures. The present Finite Element study focuses on investigating intracranial pressure and stress/strain distributions resulting from impact loads on various sites of human head. This is performed by the development of the 3D model of a human head with major segments like cerebrum, cerebellum, brain stem, CSF (cerebrospinal fluid), and skull from patient specific MRI (magnetic resonance imaging). The semi-automatic segmentation of head is performed using AMIRA software to extract finer grooves of the brain. To maintain the accuracy high number of mesh elements are required followed by high computational time. Therefore, the mesh optimization has also been performed using tetrahedral elements. In addition, model validation with experimental literature is performed as well. Hard tissues like skull is modeled as elastic whereas soft tissues like brain is modeled with viscoelastic prony series material model. This paper intends to obtain insights into the severity of brain injury by analyzing impacts on frontal, top, back, and temporal sites of the head. Yield stress (based on von Mises stress criterion for tissues) and intracranial pressure distribution due to impact on different sites (frontal, parietal, etc.) are compared and the extent of damage to cerebral tissues is discussed in detail. This paper finds that how the back impact is more injurious to overall head than the other. The present work would be helpful to understand the injury mechanism of traumatic brain injury more effectively.

Keywords: dynamic impact analysis, finite element analysis, intracranial pressure, MRI, traumatic brain injury, von Misses stress

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816 Music Listening in Dementia: Current Developments and the Potential for Automated Systems in the Home: Scoping Review and Discussion

Authors: Alexander Street, Nina Wollersberger, Paul Fernie, Leonardo Muller, Ming Hung HSU, Helen Odell-Miller, Jorg Fachner, Patrizia Di Campli San Vito, Stephen Brewster, Hari Shaji, Satvik Venkatesh, Paolo Itaborai, Nicolas Farina, Alexis Kirke, Sube Banerjee, Eduardo Reck Miranda

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Escalating neuropsychiatric symptoms (NPS) in people with dementia may lead to earlier care home admission. Music listening has been reported to stimulate cognitive function, potentially reducing agitation in this population. We present a scoping review, reporting on current developments and discussing the potential for music listening with related technology in managing agitation in dementia care. Of two searches for music listening studies, one focused on older people or people living with dementia where music listening interventions, including technology, were delivered in participants’ homes or in institutions to address neuropsychiatric symptoms, quality of life and independence. The second included any population focusing on the use of music technology for health and wellbeing. In search one 70/251 full texts were included. The majority reported either statistical significance (6, 8.5%), significance (17, 24.2%) or improvements (26, 37.1%). Agitation was specifically reported in 36 (51.4%). The second search included 51/99 full texts, reporting improvement (28, 54.9%), significance (11, 21.5%), statistical significance (1, 1.9%) and no difference compared to the control (6, 11.7%). The majority in the first focused on mood and agitation, and the second on mood and psychophysiological responses. Five studies used AI or machine learning systems to select music, all involving healthy controls and reporting benefits. Most studies in both reviews were not conducted in a home environment (review 1 = 12; 17.1%; review 2 = 11; 21.5%). Preferred music listening may help manage NPS in the care home settings. Based on these and other data extracted in the review, a reasonable progression would be to co-design and test music listening systems and protocols for NPS in all settings, including people’s homes. Machine learning and automated technology for music selection and arousal adjustment, driven by live biodata, have not been explored in dementia care. Such approaches may help deliver the right music at the appropriate time in the required dosage, reducing the use of medication and improving quality of life.

Keywords: music listening, dementia, agitation, scoping review, technology

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815 The Influence of Destination Image on Tourists' Experience at Osun Osogbo World Heritage Site

Authors: Bola Adeleke, Kayode Ogunsusi

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Heritage sites have evolved to preserve culture and heritage and also to educate and entertain tourists. Tourist travel decisions and behavior are influenced by destination image and value of the experience of tourists. Perceived value is one of the important tools for securing a competitive edge in tourism destinations. The model of Ritchie and Crouch distinguished 36 attributes of competitiveness which are classified into five factors which are quality of experience, touristic attractiveness, environment and infrastructure, entertainment/outdoor activities and cultural traditions. The study extended this model with a different grouping of the determinants of destination competitiveness. The theoretical framework used for this study assumes that apart from attractions already situated in the grove, satisfaction with destination common service, and entertainment and events, can all be used in creating a positive image for/and in attracting customers (destination selection) to visit Osun Sacred Osogbo Grove during and after annual celebrations. All these will impact positively on travel experience of customers as well as their spiritual fulfillment. Destination image has a direct impact on tourists’ satisfaction which consequently impacts on tourists’ likely future behavior on whether to revisit a cultural destination or not. The study investigated the variables responsible for destination image competitiveness of the Heritage Site; assessed the factors enhancing the destination image; and evaluated the perceived value realized by tourists from their cultural experience at the grove. A complete enumeration of tourists above 18 years of age who visited the Heritage Site within the month of March and April 2017 was taken. 240 respondents, therefore, were used for the study. The structured questionnaire with 5 Likert scales was administered. Five factors comprising 63 variables were used to determine the destination image competitiveness through principal component analysis, while multiple regressions were used to evaluate perceived value of tourists at the grove. Results revealed that 11 out of the 12 variables determining the destination image competitiveness were significant in attracting tourists to the grove. From the R-value, all factors predicted tourists’ value of experience strongly (R= 0.936). The percentage variance of customer value was explained by 87.70% of the variance of destination common service, entertainment and event satisfaction, travel environment satisfaction and spiritual satisfaction, with F-value being significant at 0.00. Factors with high alpha value contributed greatly to adding value to enhancing destination and tourists’ experience. 11 variables positively predicted tourist value with significance. Managers of Osun World Heritage Site should improve on variables critical to adding values to tourists’ experience.

Keywords: competitiveness, destination image, Osun Osogbo world heritage site, tourists

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814 Crossing of the Intestinal Barrier Thanks to Targeted Biologics: Nanofitins

Authors: Solene Masloh, Anne Chevrel, Maxime Culot, Leonardo Scapozza, Magali Zeisser-Labouebe

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The limited stability of clinically proven therapeutic antibodies limits their administration by the parenteral route. However, oral administration remains the best alternative as it is the most convenient and less invasive one. Obtaining a targeted treatment based on biologics, which can be orally administered, would, therefore, be an ideal situation to improve patient adherence and compliance. Nevertheless, the delivery of macromolecules through the intestine remains challenging because of their sensitivity to the harsh conditions of the gastrointestinal tract and their low permeability across the intestinal mucosa. To address this challenge, this project aims to demonstrate that targeting receptor-mediated endocytosis followed by transcytosis could maximize the intestinal uptake and transport of large molecules, such as Nanofitins. These affinity proteins of 7 kDa with binding properties similar to antibodies have already demonstrated retained stability in the digestive tract and local efficiency. However, their size does not allow passive diffusion through the intestinal barrier. Nanofitins having a controlled affinity for membrane receptors involved in the transcytosis mechanism used naturally for the transport of large molecules in humans were generated. Proteins were expressed using ribosome display and selected based on affinity to the targeted receptor and other characteristics. Their uptake and transport ex vivo across viable porcine intestines were investigated using an Ussing chambers system. In this paper, we will report the results achieved while addressing the different challenges linked to this study. To validate the ex vivo model, first, we proved the presence of the receptors targeted in humans on the porcine intestine. Then, after the identification of an optimal way of detection of Nanofitins, transport experiments were performed on porcine intestines with viability followed during the time of the experiment. The results, showing that the physiological process of transcytosis is capable of being triggered by the binding of Nanofitins on their target, will be reported here. In conclusion, the results show that Nanofitins can be transported across the intestinal barrier by triggering the receptor-mediated transcytosis and that the ex vivo model is an interesting technique to assess biologics absorption through the intestine.

Keywords: ex-vivo, Nanofitins, oral administration, transcytosis

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813 Efficient Estimation of Maximum Theoretical Productivity from Batch Cultures via Dynamic Optimization of Flux Balance Models

Authors: Peter C. St. John, Michael F. Crowley, Yannick J. Bomble

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Production of chemicals from engineered organisms in a batch culture typically involves a trade-off between productivity, yield, and titer. However, strategies for strain design typically involve designing mutations to achieve the highest yield possible while maintaining growth viability. Such approaches tend to follow the principle of designing static networks with minimum metabolic functionality to achieve desired yields. While these methods are computationally tractable, optimum productivity is likely achieved by a dynamic strategy, in which intracellular fluxes change their distribution over time. One can use multi-stage fermentations to increase either productivity or yield. Such strategies would range from simple manipulations (aerobic growth phase, anaerobic production phase), to more complex genetic toggle switches. Additionally, some computational methods can also be developed to aid in optimizing two-stage fermentation systems. One can assume an initial control strategy (i.e., a single reaction target) in maximizing productivity - but it is unclear how close this productivity would come to a global optimum. The calculation of maximum theoretical yield in metabolic engineering can help guide strain and pathway selection for static strain design efforts. Here, we present a method for the calculation of a maximum theoretical productivity of a batch culture system. This method follows the traditional assumptions of dynamic flux balance analysis: that internal metabolite fluxes are governed by a pseudo-steady state and external metabolite fluxes are represented by dynamic system including Michealis-Menten or hill-type regulation. The productivity optimization is achieved via dynamic programming, and accounts explicitly for an arbitrary number of fermentation stages and flux variable changes. We have applied our method to succinate production in two common microbial hosts: E. coli and A. succinogenes. The method can be further extended to calculate the complete productivity versus yield Pareto surface. Our results demonstrate that nearly optimal yields and productivities can indeed be achieved with only two discrete flux stages.

Keywords: A. succinogenes, E. coli, metabolic engineering, metabolite fluxes, multi-stage fermentations, succinate

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812 Implementation of Correlation-Based Data Analysis as a Preliminary Stage for the Prediction of Geometric Dimensions Using Machine Learning in the Forming of Car Seat Rails

Authors: Housein Deli, Loui Al-Shrouf, Hammoud Al Joumaa, Mohieddine Jelali

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When forming metallic materials, fluctuations in material properties, process conditions, and wear lead to deviations in the component geometry. Several hundred features sometimes need to be measured, especially in the case of functional and safety-relevant components. These can only be measured offline due to the large number of features and the accuracy requirements. The risk of producing components outside the tolerances is minimized but not eliminated by the statistical evaluation of process capability and control measurements. The inspection intervals are based on the acceptable risk and are at the expense of productivity but remain reactive and, in some cases, considerably delayed. Due to the considerable progress made in the field of condition monitoring and measurement technology, permanently installed sensor systems in combination with machine learning and artificial intelligence, in particular, offer the potential to independently derive forecasts for component geometry and thus eliminate the risk of defective products - actively and preventively. The reliability of forecasts depends on the quality, completeness, and timeliness of the data. Measuring all geometric characteristics is neither sensible nor technically possible. This paper, therefore, uses the example of car seat rail production to discuss the necessary first step of feature selection and reduction by correlation analysis, as otherwise, it would not be possible to forecast components in real-time and inline. Four different car seat rails with an average of 130 features were selected and measured using a coordinate measuring machine (CMM). The run of such measuring programs alone takes up to 20 minutes. In practice, this results in the risk of faulty production of at least 2000 components that have to be sorted or scrapped if the measurement results are negative. Over a period of 2 months, all measurement data (> 200 measurements/ variant) was collected and evaluated using correlation analysis. As part of this study, the number of characteristics to be measured for all 6 car seat rail variants was reduced by over 80%. Specifically, direct correlations for almost 100 characteristics were proven for an average of 125 characteristics for 4 different products. A further 10 features correlate via indirect relationships so that the number of features required for a prediction could be reduced to less than 20. A correlation factor >0.8 was assumed for all correlations.

Keywords: long-term SHM, condition monitoring, machine learning, correlation analysis, component prediction, wear prediction, regressions analysis

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811 Assessment of Utilization of Provider Initiated HIV Testing and Counseling and Associated Factors among Adult out Patient Department Patients in Wonchi Woreda, South West Shoa Zone, Central Ethiopia

Authors: Dinka Fikadu, Mulugeta Shegaze

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Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

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810 Site Suitability of Offshore Wind Energy: A Combination of Geographic Referenced Information and Analytic Hierarchy Process

Authors: Ayat-Allah Bouramdane

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Power generation from offshore wind energy does not emit carbon dioxide or other air pollutants and therefore play a role in reducing greenhouse gas emissions from the energy sector. In addition, these systems are considered more efficient than onshore wind farms, as they generate electricity from the wind blowing across the sea, thanks to the higher wind speed and greater consistency in direction due to the lack of physical interference that the land or human-made objects can present. This means offshore installations require fewer turbines to produce the same amount of energy as onshore wind farms. However, offshore wind farms require more complex infrastructure to support them and, as a result, are more expensive to construct. In addition, higher wind speeds, strong seas, and accessibility issues makes offshore wind farms more challenging to maintain. This study uses a combination of Geographic Referenced Information (GRI) and Analytic Hierarchy Process (AHP) to identify the most suitable sites for offshore wind farm development in Morocco, with a particular focus on the Dakhla city. A range of environmental, socio-economic, and technical criteria are taken into account to solve this complex Multi-Criteria Decision-Making (MCDM) problem. Based on experts' knowledge, a pairwise comparison matrix at each level of the hierarchy is performed, and fourteen sub-criteria belong to the main criteria have been weighted to generate the site suitability of offshore wind plants and obtain an in-depth knowledge on unsuitable areas, and areas with low-, moderate-, high- and very high suitability. We find that wind speed is the most decisive criteria in offshore wind farm development, followed by bathymetry, while proximity to facilities, the sediment thickness, and the remaining parameters show much lower weightings rendering technical parameters most decisive in offshore wind farm development projects. We also discuss the potential of other marine renewable energy potential, in Morocco, such as wave and tidal energy. The proposed approach and analysis can help decision-makers and can be applied to other countries in order to support the site selection process of offshore wind farms.

Keywords: analytic hierarchy process, dakhla, geographic referenced information, morocco, multi-criteria decision-making, offshore wind, site suitability

Procedia PDF Downloads 139
809 A Single-Use Endoscopy System for Identification of Abnormalities in the Distal Oesophagus of Individuals with Chronic Reflux

Authors: Nafiseh Mirabdolhosseini, Jerry Zhou, Vincent Ho

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The dramatic global rise in acid reflux has also led to oesophageal adenocarcinoma (OAC) becoming the fastest-growing cancer in developed countries. While gastroscopy with biopsy is used to diagnose OAC patients, this labour-intensive and expensive process is not suitable for population screening. This study aims to design, develop, and implement a minimally invasive system to capture optical data of the distal oesophagus for rapid screening of potential abnormalities. To develop the system and understand user requirements, a user-centric approach was employed by utilising co-design strategies. Target users’ segments were identified, and 38 patients and 14 health providers were interviewed. Next, the technical requirements were developed based on consultations with the industry. A minimally invasive optical system was designed and developed considering patient comfort. This system consists of the sensing catheter, controller unit, and analysis program. Its procedure only takes 10 minutes to perform and does not require cleaning afterward since it has a single-use catheter. A prototype system was evaluated for safety and efficacy for both laboratory and clinical performance. This prototype performed successfully when submerged in simulated gastric fluid without showing evidence of erosion after 24 hours. The system effectively recorded a video of the mid-distal oesophagus of a healthy volunteer (34-year-old male). The recorded images were used to develop an automated program to identify abnormalities in the distal oesophagus. Further data from a larger clinical study will be used to train the automated program. This system allows for quick visual assessment of the lower oesophagus in primary care settings and can serve as a screening tool for oesophageal adenocarcinoma. In addition, this system is able to be coupled with 24hr ambulatory pH monitoring to better correlate oesophageal physiological changes with reflux symptoms. It also can provide additional information on lower oesophageal sphincter functions such as opening times and bolus retention.

Keywords: endoscopy, MedTech, oesophageal adenocarcinoma, optical system, screening tool

Procedia PDF Downloads 73
808 Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on Health-Related Quality of Life among Post-Acute Coronary Syndrome Patients: A Randomized Controlled Trial

Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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807 Project-Based Learning and Evidence Based Nursing as Tools for Developing Students' Integrative Critical Thinking Skills: Content Analysis of Final Students' Projects

Authors: E. Maoz

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Background: As a teaching method, project-based learning is strongly linked to developing students’ critical thinking skills. It combines creative independent thinking, team work, and disciplinary subject-field integration. In the 'Introduction to Nursing Research Methods' course (year 3, Generic Track), project based learning is used to teach the topic of 'Evidence-Based Nursing'. This topic examines a clinical care issue encountered by students in the field. At the end of their project, students present proposals for managing the said issue. Proposals are the product of independent integrative thinking integrating a wide range of factors influencing the issue’s management. Method: Papers by 27 groups of students (165 students) were content analyzed to identify which themes emerged from the students' recommendations for managing the clinical issue. Findings: Five main themes emerged—current management approach; adapting procedures in line with current recent research recommendations; training for change (veteran nursing staff, beginner students, patients, significant others); analysis of 'economic benefit vs. patient benefit'; multidisciplinary team engagement in implementing change in practice. Two surprising themes also emerged: advertising and marketing using new technologies, which reflects how the new generation thinks. Summary and Recommendations: Among the main challenges in nursing education is training nursing graduates to think independently, integratively, and critically. Combining PBL with classical teaching methods stimulates students cognitively while opening new vistas with implications on all levels of the profession: management, research, education, and practice. Advanced students can successfully grasp and interpret the current state of clinical practice. They are competent and open to leading change and able to consider the diverse factors and interconnections that characterize the nurse's work.

Keywords: evidence based nursing, critical thinking skills, project based learning, students education

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806 Selection of Qualitative Research Strategy for Bullying and Harassment in Sport

Authors: J. Vveinhardt, V. B. Fominiene, L. Jeseviciute-Ufartiene

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Relevance of Research: Qualitative research is still regarded as highly subjective and not sufficiently scientific in order to achieve objective research results. However, it is agreed that a qualitative study allows revealing the hidden motives of the research participants, creating new theories, and highlighting the field of problem. There is enough research done to reveal these qualitative research aspects. However, each research area has its own specificity, and sport is unique due to the image of its participants, who are understood as strong and invincible. Therefore, a sport participant might have personal issues to recognize himself as a victim in the context of bullying and harassment. Accordingly, researcher has a dilemma in general making to speak a victim in sport. Thus, ethical aspects of qualitative research become relevant. The plenty fields of sport make a problem determining the sample size of research. Thus, the corresponding problem of this research is which and why qualitative research strategies are the most suitable revealing the phenomenon of bullying and harassment in sport. Object of research is qualitative research strategy for bullying and harassment in sport. Purpose of the research is to analyze strategies of qualitative research selecting suitable one for bullying and harassment in sport. Methods of research were scientific research analyses of qualitative research application for bullying and harassment research. Research Results: Four mane strategies are applied in the qualitative research; inductive, deductive, retroductive, and abductive. Inductive and deductive strategies are commonly used researching bullying and harassment in sport. The inductive strategy is applied as quantitative research in order to reveal and describe the prevalence of bullying and harassment in sport. The deductive strategy is used through qualitative methods in order to explain the causes of bullying and harassment and to predict the actions of the participants of bullying and harassment in sport and the possible consequences of these actions. The most commonly used qualitative method for the research of bullying and harassment in sports is semi-structured interviews in speech and in written. However, these methods may restrict the openness of the participants in the study when recording on the dictator or collecting incomplete answers when the participant in the survey responds in writing because it is not possible to refine the answers. Qualitative researches are more prevalent in terms of technology-defined research data. For example, focus group research in a closed forum allows participants freely interact with each other because of the confidentiality of the selected participants in the study. The moderator can purposefully formulate and submit problem-solving questions to the participants. Hence, the application of intelligent technology through in-depth qualitative research can help discover new and specific information on bullying and harassment in sport. Acknowledgement: This research is funded by the European Social Fund according to the activity ‘Improvement of researchers’ qualification by implementing world-class R&D projects of Measure No. 09.3.3-LMT-K-712.

Keywords: bullying, focus group, harassment, narrative, sport, qualitative research

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805 Effects of Mindfulness Practice on Clinician Burnout: A Scoping Review

Authors: Hani Malik

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Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

Procedia PDF Downloads 142
804 Deep Learning-Based Liver 3D Slicer for Image-Guided Therapy: Segmentation and Needle Aspiration

Authors: Ahmedou Moulaye Idriss, Tfeil Yahya, Tamas Ungi, Gabor Fichtinger

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Image-guided therapy (IGT) plays a crucial role in minimally invasive procedures for liver interventions. Accurate segmentation of the liver and precise needle placement is essential for successful interventions such as needle aspiration. In this study, we propose a deep learning-based liver 3D slicer designed to enhance segmentation accuracy and facilitate needle aspiration procedures. The developed 3D slicer leverages state-of-the-art convolutional neural networks (CNNs) for automatic liver segmentation in medical images. The CNN model is trained on a diverse dataset of liver images obtained from various imaging modalities, including computed tomography (CT) and magnetic resonance imaging (MRI). The trained model demonstrates robust performance in accurately delineating liver boundaries, even in cases with anatomical variations and pathological conditions. Furthermore, the 3D slicer integrates advanced image registration techniques to ensure accurate alignment of preoperative images with real-time interventional imaging. This alignment enhances the precision of needle placement during aspiration procedures, minimizing the risk of complications and improving overall intervention outcomes. To validate the efficacy of the proposed deep learning-based 3D slicer, a comprehensive evaluation is conducted using a dataset of clinical cases. Quantitative metrics, including the Dice similarity coefficient and Hausdorff distance, are employed to assess the accuracy of liver segmentation. Additionally, the performance of the 3D slicer in guiding needle aspiration procedures is evaluated through simulated and clinical interventions. Preliminary results demonstrate the effectiveness of the developed 3D slicer in achieving accurate liver segmentation and guiding needle aspiration procedures with high precision. The integration of deep learning techniques into the IGT workflow shows great promise for enhancing the efficiency and safety of liver interventions, ultimately contributing to improved patient outcomes.

Keywords: deep learning, liver segmentation, 3D slicer, image guided therapy, needle aspiration

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803 High Resolution Satellite Imagery and Lidar Data for Object-Based Tree Species Classification in Quebec, Canada

Authors: Bilel Chalghaf, Mathieu Varin

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Forest characterization in Quebec, Canada, is usually assessed based on photo-interpretation at the stand level. For species identification, this often results in a lack of precision. Very high spatial resolution imagery, such as DigitalGlobe, and Light Detection and Ranging (LiDAR), have the potential to overcome the limitations of aerial imagery. To date, few studies have used that data to map a large number of species at the tree level using machine learning techniques. The main objective of this study is to map 11 individual high tree species ( > 17m) at the tree level using an object-based approach in the broadleaf forest of Kenauk Nature, Quebec. For the individual tree crown segmentation, three canopy-height models (CHMs) from LiDAR data were assessed: 1) the original, 2) a filtered, and 3) a corrected model. The corrected CHM gave the best accuracy and was then coupled with imagery to refine tree species crown identification. When compared with photo-interpretation, 90% of the objects represented a single species. For modeling, 313 variables were derived from 16-band WorldView-3 imagery and LiDAR data, using radiance, reflectance, pixel, and object-based calculation techniques. Variable selection procedures were employed to reduce their number from 313 to 16, using only 11 bands to aid reproducibility. For classification, a global approach using all 11 species was compared to a semi-hierarchical hybrid classification approach at two levels: (1) tree type (broadleaf/conifer) and (2) individual broadleaf (five) and conifer (six) species. Five different model techniques were used: (1) support vector machine (SVM), (2) classification and regression tree (CART), (3) random forest (RF), (4) k-nearest neighbors (k-NN), and (5) linear discriminant analysis (LDA). Each model was tuned separately for all approaches and levels. For the global approach, the best model was the SVM using eight variables (overall accuracy (OA): 80%, Kappa: 0.77). With the semi-hierarchical hybrid approach, at the tree type level, the best model was the k-NN using six variables (OA: 100% and Kappa: 1.00). At the level of identifying broadleaf and conifer species, the best model was the SVM, with OA of 80% and 97% and Kappa values of 0.74 and 0.97, respectively, using seven variables for both models. This paper demonstrates that a hybrid classification approach gives better results and that using 16-band WorldView-3 with LiDAR data leads to more precise predictions for tree segmentation and classification, especially when the number of tree species is large.

Keywords: tree species, object-based, classification, multispectral, machine learning, WorldView-3, LiDAR

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802 Immobilizing Quorum Sensing Inhibitors on Biomaterial Surfaces

Authors: Aditi Taunk, George Iskander, Kitty Ka Kit Ho, Mark Willcox, Naresh Kumar

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Bacterial infections on biomaterial implants and medical devices accounts for 60-70% of all hospital acquired infections (HAIs). Treatment or removal of these infected devices results in high patient mortality and morbidity along with increased hospital expenses. In addition, with no effective strategies currently available and rapid development of antibacterial resistance has made device-related infections extremely difficult to treat. Therefore, in this project we have developed biomaterial surfaces using antibacterial compounds that inhibit biofilm formation by interfering with the bacterial communication mechanism known as quorum sensing (QS). This study focuses on covalent attachment of potent quorum sensing (QS) inhibiting compounds, halogenated furanones (FUs) and dihydropyrrol-2-ones (DHPs), onto glass surfaces. The FUs were attached by photoactivating the azide groups on the surface, and the acid functionalized DHPs were immobilized on amine surface via EDC/NHS coupling. The modified surfaces were tested in vitro against pathogenic organisms such as Staphylococcus aureus and Pseudomonas aeruginosa using confocal laser scanning microscopy (CLSM). Successful attachment of compounds on the substrates was confirmed by X-ray photoelectron spectroscopy (XPS) and contact angle measurements. The antibacterial efficacy was assessed, and significant reduction in bacterial adhesion and biofilm formation was observed on the FU and DHP coated surfaces. The activity of the coating was dependent upon the type of substituent present on the phenyl group of the DHP compound. For example, the ortho-fluorophenyl DHP (DHP-2) exhibited 79% reduction in bacterial adhesion against S. aureus and para-fluorophenyl DHP (DHP-3) exhibited 70% reduction against P. aeruginosa. The results were found to be comparable to DHP coated surfaces prepared in earlier study via Michael addition reaction. FUs and DHPs were able to retain their in vitro antibacterial efficacy after covalent attachment via azide chemistry. This approach is a promising strategy to develop efficient antibacterial biomaterials to reduce device related infections.

Keywords: antibacterial biomaterials, biomedical device-related infections, quorum sensing, surface functionalization

Procedia PDF Downloads 254
801 Medical Authorizations for Cannabis-Based Products in Canada: Sante Cannabis Data on Patient’s Safety and Treatment Profiles

Authors: Rihab Gamaoun, Cynthia El Hage, Laura Ruiz, Erin Prosk, Antonio Vigano

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Introduction: Santé Cannabis (SC), a Canadian medical cannabis-specialized group of clinics based in Montreal and in the province of Québec, has served more than 5000 patients seeking cannabis-based treatment prescription for medical indications over the past five years. Within a research frame, data on the use of medical cannabis products from all the above patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to gather information on the profiles of both patients and prescribed medical cannabis products at SC clinics and to assess the safety of medical cannabis among Canadian patients. Methods: Using a retrospective analysis of the database, records of 2585 patients who were prescribed medical cannabis products for therapeutic purposes between 01-November 2017 and 04-September 2019 were included. Patients’ demographics, primary diagnosis, route of administration, and chemovars recorded at the initial visits were investigated. Results: At baseline: 9% of SC patients were female, with a mean age of 57 (SD= 15.8, range= [18-96]); Cannabis products were prescribed mainly for patients with a diagnosis of chronic pain (65.9% of patients), cancer (9.4%), neurological disorders (6.5%), mood disorders (5.8 %) and inflammatory diseases (4.1%). Route of administration and chemovars of prescribed cannabis products were the following: 96% of patients received cannabis oil (51% CBD rich, 42.5% CBD:THC); 32.1% dried cannabis (21.3% CBD:THC, 7.4% THC rich, 3.4 CBD rich), and 2.1% oral spray cannabis (1.1% CBD:THC, 0.8% CBD rich, 0.2% THC rich). Most patients were prescribed simultaneously, a combination of products with different administration routes and chemovars. Safety analysis is undergoing. Conclusion: Our results provided initial information on the profile of medical cannabis products prescribed in a Canadian population and the experienced adverse events over the past three years. The Santé Cannabis database represents a unique opportunity for comparing clinical practices in prescribing and titrating cannabis-based medications across different centers. Ultimately real-world data, including information about safety and effectiveness, will help to create standardized and validated guidelines for choosing dose, route of administration, and chemovars types for the cannabis-based medication in different diseases and indications.

Keywords: medical cannabis, real-world data, safety, pharmacovigilance

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800 Enhancing Fault Detection in Rotating Machinery Using Wiener-CNN Method

Authors: Mohamad R. Moshtagh, Ahmad Bagheri

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Accurate fault detection in rotating machinery is of utmost importance to ensure optimal performance and prevent costly downtime in industrial applications. This study presents a robust fault detection system based on vibration data collected from rotating gears under various operating conditions. The considered scenarios include: (1) both gears being healthy, (2) one healthy gear and one faulty gear, and (3) introducing an imbalanced condition to a healthy gear. Vibration data was acquired using a Hentek 1008 device and stored in a CSV file. Python code implemented in the Spider environment was used for data preprocessing and analysis. Winner features were extracted using the Wiener feature selection method. These features were then employed in multiple machine learning algorithms, including Convolutional Neural Networks (CNN), Multilayer Perceptron (MLP), K-Nearest Neighbors (KNN), and Random Forest, to evaluate their performance in detecting and classifying faults in both the training and validation datasets. The comparative analysis of the methods revealed the superior performance of the Wiener-CNN approach. The Wiener-CNN method achieved a remarkable accuracy of 100% for both the two-class (healthy gear and faulty gear) and three-class (healthy gear, faulty gear, and imbalanced) scenarios in the training and validation datasets. In contrast, the other methods exhibited varying levels of accuracy. The Wiener-MLP method attained 100% accuracy for the two-class training dataset and 100% for the validation dataset. For the three-class scenario, the Wiener-MLP method demonstrated 100% accuracy in the training dataset and 95.3% accuracy in the validation dataset. The Wiener-KNN method yielded 96.3% accuracy for the two-class training dataset and 94.5% for the validation dataset. In the three-class scenario, it achieved 85.3% accuracy in the training dataset and 77.2% in the validation dataset. The Wiener-Random Forest method achieved 100% accuracy for the two-class training dataset and 85% for the validation dataset, while in the three-class training dataset, it attained 100% accuracy and 90.8% accuracy for the validation dataset. The exceptional accuracy demonstrated by the Wiener-CNN method underscores its effectiveness in accurately identifying and classifying fault conditions in rotating machinery. The proposed fault detection system utilizes vibration data analysis and advanced machine learning techniques to improve operational reliability and productivity. By adopting the Wiener-CNN method, industrial systems can benefit from enhanced fault detection capabilities, facilitating proactive maintenance and reducing equipment downtime.

Keywords: fault detection, gearbox, machine learning, wiener method

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799 The Effects of Culture and Language on Social Impression Formation from Voice Pleasantness: A Study with French and Iranian People

Authors: L. Bruckert, A. Mansourzadeh

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The voice has a major influence on interpersonal communication in everyday life via the perception of pleasantness. The evolutionary perspective postulates that the mechanisms underlying the pleasantness judgments are universal adaptations that have evolved in the service of choosing a mate (through the process of sexual selection). From this point of view, the favorite voices would be those with more marked sexually dimorphic characteristics; for example, in men with lower voice pitch, pitch is the main criterion. On the other hand, one can postulate that the mechanisms involved are gradually established since childhood through exposure to the environment, and thus the prosodic elements could take precedence in everyday life communication as it conveys information about the speaker's attitude (willingness to communicate, interest toward the interlocutors). Our study focuses on voice pleasantness and its relationship with social impression formation, exploring both the spectral aspects (pitch, timbre) and the prosodic ones. In our study, we recorded the voices through two vocal corpus (five vowels and a reading text) of 25 French males speaking French and 25 Iranian males speaking Farsi. French listeners (40 male/40 female) listened to the French voices and made a judgment either on the voice's pleasantness or on the speaker (judgment about his intelligence, honesty, sociability). The regression analyses from our acoustic measures showed that the prosodic elements (for example, the intonation and the speech rate) are the most important criteria concerning pleasantness, whatever the corpus or the listener's gender. Moreover, the correlation analyses showed that the speakers with the voices judged as the most pleasant are considered the most intelligent, sociable, and honest. The voices in Farsi have been judged by 80 other French listeners (40 male/40 female), and we found the same effect of intonation concerning the judgment of pleasantness with the corpus «vowel» whereas with the corpus «text» the pitch is more important than the prosody. It may suggest that voice perception contains some elements invariant across culture/language, whereas others are influenced by the cultural/linguistic background of the listener. Shortly in the future, Iranian people will be asked to listen either to the French voices for half of them or to the Farsi voices for the other half and produce the same judgments as the French listeners. This experimental design could potentially make it possible to distinguish what is linked to culture and what is linked to language in the case of differences in voice perception.

Keywords: cross-cultural psychology, impression formation, pleasantness, voice perception

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798 Development of Biodegradable Wound Healing Patch of Curcumin

Authors: Abhay Asthana, Shally Toshkhani, Gyati Shilakari

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The objective of the present research work is to develop a topical biodegradable dermal patch based formulation to aid accelerated wound healing. It is always better for patient compliance to be able to reduce the frequency of dressings with improved drug delivery and overall therapeutic efficacy. In present study optimized formulation using biodegradable components was obtained evaluating polymers and excipients (HPMC K4M, Ethylcellulose, Povidone, Polyethylene glycol and Gelatin) to impart significant folding endurance, elasticity, and strength. Molten gelatin was used to get a mixture using ethylene glycol. Chitosan dissolved in acidic medium was mixed with stirring to Gelatin mixture. With continued stirring to the mixture Curcumin was added with the aid of DCM and Methanol in an optimized ratio of 60:40 to get homogenous dispersion. Polymers were dispersed with stirring in the final formulation. The mixture was sonicated casted to get the film form. All steps were carried out under strict aseptic conditions. The final formulation was a thin uniformly smooth textured film with dark brown-yellow color. The film was found to have folding endurance was around 20 to 21 times without a crack in an optimized formulation at RT (23°C). The drug content was in range 96 to 102% and it passed the content uniform test. The final moisture content of the optimized formulation film was NMT 9.0%. The films passed stability study conducted at refrigerated conditions (4±0.2°C) and at room temperature (23 ± 2°C) for 30 days. Further, the drug content and texture remained undisturbed with stability study conducted at RT 23±2°C for 45 and 90 days. Percentage cumulative drug release was found to be 80% in 12h and matched the biodegradation rate as tested in vivo with correlation factor R2>0.9. In in vivo study administration of one dose in equivalent quantity per 2 days was applied topically. The data demonstrated a significant improvement with percentage wound contraction in contrast to control and plain drug respectively in given period. The film based formulation developed shows promising results in terms of stability and in vivo performance.

Keywords: wound healing, biodegradable, polymers, patch

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797 Comparative Study between Mesenchymal Stem Cells and Regulatory T-Cells in Macrophage Polarization for Organ Transplant Tolerance: In Vitro Study

Authors: Vijaya Madhuri Devraj, Swarnalatha Guditi, Kiran Kumar Bokara, Gangadhar Taduri

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Cell-based strategies may open therapeutic approaches that promote tolerance through manipulation of macrophages to increase long-term transplant survival rates and minimize side effects of the current immune suppressive regimens. The aim of the present study was, therefore, to test and compare the therapeutic potential of MSC and Tregs on macrophage polarization to develop an alternate cell-based treatment option in kidney transplantation. In the current protocol, macrophages from kidney transplant recipients with graft dysfunction were co-cultured with MSCs and Treg cells with and without cell-cell contact on transwell plates, further to quantitatively assess macrophage polarization in response to MSC and Treg treatment over time, M1 and M2 cell surface markers were used. Additionally, multiple soluble analytes were analyzed in cell supernatant by using bead-based immunoassays. Furthermore, to confirm our findings, gene expression analysis was done. MSCs induced the formation of M2 macrophages more than Tregs when macrophages M0 were cultured in transwell without cell contact. From this, we deduced the mechanism that soluble factors present in the MSCs condition media are involved in skewing of macrophages towards type 2 macrophages; similarly, in co-culture with cell-cell contact, MSCs resulted in more M2 type macrophages than Tregs. And an important finding of this study is the combination of both MSC-Treg showed significantly effective and consistent results in both with and without cell contact setups. Hence, it is suggestive to prefer MSCs over Tregs for secretome-based therapy and a combination of both for either therapy for effective transplantation outcomes. Our findings underline a key role of Tregs and MSCs in promoting macrophage polarization towards anti-inflammatory type. The study has great importance in prolongation of allograft and patient survival without any rejection by cell-based therapy, which induce self-tolerance and controlling infection.

Keywords: graft rejection, graft tolerance, macrophage polarization, mesenchymal stem cells, regulatory T cells, transplant immunology

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796 Community Re-Integrated Soldiers’ Perceptions of Barriers and Facilitators to A Home-Based Physical Rehabilitation Programme Following Lower-Limb Amputation

Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

Procedia PDF Downloads 158