Search results for: data analysis system
Commenced in January 2007
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Edition: International
Paper Count: 49405

Search results for: data analysis system

565 Project Management and International Development: Competencies for International Assignment

Authors: M. P. Leroux, C. Coulombe

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Projects are popular vehicles through which international aid is delivered in developing countries. To achieve their objectives, many northern organizations develop projects with local partner organizations in the developing countries through technical assistance projects. International aid and international development projects precisely have long been criticized for poor results although billions are spent every year. Little empirical research in the field of project management has the focus on knowledge transfer in international development context. This paper focuses particularly on personal dimensions of international assignees participating in project within local team members in the host country. We propose to explore the possible links with a human resource management perspective in order to shed light on the less research problematic of knowledge transfer in development cooperation projects. The process leading to capacity building being far complex, involving multiple dimensions and far from being linear, we propose here to assess if traditional research on expatriate in multinational corporations pertain to the field of project management in developing countries. The following question is addressed: in the context of international development project cooperation, what personal determinants should the selection process focus when looking to fill a technical assistance position in a developing country? To answer that question, we first reviewed the literature on expatriate in the context of inter organizational knowledge transfer. Second, we proposed a theoretical framework combining perspectives of development studies and management to explore if parallels can be draw between traditional international assignment and technical assistance project assignment in developing countries. We conducted an exploratory study using case studies from technical assistance initiatives led in Haiti, a country in Central America. Data were collected from multiple sources following qualitative study research methods. Direct observations in the field were allowed by local leaders of six organization; individual interviews with present and past international assignees, individual interview with local team members, and focus groups were organized in order to triangulate information collected. Contrary from empirical research on knowledge transfer in multinational corporations, results tend to show that technical expertise rank well behind many others characteristics. Results tend to show the importance of soft skills, as a prerequisite to succeed in projects where local team have to collaborate. More importantly, international assignees who were talking knowledge sharing instead of knowledge transfer seemed to feel more satisfied at the end of their mandate than the others. Reciprocally, local team members who perceived to have participated in a project with an expat looking to share instead of aiming to transfer knowledge seemed to describe the results of project in more positive terms than the others. Results obtained from this exploratory study open the way for a promising research agenda in the field of project management. It emphasises the urgent need to achieve a better understanding on the complex set of soft skills project managers or project chiefs would benefit to develop, in particular, the ability to absorb knowledge and the willingness to share one’s knowledge.

Keywords: international assignee, international project cooperation, knowledge transfer, soft skills

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564 Multi-Objective Optimization of Assembly Manufacturing Factory Setups

Authors: Andreas Lind, Aitor Iriondo Pascual, Dan Hogberg, Lars Hanson

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Factory setup lifecycles are most often described and prepared in CAD environments; the preparation is based on experience and inputs from several cross-disciplinary processes. Early in the factory setup preparation, a so-called block layout is created. The intention is to describe a high-level view of the intended factory setup and to claim area reservations and allocations. Factory areas are then blocked, i.e., targeted to be used for specific intended resources and processes, later redefined with detailed factory setup layouts. Each detailed layout is based on the block layout and inputs from cross-disciplinary preparation processes, such as manufacturing sequence, productivity, workers’ workplace requirements, and resource setup preparation. However, this activity is often not carried out with all variables considered simultaneously, which might entail a risk of sub-optimizing the detailed layout based on manual decisions. Therefore, this work aims to realize a digital method for assembly manufacturing layout planning where productivity, area utilization, and ergonomics can be considered simultaneously in a cross-disciplinary manner. The purpose of the digital method is to support engineers in finding optimized designs of detailed layouts for assembly manufacturing factories, thereby facilitating better decisions regarding setups of future factories. Input datasets are company-specific descriptions of required dimensions for specific area reservations, such as defined dimensions of a worker’s workplace, material façades, aisles, and the sequence to realize the product assembly manufacturing process. To test and iteratively develop the digital method, a demonstrator has been developed with an adaptation of existing software that simulates and proposes optimized designs of detailed layouts. Since the method is to consider productivity, ergonomics, area utilization, and constraints from the automatically generated block layout, a multi-objective optimization approach is utilized. In the demonstrator, the input data are sent to the simulation software industrial path solutions (IPS). Based on the input and Lua scripts, the IPS software generates a block layout in compliance with the company’s defined dimensions of area reservations. Communication is then established between the IPS and the software EPP (Ergonomics in Productivity Platform), including intended resource descriptions, assembly manufacturing process, and manikin (digital human) resources. Using multi-objective optimization approaches, the EPP software then calculates layout proposals that are sent iteratively and simulated and rendered in IPS, following the rules and regulations defined in the block layout as well as productivity and ergonomics constraints and objectives. The software demonstrator is promising. The software can handle several parameters to optimize the detailed layout simultaneously and can put forward several proposals. It can optimize multiple parameters or weight the parameters to fine-tune the optimal result of the detailed layout. The intention of the demonstrator is to make the preparation between cross-disciplinary silos transparent and achieve a common preparation of the assembly manufacturing factory setup, thereby facilitating better decisions.

Keywords: factory setup, multi-objective, optimization, simulation

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563 The Effects of Heavy Metal and Aromatic Hydrocarbon Pollution on Bees

Authors: Katarzyna Zięba, Hajnalka Szentgyörgyi, Paweł Miśkowiec, Agnieszka Moos-Matysik

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Bees are effective pollinators of plants using by humans. However, there is a concern about the fate different species due to their recently decline. Pollution of the environment is described in the literature as one of the causes of this phenomenon. Due to human activities, heavy metals and aromatic hydrocarbons can occur in bee organisms in high concentrations. The presented study aims to provide information on how pollution affects bee quality, taking into account, also the biological differences between various groups of bees. Understanding the consequences of environmental pollution on bees can help to create and promote bee friendly habitats and actions. The analyses were carried out using two contamination gradients with 5 sites on each. The first, mainly heavy metal polluted gradient is stretching approx. 30km from the Bukowno Zinc smelter near Olkusz in the Lesser Poland Voivodship, to the north. The second cuts through the agglomeration of Kraków up to the southern borders of the Ojców National Park. The gradient near Olkusz is a well-described pollution gradient contaminated mainly by zinc, lead, and cadmium. The second gradient cut through the agglomeration of Kraków and end below the Ojców National Park. On each gradient, two bee species were installed: red mason bees (Osmia bicornis) and honey bees (Apis mellifera). Red mason bee is a polylectic, solitary bee species, widely distributed in Poland. Honey bees are a highly social species of bees, with clearly defined casts and roles in the colony. Before installing the bees in the field, samples of imagos of red mason bees and samples of pollen and imagos from each honey bee colony were analysed for zinc, lead cadmium, polycyclic and monocyclic hydrocarbons levels. After collecting the bees from the field, samples of bees and pollen samples for each site were prepared for heavy metal, monocyclic hydrocarbon, and polycyclic hydrocarbon analysis. Analyses of aromatic hydrocarbons were performed with gas chromatography coupled with a headspace sampler (HP 7694E) and mass spectrometer (MS) as detector. Monocyclic compounds were injected into column with headspace sampler while polycyclic ones with manual injector (after solid-liquid extraction with hexane). The heavy metal content (zinc, lead and cadmium) was assessed with flame atomic absorption spectroscopy (FAAS AAnalyst 300 Perkin Elmer spectrometer) according to the methods for honey and bee products described in the literature. Pollution levels found in bee bodies and imago body masses in both species, and proportion of sex in case of red mason bees were correlated with pollution levels found in pollen for each site and colony or trap nest. An attempt to pinpoint the most important form of contamination regarding bee health was also be undertaken based on the achieved results.

Keywords: heavy metals, aromatic hydrocarbons, bees, pollution

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562 Loud Silence: A Situation Analysis of Youth Living with Hearing Impairment in Uganda

Authors: Wandera Stephen Ojumbo

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People living with hearing impairment in Uganda are one of the most excluded minority groups in the country. The Uganda National Association of the Deaf estimates that deaf people make up 3.4% of Uganda’s 43 million people. Deaf Children and youth often appear withdrawn because they face social stigma. In 2009, photojournalist Stephen Wandera Ojumbo conducted an exhibition in Kampala titled “Silent Voices with colourful Hearts” showcasing the life of deaf children at Uganda School for the Deaf, Ntinda, in order to create awareness of their plight, raising funds for the construction of a vocational centre for the deaf that didn’t continue their education due to: lack of funds, non-inclusive educational institutions, and for those who cannot read and write. These children, whose lives were exhibited in 2009, are currently youths. In Uganda, there are just five primary schools for the deaf (three of these are located in Kampala, the capital city), and barely five secondary schools for the deaf. At the moment, some deaf children only receive special needs training equivalent to primary seven levels and the majority don’t make it to secondary school education level due to the fact that English is a second language to them. There is a communication gap between speaking parents and deaf children, which leads to the breakage of family bonds. The deaf youth run away from their homes to form a community where they can communicate freely. Likewise, employment opportunities for the deaf are equally very limited. It’s for this reason that a follow-up photo exhibition was conducted to expose more about what the youthful deaf people and their guardians go through in Uganda to get jobs, live and fit in the community, how they communicate and get understood, bonding with families instead of running away to bond with fellow deaf persons. The photo exhibition under the theme “Loud Silence” was significant in showcasing the ability of deaf youths in Uganda and eliciting solutions to make a more inclusive society for the deaf. It is hoped that partners in development will join in for intervention. The methodology used included individual interviews with the deaf youth and their parents and caretakers; photography at household and community levels; document review at organizations working with the deaf; observations; and key informant interviews with relevant personnel working with the deaf. Some of the major findings include: i) Effective sign language communication is key in deaf education, family bonding, and developing a sense of belonging; ii) Love and intimacy can keep the deaf bound together; iii) Education is important; everybody should struggle even if alone; iv) Games and sports are a unifying factor and most loved among the deaf; and v) better communication skills build confidence in deaf youth. In conclusion, concerted efforts are still needed to make Uganda schools more inclusive for deaf persons. This will enable a secure future for deaf youths.

Keywords: deaf, education, excluded, photo exhibition

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561 Innovation in PhD Training in the Interdisciplinary Research Institute

Authors: B. Shaw, K. Doherty

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The Cultural Communication and Computing Research Institute (C3RI) is a diverse multidisciplinary research institute including art, design, media production, communication studies, computing and engineering. Across these disciplines it can seem like there are enormous differences of research practice and convention, including differing positions on objectivity and subjectivity, certainty and evidence, and different political and ethical parameters. These differences sit within, often unacknowledged, histories, codes, and communication styles of specific disciplines, and it is all these aspects that can make understanding of research practice across disciplines difficult. To explore this, a one day event was orchestrated, testing how a PhD community might communicate and share research in progress in a multi-disciplinary context. Instead of presenting results at a conference, research students were tasked to articulate their method of inquiry. A working party of students from across disciplines had to design a conference call, visual identity and an event framework that would work for students across all disciplines. The process of establishing the shape and identity of the conference was revealing. Even finding a linguistic frame that would meet the expectations of different disciplines for the conference call was challenging. The first abstracts submitted either resorted to reporting findings, or only described method briefly. It took several weeks of supported intervention for research students to get ‘inside’ their method and to understand their research practice as a process rich with philosophical and practical decisions and implications. In response to the abstracts the conference committee generated key methodological categories for conference sessions, including sampling, capturing ‘experience’, ‘making models’, researcher identities, and ‘constructing data’. Each session involved presentations by visual artists, communications students and computing researchers with inter-disciplinary dialogue, facilitated by alumni Chairs. The apparently simple focus on method illuminated research process as a site of creativity, innovation and discovery, and also built epistemological awareness, drawing attention to what is being researched and how it can be known. It was surprisingly difficult to limit students to discussing method, and it was apparent that the vocabulary available for method is sometimes limited. However, by focusing on method rather than results, the genuine process of research, rather than one constructed for approval, could be captured. In unlocking the twists and turns of planning and implementing research, and the impact of circumstance and contingency, students had to reflect frankly on successes and failures. This level of self – and public- critique emphasised the degree of critical thinking and rigour required in executing research and demonstrated that honest reportage of research, faults and all, is good valid research. The process also revealed the degree that disciplines can learn from each other- the computing students gained insights from the sensitive social contextualizing generated by communications and art and design students, and art and design students gained understanding from the greater ‘distance’ and emphasis on application that computing students applied to their subjects. Finding the means to develop dialogue across disciplines makes researchers better equipped to devise and tackle research problems across disciplines, potentially laying the ground for more effective collaboration.

Keywords: interdisciplinary, method, research student, training

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560 Effects of a School-based Mindfulness Intervention on Stress Levels and Emotion Regulation of Adolescent Students Enrolled in an Independent School

Authors: Tracie Catlett

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Students enrolled in high-achieving schools are under tremendous pressure to perform at high levels inside and outside the classroom. Achievement pressure is a prevalent source of stress for students enrolled in high-achieving schools, and female students, in particular, experience a higher frequency and higher levels of stress compared to their male peers. The practice of mindfulness in a school setting is one tool that has been linked to improved self-regulation of emotions, increased positive emotions, and stress reduction. A mixed methods randomized pretest-posttest no-treatment control trial evaluated the effects of a six-session mindfulness intervention taught during a regularly scheduled life skills period in an independent day school, one type of high-achieving school. Twenty-nine students in Grades 10 and 11 were randomized by class, where Grade 11 students were in the intervention group (n = 14) and Grade 10 students were in the control group (n = 15). Findings from the study produced mixed results. There was no evidence that the mindfulness program reduced participants’ stress levels and negative emotions. In fact, contrary to what was expected, students enrolled in the intervention group experienced higher levels of stress and increased negative emotions at posttreatment when compared to pretreatment. Neither the within-group nor the between-groups changes in stress level were statistically significant, p > .05, and the between-groups effect size was small, d = .2. The study found evidence that the mindfulness program may have had a positive impact on students’ ability to regulate their emotions. The within-group comparison and the between-groups comparison at posttreatment found that students in the mindfulness course experienced statistically significant improvement in the in their ability to regulate their emotions at posttreatment, p = .009 < .05 and p =. 034 < .05, respectively. The between-groups effect size was medium, d =.7, suggesting that the positive differences in emotion regulation difficulties were substantial and have practical implications. The analysis of gender differences, as they relate to stress and emotions, revealed that female students perceive higher levels of stress and report experiencing stress more often than males. There were no gender differences when analyzing sources of stress experienced by the student participants. Both females and males experience regular achievement pressures related to their school performance and worry about their future, college acceptance, grades, and parental expectations. Females reported an increased awareness of their stress and actively engaged in practicing mindfulness to manage their stress. Students in the treatment group expressed that the practice of mindfulness resulted in feelings of relaxation and calmness.

Keywords: achievement pressure, adolescents, emotion regulation, emotions, high-achieving schools, independent schools, mindfulness, negative affect, positive affect, stress

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559 Assessment of Socio-Cultural Sustainability: A Comparative Analysis of Two Neighborhoods in Kolkata Metropolitan Area

Authors: Tanima Bhattacharya, Joy Sen

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To transform a space into a better livable and sustainable zone, United Nations Summit in New York 2015, has decided upon 17 sustainable development goals (SDGs) that approach directly to achieve inclusive, people-centric, sustainable developments. Though sustainability has been majorly constructed by four pillars, namely, Ecological, Economic, Social and Cultural, but it is essentially reduced to economic and ecological consideration in the context of developing countries. Therefore, in most cases planning has reduced its ambit to concentrate around the tangible infrastructure, ignoring the fundamentals of socio-cultural heritage. With the accentuating hype of infrastructural augmentation, lack of emphasis of traditional concerns like ethnicity and social connection have further diluted the situation, disintegrating cultural continuity. As cultural continuity lacks its cohesion, it’s growing absence increasingly acts as a catalyst to degrade the heritage structures, spaces around and linking these structures, and the ability of stakeholders in identifying themselves rooted in that particular space. Hence, this paper will argue that sustainability depends on the people and their interaction with their surroundings, their culture and livelihood. The interaction between people and their surroundings strengthen community building and social interaction that abides by stakeholders reverting back to their roots. To assess the socio-cultural sustainability of the city of Kolkata, two study areas are selected, namely, an old settlement from the northern part of the city of Kolkata (KMA), imbued with social connection, age-old cultural and ethnic bonding and, another cluster of new high-rises coming up in the Newtown area having portions of planned city extension on the eastern side of the city itself. Whereas, Newtown prioritizes the surging post-industrial trends of economic aspiration and ecological aspects of urban sustainability; the former settlements of northern Kolkata still continue to represent the earliest community settlement of the British-colonial-cum native era and even the pre-colonial era, permeated with socio-cultural reciprocation. Thus, to compare and assess the inlayed organizational structure of both the spaces in the two cases, selected areas have been surveyed to portray their current imageability. The argument of this paper is structured in 5parts. First, an introduction of the idea has been forwarded, Secondly, a literature review has been conducted to ground the proposed ideas, Thirdly, methodology has been discussed and appropriate case study areas have been selected, Fourthly, surveys and analyses has been forwarded and lastly, the paper has arrived at a set of conclusions by suggesting a threefold development to create happy, healthy and sustainable community.

Keywords: art innovation, current scenario assessment, heritage, imageability, socio-cultural sustainability

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558 Hampering The 'Right to Know': Consequences of the Excessive Interpretation of the Notion of Exemption from the Right to Information

Authors: Tomasz Lewinski

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The right to know becomes gradually recognised as an increasing number of states adopts national legislations regarding access to state-held information. Laws differ from each other in the scope of the right to information (hereinafter: RTI). In all regimes of RTI, there are exceptions from the general notion of the right. States’ authorities too often use exceptions to justify refusals to requests for state-held information. This paper sets out how states hamper RTI basing on the notion of exception and by not providing an effective procedure that could redress unlawful denials. This paper bases on two selected examples of RTI incorporation into the national legal regime, United Kingdom, and South Africa. It succinctly outlines the international standard given in Article 19 of the International Covenant on Civil and Political Rights (hereinafter: ICCPR) and its influence on the RTI in selected countries. It shortly demonstrates as a background to further analysis the Human Rights Committee’s jurisprudence and standards articulated by successive Special Rapporteurs on freedom of opinion and expression. Subsequently, it presents a brief comparison of these standards with the regional standards, namely the African Charter on Human and Peoples' Rights and the European Convention on Human Rights. It critically discusses the regimes of exceptions in RTI legislations in respective national laws. It shows how excessive these regimes are, what implications they have for the transparency in general. Also, the objective is to divide exceptions enumerated in legislations of selected states in relation to exceptions provided in Article 19 of the ICCPR. Basing on the established division of exceptions by its natures, it compares both regimes of exceptions related to the principle of national security. That is to compare jurisprudence of domestic courts, and overview practices of states’ authorities applied to RTI requests. The paper evaluates remedies available in legislations, including contexts of the length and costs of the subsequent proceedings. This provides a general assessment of the given mechanisms and present potential risks of its ineffectiveness. The paper relies on examination of the national legislations, comments of the credible non-governmental organisations (e.g. The Public's Right to Know Principles on Freedom of Information Legislation by the Article 19, The Tshwane Principles on National Security and the Right to Information), academics and also the research of the relevant judgements delivered by domestic and international courts. Conclusion assesses whether selected countries’ legislations go in line with international law and trends, whether the jurisprudence of the regional courts provide appropriate benchmarks for national courts to address RTI issues effectively. Furthermore, it identifies the largest disadvantages of current legislations and to what outcomes it leads in domestic courts jurisprudences. In the end, it provides recommendations and policy arguments for states to improve transparency and support local organisations in their endeavours to establish more transparent states and societies.

Keywords: access to information, freedom of information, national security, right to know, transparency

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557 Assessment of Biofilm Production Capacity of Industrially Important Bacteria under Electroinductive Conditions

Authors: Omolola Ojetayo, Emmanuel Garuba, Obinna Ajunwa, Abiodun A. Onilude

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Introduction: Biofilm is a functional community of microorganisms that are associated with a surface or an interface. These adherent cells become embedded within an extracellular matrix composed of polymeric substances, i.e., biofilms refer to biological deposits consisting of both microbes and their extracellular products on biotic and abiotic surfaces. Despite their detrimental effects in medicine, biofilms as natural cell immobilization have found several applications in biotechnology, such as in the treatment of wastewater, bioremediation and biodegradation, desulfurization of gas, and conversion of agro-derived materials into alcohols and organic acids. The means of enhancing immobilized cells have been chemical-inductive, and this affects the medium composition and final product. Physical factors including electrical, magnetic, and electromagnetic flux have shown potential for enhancing biofilms depending on the bacterial species, nature, and intensity of emitted signals, the duration of exposure, and substratum used. However, the concept of cell immobilisation by electrical and magnetic induction is still underexplored. Methods: To assess the effects of physical factors on biofilm formation, six American typed culture collection (Acetobacter aceti ATCC15973, Pseudomonas aeruginosa ATCC9027, Serratia marcescens ATCC14756, Gluconobacter oxydans ATCC19357, Rhodobacter sphaeroides ATCC17023, and Bacillus subtilis ATCC6633) were used. Standard culture techniques for bacterial cells were adopted. Natural autoimmobilisation potentials of test bacteria were carried out by simple biofilms ring formation on tubes, while crystal violet binding assay techniques were adopted in the characterisation of biofilm quantity. Electroinduction of bacterial cells by direct current (DC) application in cell broth, static magnetic field exposure, and electromagnetic flux were carried out, and autoimmobilisation of cells in a biofilm pattern was determined on various substrata tested, including wood, glass, steel, polyvinylchloride (PVC) and polyethylene terephthalate. Biot Savart law was used in quantifying magnetic field intensity, and statistical analyses of data obtained were carried out using the analyses of variance (ANOVA) as well as other statistical tools. Results: Biofilm formation by the selected test bacteria was enhanced by the physical factors applied. Electromagnetic induction had the greatest effect on biofilm formation, with magnetic induction producing the least effect across all substrata used. Microbial cell-cell communication could be a possible means via which physical signals affected the cells in a polarisable manner. Conclusion: The enhancement of biofilm formation by bacteria using physical factors has shown that their inherent capability as a cell immobilization method can be further optimised for industrial applications. A possible relationship between the presence of voltage-dependent channels, mechanosensitive channels, and bacterial biofilms could shed more light on this phenomenon.

Keywords: bacteria, biofilm, cell immobilization, electromagnetic induction, substrata

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556 Immunoliposome-Mediated Drug Delivery to Plasmodium-Infected and Non-Infected Red Blood Cells as a Dual Therapeutic/Prophylactic Antimalarial Strategy

Authors: Ernest Moles, Patricia Urbán, María Belén Jiménez-Díaz, Sara Viera-Morilla, Iñigo Angulo-Barturen, Maria Antònia Busquets, Xavier Fernàndez-Busquets

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Bearing in mind the absence of an effective vaccine against malaria and its severe clinical manifestations causing nearly half a million deaths every year, this disease represents nowadays a major threat to life. Besides, the basic rationale followed by currently marketed antimalarial approaches is based on the administration of drugs on their own, promoting the emergence of drug-resistant parasites owing to the limitation in delivering drug payloads into the parasitized erythrocyte high enough to kill the intracellular pathogen while minimizing the risk of causing toxic side effects to the patient. Such dichotomy has been successfully addressed through the specific delivery of immunoliposome (iLP)-encapsulated antimalarials to Plasmodium falciparum-infected red blood cells (pRBCs). Unfortunately, this strategy has not progressed towards clinical applications, whereas in vitro assays rarely reach drug efficacy improvements above 10-fold. Here, we show that encapsulation efficiencies reaching >96% can be achieved for the weakly basic drugs chloroquine (CQ) and primaquine using the pH gradient active loading method in liposomes composed of neutrally charged, saturated phospholipids. Targeting antibodies are best conjugated through their primary amino groups, adjusting chemical crosslinker concentration to retain significant antigen recognition. Antigens from non-parasitized RBCs have also been considered as targets for the intracellular delivery of drugs not affecting the erythrocytic metabolism. Using this strategy, we have obtained unprecedented nanocarrier targeting to early intraerythrocytic stages of the malaria parasite for which there is a lack of specific extracellular molecular tags. Polyethylene glycol-coated liposomes conjugated with monoclonal antibodies specific for the erythrocyte surface protein glycophorin A (anti-GPA iLP) were capable of targeting 100% RBCs and pRBCs at the low concentration of 0.5 μM total lipid in the culture, with >95% of added iLPs retained into the cells. When exposed for only 15 min to P. falciparum in vitro cultures synchronized at early stages, free CQ had no significant effect over parasite viability up to 200 nM drug, whereas iLP-encapsulated 50 nM CQ completely arrested its growth. Furthermore, when assayed in vivo in P. falciparum-infected humanized mice, anti-GPA iLPs cleared the pathogen below detectable levels at a CQ dose of 0.5 mg/kg. In comparison, free CQ administered at 1.75 mg/kg was, at most, 40-fold less efficient. Our data suggest that this significant improvement in drug antimalarial efficacy is in part due to a prophylactic effect of CQ found by the pathogen in its host cell right at the very moment of invasion.

Keywords: immunoliposomal nanoparticles, malaria, prophylactic-therapeutic polyvalent activity, targeted drug delivery

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555 Teaching Academic Writing for Publication: A Liminal Threshold Experience Towards Development of Scholarly Identity

Authors: Belinda du Plooy, Ruth Albertyn, Christel Troskie-De Bruin, Ella Belcher

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In the academy, scholarliness or intellectual craftsmanship is considered the highest level of achievement, culminating in being consistently successfully published in impactful, peer-reviewed journals and books. Scholarliness implies rigorous methods, systematic exposition, in-depth analysis and evaluation, and the highest level of critical engagement and reflexivity. However, being a scholar does not happen automatically when one becomes an academic or completes graduate studies. A graduate qualification is an indication of one’s level of research competence but does not necessarily prepare one for the type of scholarly writing for publication required after a postgraduate qualification has been conferred. Scholarly writing for publication requires a high-level skillset and a specific mindset, which must be intentionally developed. The rite of passage to become a scholar is an iterative process with liminal spaces, thresholds, transitions, and transformations. The journey from researcher to published author is often fraught with rejection, insecurity, and disappointment and requires resilience and tenacity from those who eventually triumph. It cannot be achieved without support, guidance, and mentorship. In this article, the authors use collective auto-ethnography (CAE) to describe the phases and types of liminality encountered during the liminal journey toward scholarship. The authors speak as long-time facilitators of Writing for Academic Publication (WfAP) capacity development events (training workshops and writing retreats) presented at South African universities. Their WfAP facilitation practice is structured around experiential learning principles that allow them to act as critical reading partners and reflective witnesses for the writer-participants of their WfAP events. They identify three essential facilitation features for the effective holding of a generative, liminal, and transformational writing space for novice academic writers in order to enable their safe passage through the various liminal spaces they encounter during their scholarly development journey. These features are that facilitators should be agents of disruption and liminality while also guiding writers through these liminal spaces; that there should be a sense of mutual trust and respect, shared responsibility and accountability in order for writers to produce publication-worthy scholarly work; and that this can only be accomplished with the continued application of high levels of sensitivity and discernment by WfAP facilitators. These are key features for successful WfAP scholarship training events, where focused, individual input triggers personal and professional transformational experiences, which in turn translate into high-quality scholarly outputs.

Keywords: academic writing, liminality, scholarship, scholarliness, threshold experience, writing for publication

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554 Stability in Slopes Related to Expansive Soils

Authors: Ivelise M. Strozberg, Lucas O. Vale, Maria V. V. Morais

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Expansive soils are characterized by their significant volumetric variations, tending to suffer an increase of this volume when added water in their voids and a decrease of volume when this water is removed. The parameters of resistance (especially the angle of friction, cohesion and specific weight) of expansive or non-expansive soils of the same field present differences, as found in laboratory tests. What is expected is that, through this research, demonstrate that this variation directly affects the results of the calculation of factors of safety for slope stability. The expansibility due to specific clay minerals such as montmorillonites and vermiculites is the most common form of expansion of soils or rocks, causing expansion pressures. These pressures can become an aggravating problem in regions across the globe that, when not previously studied, may present high risks to the enterprise, such as cracks, fissures, movements in structures, breaking of retaining walls, drilling of wells, among others. The study provides results based on analyzes carried out in the Slide 2018 software belonging to the Rocsience group, where the software is a two-dimensional equilibrium slope stability program that calculates the factor of safety or probability of failure of certain surfaces composed of soils or rocks (or both, depending on the situation), - through the methods of: Bishop simplified, Fellenius and Janbu corrected. This research compares the factors of safety of a homogeneous earthfill dam geometry, analysed for operation and end-of-construction situations, having a height of approximately 35 meters, with a slope of 1.5: 1 in the slope downstream and 2: 1 on the upstream slope. As the water level is 32.73m high and the water table is drawn automatically by the Slide program using the finite element method for the operating situation, considering two hypotheses for the use of materials - the first with soils with characteristics of expansion and the second with soils without expansibility. For this purpose, soil samples were collected from the region of São Bento do Una - Pernambuco, Brazil and taken to the soil mechanics laboratory to characterize and determine the percentage of expansibility. There were found 2 types of soils in that area: 1 site of expansive soils (8%) and another with non- expansive ones. Based on the results found, the analysis of the values of factors of safety indicated, both upstream and downstream slopes, the highest values were obtained in the case where there is no presence of materials with expansibility resulting, for one of the situations, values of 1.353 (Fellenius), 1,295 (Janbu corrected) and 1,409 (Bishop simplified). There is a considerable drop in safety factors in cases where soils are potentially expansive, resulting in values for the same situation of 0.859 (Fellenius), 0.809 (Janbu corrected) and 0.842 (Bishop simplified), in the case of higher expansibility (8 %). This shows that the expansibility is a determinant factor in the fall of resistance of soil, determined by the factors of cohesion and angle of friction.

Keywords: dam. slope. software. swelling soil

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553 Digital Advance Care Planning and Directives: Early Observations of Adoption Statistics and Responses from an All-Digital Consumer-Driven Approach

Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

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Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

Procedia PDF Downloads 301
552 Treatment of Onshore Petroleum Drill Cuttings via Soil Washing Process: Characterization and Optimal Conditions

Authors: T. Poyai, P. Painmanakul, N. Chawaloesphonsiya, P. Dhanasin, C. Getwech, P. Wattana

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Drilling is a key activity in oil and gas exploration and production. Drilling always requires the use of drilling mud for lubricating the drill bit and controlling the subsurface pressure. As drilling proceeds, a considerable amount of cuttings or rock fragments is generated. In general, water or Water Based Mud (WBM) serves as drilling fluid for the top hole section. The cuttings generated from this section is non-hazardous and normally applied as fill materials. On the other hand, drilling the bottom hole to reservoir section uses Synthetic Based Mud (SBM) of which synthetic oils are composed. The bottom-hole cuttings, SBM cuttings, is regarded as a hazardous waste, in accordance with the government regulations, due to the presence of hydrocarbons. Currently, the SBM cuttings are disposed of as an alternative fuel and raw material in cement kiln. Instead of burning, this work aims to propose an alternative for drill cuttings management under two ultimate goals: (1) reduction of hazardous waste volume; and (2) making use of the cleaned cuttings. Soil washing was selected as the major treatment process. The physiochemical properties of drill cuttings were analyzed, such as size fraction, pH, moisture content, and hydrocarbons. The particle size of cuttings was analyzed via light scattering method. Oil present in cuttings was quantified in terms of total petroleum hydrocarbon (TPH) through gas chromatography equipped with flame ionization detector (GC-FID). Other components were measured by the standard methods for soil analysis. Effects of different washing agents, liquid-to-solid (L/S) ratio, washing time, mixing speed, rinse-to-solid (R/S) ratio, and rinsing time were also evaluated. It was found that drill cuttings held the electrical conductivity of 3.84 dS/m, pH of 9.1, and moisture content of 7.5%. The TPH in cuttings existed in the diesel range with the concentration ranging from 20,000 to 30,000 mg/kg dry cuttings. A majority of cuttings particles held a mean diameter of 50 µm, which represented silt fraction. The results also suggested that a green solvent was considered most promising for cuttings treatment regarding occupational health, safety, and environmental benefits. The optimal washing conditions were obtained at L/S of 5, washing time of 15 min, mixing speed of 60 rpm, R/S of 10, and rinsing time of 1 min. After washing process, three fractions including clean cuttings, spent solvent, and wastewater were considered and provided with recommendations. The residual TPH less than 5,000 mg/kg was detected in clean cuttings. The treated cuttings can be then used for various purposes. The spent solvent held the calorific value of higher than 3,000 cal/g, which can be used as an alternative fuel. Otherwise, the recovery of the used solvent can be conducted using distillation or chromatography techniques. Finally, the generated wastewater can be combined with the produced water and simultaneously managed by re-injection into the reservoir.

Keywords: drill cuttings, green solvent, soil washing, total petroleum hydrocarbon (TPH)

Procedia PDF Downloads 133
551 The Properties of Risk-based Approaches to Asset Allocation Using Combined Metrics of Portfolio Volatility and Kurtosis: Theoretical and Empirical Analysis

Authors: Maria Debora Braga, Luigi Riso, Maria Grazia Zoia

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Risk-based approaches to asset allocation are portfolio construction methods that do not rely on the input of expected returns for the asset classes in the investment universe and only use risk information. They include the Minimum Variance Strategy (MV strategy), the traditional (volatility-based) Risk Parity Strategy (SRP strategy), the Most Diversified Portfolio Strategy (MDP strategy) and, for many, the Equally Weighted Strategy (EW strategy). All the mentioned approaches were based on portfolio volatility as a reference risk measure but in 2023, the Kurtosis-based Risk Parity strategy (KRP strategy) and the Minimum Kurtosis strategy (MK strategy) were introduced. Understandably, they used the fourth root of the portfolio-fourth moment as a proxy for portfolio kurtosis to work with a homogeneous function of degree one. This paper contributes mainly theoretically and methodologically to the framework of risk-based asset allocation approaches with two steps forward. First, a new and more flexible objective function considering a linear combination (with positive coefficients that sum to one) of portfolio volatility and portfolio kurtosis is used to alternatively serve a risk minimization goal or a homogeneous risk distribution goal. Hence, the new basic idea consists in extending the achievement of typical risk-based approaches’ goals to a combined risk measure. To give the rationale behind operating with such a risk measure, it is worth remembering that volatility and kurtosis are expressions of uncertainty, to be read as dispersion of returns around the mean and that both preserve adherence to a symmetric framework and consideration for the entire returns distribution as well, but also that they differ from each other in that the former captures the “normal” / “ordinary” dispersion of returns, while the latter is able to catch the huge dispersion. Therefore, the combined risk metric that uses two individual metrics focused on the same phenomena but differently sensitive to its intensity allows the asset manager to express, in the context of an objective function by varying the “relevance coefficient” associated with the individual metrics, alternatively, a wide set of plausible investment goals for the portfolio construction process while serving investors differently concerned with tail risk and traditional risk. Since this is the first study that also implements risk-based approaches using a combined risk measure, it becomes of fundamental importance to investigate the portfolio effects triggered by this innovation. The paper also offers a second contribution. Until the recent advent of the MK strategy and the KRP strategy, efforts to highlight interesting properties of risk-based approaches were inevitably directed towards the traditional MV strategy and SRP strategy. Previous literature established an increasing order in terms of portfolio volatility, starting from the MV strategy, through the SRP strategy, arriving at the EQ strategy and provided the mathematical proof for the “equalization effect” concerning marginal risks when the MV strategy is considered, and concerning risk contributions when the SRP strategy is considered. Regarding the validity of similar conclusions when referring to the MK strategy and KRP strategy, the development of a theoretical demonstration is still pending. This paper fills this gap.

Keywords: risk parity, portfolio kurtosis, risk diversification, asset allocation

Procedia PDF Downloads 42
550 The Location-Routing Problem with Pickup Facilities and Heterogeneous Demand: Formulation and Heuristics Approach

Authors: Mao Zhaofang, Xu Yida, Fang Kan, Fu Enyuan, Zhao Zhao

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Nowadays, last-mile distribution plays an increasingly important role in the whole industrial chain delivery link and accounts for a large proportion of the whole distribution process cost. Promoting the upgrading of logistics networks and improving the layout of final distribution points has become one of the trends in the development of modern logistics. Due to the discrete and heterogeneous needs and spatial distribution of customer demand, which will lead to a higher delivery failure rate and lower vehicle utilization, last-mile delivery has become a time-consuming and uncertain process. As a result, courier companies have introduced a range of innovative parcel storage facilities, including pick-up points and lockers. The introduction of pick-up points and lockers has not only improved the users’ experience but has also helped logistics and courier companies achieve large-scale economy. Against the backdrop of the COVID-19 of the previous period, contactless delivery has become a new hotspot, which has also created new opportunities for the development of collection services. Therefore, a key issue for logistics companies is how to design/redesign their last-mile distribution network systems to create integrated logistics and distribution networks that consider pick-up points and lockers. This paper focuses on the introduction of self-pickup facilities in new logistics and distribution scenarios and the heterogeneous demands of customers. In this paper, we consider two types of demand, including ordinary products and refrigerated products, as well as corresponding transportation vehicles. We consider the constraints associated with self-pickup points and lockers and then address the location-routing problem with self-pickup facilities and heterogeneous demands (LRP-PFHD). To solve this challenging problem, we propose a mixed integer linear programming (MILP) model that aims to minimize the total cost, which includes the facility opening cost, the variable transport cost, and the fixed transport cost. Due to the NP-hardness of the problem, we propose a hybrid adaptive large-neighbourhood search algorithm to solve LRP-PFHD. We evaluate the effectiveness and efficiency of the proposed algorithm by using instances generated based on benchmark instances. The results demonstrate that the hybrid adaptive large neighbourhood search algorithm is more efficient than MILP solvers such as Gurobi for LRP-PFHD, especially for large-scale instances. In addition, we made a comprehensive analysis of some important parameters (e.g., facility opening cost and transportation cost) to explore their impacts on the results and suggested helpful managerial insights for courier companies.

Keywords: city logistics, last-mile delivery, location-routing, adaptive large neighborhood search

Procedia PDF Downloads 41
549 The Rise of Blue Water Navy and its Implication for the Region

Authors: Riddhi Chopra

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Alfred Thayer Mahan described the sea as a ‘great common,’ which would serve as a medium for communication, trade, and transport. The seas of Asia are witnessing an intriguing historical anomaly – rise of an indigenous maritime power against the backdrop of US domination over the region. As China transforms from an inward leaning economy to an outward-leaning economy, it has become increasingly dependent on the global sea; as a result, we witness an evolution in its maritime strategy from near seas defense to far seas deployment strategies. It is not only patrolling the international waters but has also built a network of civilian and military infrastructure across the disputed oceanic expanse. The paper analyses the reorientation of China from a naval power to a blue water navy in an era of extensive globalisation. The actions of the Chinese have created a zone of high alert amongst its neighbors such as Japan, Philippines, Vietnam and North Korea. These nations are trying to align themselves so as to counter China’s growing brinkmanship, but China has been pursuing claims through a carefully calibrated strategy in the region shunning any coercive measures taken by other forces. If China continues to expand its maritime boundaries, its neighbors – all smaller and weaker Asian nations would be limited to a narrow band of the sea along its coastlines. Hence it is essential for the US to intervene and support its allies to offset Chinese supremacy. The paper intends to provide a profound analysis over the disputes in South China Sea and East China Sea focusing on Philippines and Japan respectively. Moreover, the paper attempts to give an account of US involvement in the region and its alignment with its South Asian allies. The geographic dynamics is said the breed a national coalition dominating the strategic ambitions of China as well as the weak littoral states. China has conducted behind the scenes diplomacy trying to persuade its neighbors to support its position on the territorial disputes. These efforts have been successful in creating fault lines in ASEAN thereby undermining regional integrity to reach a consensus on the issue. Chinese diplomatic efforts have also forced the US to revisit its foreign policy and engage with players like Cambodia and Laos. The current scenario in the SCS points to a strong Chinese hold trying to outspace all others with no regards to International law. Chinese activities are in contrast with US principles like Freedom of Navigation thereby signaling US to take bold actions to prevent Chinese hegemony in the region. The paper ultimately seeks to explore the changing power dynamics among various claimants where a rival superpower like US can pursue the traditional policy of alliance formation play a decisive role in changing the status quo in the arena, consequently determining the future trajectory.

Keywords: China, East China Sea, South China Sea, USA

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548 Screening for Women with Chorioamnionitis: An Integrative Literature Review

Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

Procedia PDF Downloads 100
547 Improving Literacy Level Through Digital Books for Deaf and Hard of Hearing Students

Authors: Majed A. Alsalem

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In our contemporary world, literacy is an essential skill that enables students to increase their efficiency in managing the many assignments they receive that require understanding and knowledge of the world around them. In addition, literacy enhances student participation in society improving their ability to learn about the world and interact with others and facilitating the exchange of ideas and sharing of knowledge. Therefore, literacy needs to be studied and understood in its full range of contexts. It should be seen as social and cultural practices with historical, political, and economic implications. This study aims to rebuild and reorganize the instructional designs that have been used for deaf and hard-of-hearing (DHH) students to improve their literacy level. The most critical part of this process is the teachers; therefore, teachers will be the center focus of this study. Teachers’ main job is to increase students’ performance by fostering strategies through collaborative teamwork, higher-order thinking, and effective use of new information technologies. Teachers, as primary leaders in the learning process, should be aware of new strategies, approaches, methods, and frameworks of teaching in order to apply them to their instruction. Literacy from a wider view means acquisition of adequate and relevant reading skills that enable progression in one’s career and lifestyle while keeping up with current and emerging innovations and trends. Moreover, the nature of literacy is changing rapidly. The notion of new literacy changed the traditional meaning of literacy, which is the ability to read and write. New literacy refers to the ability to effectively and critically navigate, evaluate, and create information using a range of digital technologies. The term new literacy has received a lot of attention in the education field over the last few years. New literacy provides multiple ways of engagement, especially to those with disabilities and other diverse learning needs. For example, using a number of online tools in the classroom provides students with disabilities new ways to engage with the content, take in information, and express their understanding of this content. This study will provide teachers with the highest quality of training sessions to meet the needs of DHH students so as to increase their literacy levels. This study will build a platform between regular instructional designs and digital materials that students can interact with. The intervention that will be applied in this study will be to train teachers of DHH to base their instructional designs on the notion of Technology Acceptance Model (TAM) theory. Based on the power analysis that has been done for this study, 98 teachers are needed to be included in this study. This study will choose teachers randomly to increase internal and external validity and to provide a representative sample from the population that this study aims to measure and provide the base for future and further studies. This study is still in process and the initial results are promising by showing how students have engaged with digital books.

Keywords: deaf and hard of hearing, digital books, literacy, technology

Procedia PDF Downloads 465
546 Crustal Scale Seismic Surveys in Search for Gawler Craton Iron Oxide Cu-Au (IOCG) under Very Deep Cover

Authors: E. O. Okan, A. Kepic, P. Williams

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Iron oxide copper gold (IOCG) deposits constitute important sources of copper and gold in Australia especially since the discovery of the supergiant Olympic Dam deposits in 1975. They are considered to be metasomatic expressions of large crustal-scale alteration events occasioned by intrusive actions and are associated with felsic igneous rocks in most cases, commonly potassic igneous magmatism, with the deposits ranging from ~2.2 –1.5 Ga in age. For the past two decades, geological, geochemical and potential methods have been used to identify the structures hosting these deposits follow up by drilling. Though these methods have largely been successful for shallow targets, at deeper depth due to low resolution they are limited to mapping only very large to gigantic deposits with sufficient contrast. As the search for ore-bodies under regolith cover continues due to depletion of the near surface deposits, there is a compelling need to develop new exploration technology to explore these deep seated ore-bodies within 1-4km which is the current mining depth range. Seismic reflection method represents this new technology as it offers a distinct advantage over all other geophysical techniques because of its great depth of penetration and superior spatial resolution maintained with depth. Further, in many different geological scenarios, it offers a greater ‘3D mapability’ of units within the stratigraphic boundary. Despite these superior attributes, no arguments for crustal scale seismic surveys have been proposed because there has not been a compelling argument of economic benefit to proceed with such work. For the seismic reflection method to be used at these scales (100’s to 1000’s of square km covered) the technical risks or the survey costs have to be reduced. In addition, as most IOCG deposits have large footprint due to its association with intrusions and large fault zones; we hypothesized that these deposits can be found by mainly looking for the seismic signatures of intrusions along prospective structures. In this study, we present two of such cases: - Olympic Dam and Vulcan iron-oxide copper-gold (IOCG) deposits all located in the Gawler craton, South Australia. Results from our 2D modelling experiments revealed that seismic reflection surveys using 20m geophones and 40m shot spacing as an exploration tool for locating IOCG deposit is possible even when hosted in very complex structures. The migrated sections were not only able to identify and trace various layers plus the complex structures but also show reflections around the edges of intrusive packages. The presences of such intrusions were clearly detected from 100m to 1000m depth range without losing its resolution. The modelled seismic images match the available real seismic data and have the hypothesized characteristics; thus, the seismic method seems to be a valid exploration tool to find IOCG deposits. We therefore propose that 2D seismic survey is viable for IOCG exploration as it can detect mineralised intrusive structures along known favourable corridors. This would help in reducing the exploration risk associated with locating undiscovered resources as well as conducting a life-of-mine study which will enable better development decisions at the very beginning.

Keywords: crustal scale, exploration, IOCG deposit, modelling, seismic surveys

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545 Improving the Biomechanical Resistance of a Treated Tooth via Composite Restorations Using Optimised Cavity Geometries

Authors: Behzad Babaei, B. Gangadhara Prusty

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The objective of this study is to assess the hypotheses that a restored tooth with a class II occlusal-distal (OD) cavity can be strengthened by designing an optimized cavity geometry, as well as selecting the composite restoration with optimized elastic moduli when there is a sharp de-bonded edge at the interface of the tooth and restoration. Methods: A scanned human maxillary molar tooth was segmented into dentine and enamel parts. The dentine and enamel profiles were extracted and imported into a finite element (FE) software. The enamel rod orientations were estimated virtually. Fifteen models for the restored tooth with different cavity occlusal depths (1.5, 2, and 2.5 mm) and internal cavity angles were generated. By using a semi-circular stone part, a 400 N load was applied to two contact points of the restored tooth model. The junctions between the enamel, dentine, and restoration were considered perfectly bonded. All parts in the model were considered homogeneous, isotropic, and elastic. The quadrilateral and triangular elements were employed in the models. A mesh convergence analysis was conducted to verify that the element numbers did not influence the simulation results. According to the criteria of a 5% error in the stress, we found that a total element number of over 14,000 elements resulted in the convergence of the stress. A Python script was employed to automatically assign 2-22 GPa moduli (with increments of 4 GPa) for the composite restorations, 18.6 GPa to the dentine, and two different elastic moduli to the enamel (72 GPa in the enamel rods’ direction and 63 GPa in perpendicular one). The linear, homogeneous, and elastic material models were considered for the dentine, enamel, and composite restorations. 108 FEA simulations were successively conducted. Results: The internal cavity angles (α) significantly altered the peak maximum principal stress at the interface of the enamel and restoration. The strongest structures against the contact loads were observed in the models with α = 100° and 105. Even when the enamel rods’ directional mechanical properties were disregarded, interestingly, the models with α = 100° and 105° exhibited the highest resistance against the mechanical loads. Regarding the effect of occlusal cavity depth, the models with 1.5 mm depth showed higher resistance to contact loads than the model with thicker cavities (2.0 and 2.5 mm). Moreover, the composite moduli in the range of 10-18 GPa alleviated the stress levels in the enamel. Significance: For the class II OD cavity models in this study, the optimal geometries, composite properties, and occlusal cavity depths were determined. Designing the cavities with α ≥100 ̊ was significantly effective in minimizing peak stress levels. The composite restoration with optimized properties reduced the stress concentrations on critical points of the models. Additionally, when more enamel was preserved, the sturdier enamel-restoration interface against the mechanical loads was observed.

Keywords: dental composite restoration, cavity geometry, finite element approach, maximum principal stress

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544 Suicide Wrongful Death: Standard of Care Problems Involving the Inaccurate Discernment of Lethal Risk When Focusing on the Elicitation of Suicide Ideation

Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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543 A Biophysical Study of the Dynamic Properties of Glucagon Granules in α Cells by Imaging-Derived Mean Square Displacement and Single Particle Tracking Approaches

Authors: Samuele Ghignoli, Valentina de Lorenzi, Gianmarco Ferri, Stefano Luin, Francesco Cardarelli

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Insulin and glucagon are the two essential hormones for maintaining proper blood glucose homeostasis, which is disrupted in Diabetes. A constantly growing research interest has been focused on the study of the subcellular structures involved in hormone secretion, namely insulin- and glucagon-containing granules, and on the mechanisms regulating their behaviour. Yet, while several successful attempts were reported describing the dynamic properties of insulin granules, little is known about their counterparts in α cells, the glucagon-containing granules. To fill this gap, we used αTC1 clone 9 cells as a model of α cells and ZIGIR as a fluorescent Zinc chelator for granule labelling. We started by using spatiotemporal fluorescence correlation spectroscopy in the form of imaging-derived mean square displacement (iMSD) analysis. This afforded quantitative information on the average dynamical and structural properties of glucagon granules having insulin granules as a benchmark. Interestingly, the iMSD sensitivity to average granule size allowed us to confirm that glucagon granules are smaller than insulin ones (~1.4 folds, further validated by STORM imaging). To investigate possible heterogeneities in granule dynamic properties, we moved from correlation spectroscopy to single particle tracking (SPT). We developed a MATLAB script to localize and track single granules with high spatial resolution. This enabled us to classify the glucagon granules, based on their dynamic properties, as ‘blocked’ (i.e., trajectories corresponding to immobile granules), ‘confined/diffusive’ (i.e., trajectories corresponding to slowly moving granules in a defined region of the cell), or ‘drifted’ (i.e., trajectories corresponding to fast-moving granules). In cell-culturing control conditions, results show this average distribution: 32.9 ± 9.3% blocked, 59.6 ± 9.3% conf/diff, and 7.4 ± 3.2% drifted. This benchmarking provided us with a foundation for investigating selected experimental conditions of interest, such as the glucagon-granule relationship with the cytoskeleton. For instance, if Nocodazole (10 μM) is used for microtubule depolymerization, the percentage of drifted motion collapses to 3.5 ± 1.7% while immobile granules increase to 56.0 ± 10.7% (remaining 40.4 ± 10.2% of conf/diff). This result confirms the clear link between glucagon-granule motion and cytoskeleton structures, a first step towards understanding the intracellular behaviour of this subcellular compartment. The information collected might now serve to support future investigations on glucagon granules in physiology and disease. Acknowledgment: This work has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 866127, project CAPTUR3D).

Keywords: glucagon granules, single particle tracking, correlation spectroscopy, ZIGIR

Procedia PDF Downloads 70
542 A Numerical Hybrid Finite Element Model for Lattice Structures Using 3D/Beam Elements

Authors: Ahmadali Tahmasebimoradi, Chetra Mang, Xavier Lorang

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Thanks to the additive manufacturing process, lattice structures are replacing the traditional structures in aeronautical and automobile industries. In order to evaluate the mechanical response of the lattice structures, one has to resort to numerical techniques. Ansys is a globally well-known and trusted commercial software that allows us to model the lattice structures and analyze their mechanical responses using either solid or beam elements. In this software, a script may be used to systematically generate the lattice structures for any size. On the one hand, solid elements allow us to correctly model the contact between the substrates (the supports of the lattice structure) and the lattice structure, the local plasticity, and the junctions of the microbeams. However, their computational cost increases rapidly with the size of the lattice structure. On the other hand, although beam elements reduce the computational cost drastically, it doesn’t correctly model the contact between the lattice structures and the substrates nor the junctions of the microbeams. Also, the notion of local plasticity is not valid anymore. Moreover, the deformed shape of the lattice structure doesn’t correspond to the deformed shape of the lattice structure using 3D solid elements. In this work, motivated by the pros and cons of the 3D and beam models, a numerically hybrid model is presented for the lattice structures to reduce the computational cost of the simulations while avoiding the aforementioned drawbacks of the beam elements. This approach consists of the utilization of solid elements for the junctions and beam elements for the microbeams connecting the corresponding junctions to each other. When the global response of the structure is linear, the results from the hybrid models are in good agreement with the ones from the 3D models for body-centered cubic with z-struts (BCCZ) and body-centered cubic without z-struts (BCC) lattice structures. However, the hybrid models have difficulty to converge when the effect of large deformation and local plasticity are considerable in the BCCZ structures. Furthermore, the effect of the junction’s size of the hybrid models on the results is investigated. For BCCZ lattice structures, the results are not affected by the junction’s size. This is also valid for BCC lattice structures as long as the ratio of the junction’s size to the diameter of the microbeams is greater than 2. The hybrid model can take into account the geometric defects. As a demonstration, the point clouds of two lattice structures are parametrized in a platform called LATANA (LATtice ANAlysis) developed by IRT-SystemX. In this process, for each microbeam of the lattice structures, an ellipse is fitted to capture the effect of shape variation and roughness. Each ellipse is represented by three parameters; semi-major axis, semi-minor axis, and angle of rotation. Having the parameters of the ellipses, the lattice structures are constructed in Spaceclaim (ANSYS) using the geometrical hybrid approach. The results show a negligible discrepancy between the hybrid and 3D models, while the computational cost of the hybrid model is lower than the computational cost of the 3D model.

Keywords: additive manufacturing, Ansys, geometric defects, hybrid finite element model, lattice structure

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541 Satisfaction Among Preclinical Medical Students with Low-Fidelity Simulation-Based Learning

Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

Abstract:

Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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540 Improving the Quality of Discussion and Documentation of Advance Care Directives in a Community-Based Resident Primary Care Clinic

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

Abstract:

Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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539 Lean Comic GAN (LC-GAN): a Light-Weight GAN Architecture Leveraging Factorized Convolution and Teacher Forcing Distillation Style Loss Aimed to Capture Two Dimensional Animated Filtered Still Shots Using Mobile Phone Camera and Edge Devices

Authors: Kaustav Mukherjee

Abstract:

In this paper we propose a Neural Style Transfer solution whereby we have created a Lightweight Separable Convolution Kernel Based GAN Architecture (SC-GAN) which will very useful for designing filter for Mobile Phone Cameras and also Edge Devices which will convert any image to its 2D ANIMATED COMIC STYLE Movies like HEMAN, SUPERMAN, JUNGLE-BOOK. This will help the 2D animation artist by relieving to create new characters from real life person's images without having to go for endless hours of manual labour drawing each and every pose of a cartoon. It can even be used to create scenes from real life images.This will reduce a huge amount of turn around time to make 2D animated movies and decrease cost in terms of manpower and time. In addition to that being extreme light-weight it can be used as camera filters capable of taking Comic Style Shots using mobile phone camera or edge device cameras like Raspberry Pi 4,NVIDIA Jetson NANO etc. Existing Methods like CartoonGAN with the model size close to 170 MB is too heavy weight for mobile phones and edge devices due to their scarcity in resources. Compared to the current state of the art our proposed method which has a total model size of 31 MB which clearly makes it ideal and ultra-efficient for designing of camera filters on low resource devices like mobile phones, tablets and edge devices running OS or RTOS. .Owing to use of high resolution input and usage of bigger convolution kernel size it produces richer resolution Comic-Style Pictures implementation with 6 times lesser number of parameters and with just 25 extra epoch trained on a dataset of less than 1000 which breaks the myth that all GAN need mammoth amount of data. Our network reduces the density of the Gan architecture by using Depthwise Separable Convolution which does the convolution operation on each of the RGB channels separately then we use a Point-Wise Convolution to bring back the network into required channel number using 1 by 1 kernel.This reduces the number of parameters substantially and makes it extreme light-weight and suitable for mobile phones and edge devices. The architecture mentioned in the present paper make use of Parameterised Batch Normalization Goodfellow etc al. (Deep Learning OPTIMIZATION FOR TRAINING DEEP MODELS page 320) which makes the network to use the advantage of Batch Norm for easier training while maintaining the non-linear feature capture by inducing the learnable parameters

Keywords: comic stylisation from camera image using GAN, creating 2D animated movie style custom stickers from images, depth-wise separable convolutional neural network for light-weight GAN architecture for EDGE devices, GAN architecture for 2D animated cartoonizing neural style, neural style transfer for edge, model distilation, perceptual loss

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538 Role of Indigenous Women in Securing Sustainable Livelihoods in Western Himalayan Region, India

Authors: Haresh Sharma, Jaimini Luharia

Abstract:

The ecology in the Western Himalayan region transforms with the change in altitude. This change is observed in terms of topography, species of flora and fauna and the quality of the soil. The current study focuses on women of indigenous communities of Pangi Valley, which is located in the state of Himachal Pradesh, India. The valley is bifurcated into three different areas –Saichu, Hudan Bhatori, and Sural Bhatori valleys. It is one of the most remote, rugged and difficult to access tribal regions of Chamba district. The altitude of the valley ranges from 2,000 m to 6,000 m above sea level. The Pangi valley is inhabited by ‘Pangwals’ and ‘Bhots’ tribes of the Himalayas who speak their local tribal language called’ Pangwali’. The valley is cut-off from the mainland due to heavy snow and lack of proper roads during peak winters. Due to difficult geographical location, the daily lives of the people are constantly challenged, and they are most of the times deprived of benefits targeted through government programs. However, the indigenous communities earn their livelihood through livestock and forest-based produce while some of them migrate to nearby places for better work. The current study involves snowball sampling methodology for data collection along with in-depth interviews of women members of Self-Help Groups and women farmers. The findings reveal that the lives of these indigenous communities largely depend on forest-based products. So, it creates all the more significance of enhancing, maintaining, and consuming natural resources sustainably. Under such circumstances, the women of the community play a significant role of guardians in conservation and protection of the forests. They are the custodians of traditional knowledge of environment conservation practices that have been followed for many years in the region. The present study also sought to establish a relationship between some of the development initiatives undertaken by the women in the valley that stimulate sustainable mountain economy and conservation practices. These initiatives include cultivation of products like hazelnut, ‘Gucchi’ rare quality mushroom, medicinal plants exclusively found in the region, thereby promoting long term sustainable conservation of agro-biodiversity of the Western Himalayan region. The measures taken by the community women are commendable as they ensure access and distribution of natural resources as well as manage them for future generations. Apart from this, the tribal women have actively formed Self-Help Groups promoting financial inclusion through various activities that augment ownership and accountability towards the overall development of the communities. But, the results also suggest that there’s not enough recognition given to women’s role in forests conservation practices due to several local socio-political reasons. There are not enough research studies done on communities of Pangi Valley due to inaccessibility created out of lack of proper roads and other resources. Also, there emerged a need to concretize indigenous and traditional knowledge of conservation practices followed by women in the community.

Keywords: forest conservation, indigenous community women, sustainable livelihoods, sustainable development, poverty alleviation, Western Himalayas

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537 Improving Working Memory in School Children through Chess Training

Authors: Veena Easvaradoss, Ebenezer Joseph, Sumathi Chandrasekaran, Sweta Jain, Aparna Anna Mathai, Senta Christy

Abstract:

Working memory refers to a cognitive processing space where information is received, managed, transformed, and briefly stored. It is an operational process of transforming information for the execution of cognitive tasks in different and new ways. Many class room activities require children to remember information and mentally manipulate it. While the impact of chess training on intelligence and academic performance has been unequivocally established, its impact on working memory needs to be studied. This study, funded by the Cognitive Science Research Initiative, Department of Science & Technology, Government of India, analyzed the effect of one-year chess training on the working memory of children. A pretest–posttest with control group design was used, with 52 children in the experimental group and 50 children in the control group. The sample was selected from children studying in school (grades 3 to 9), which included both the genders. The experimental group underwent weekly chess training for one year, while the control group was involved in extracurricular activities. Working memory was measured by two subtests of WISC-IV INDIA. The Digit Span Subtest involves recalling a list of numbers of increasing length presented orally in forward and in reverse order, and the Letter–Number Sequencing Subtest involves rearranging jumbled alphabets and numbers presented orally following a given rule. Both tasks require the child to receive and briefly store information, manipulate it, and present it in a changed format. The Children were trained using Winning Moves curriculum, audio- visual learning method, hands-on- chess training and recording the games using score sheets, analyze their mistakes, thereby increasing their Meta-Analytical abilities. They were also trained in Opening theory, Checkmating techniques, End-game theory and Tactical principles. Pre equivalence of means was established. Analysis revealed that the experimental group had significant gains in working memory compared to the control group. The present study clearly establishes a link between chess training and working memory. The transfer of chess training to the improvement of working memory could be attributed to the fact that while playing chess, children evaluate positions, visualize new positions in their mind, analyze the pros and cons of each move, and choose moves based on the information stored in their mind. If working-memory’s capacity could be expanded or made to function more efficiently, it could result in the improvement of executive functions as well as the scholastic performance of the child.

Keywords: chess training, cognitive development, executive functions, school children, working memory

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536 Screening of Osteoporosis in Aging Populations

Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

Abstract:

Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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