Search results for: medical and health
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11241

Search results for: medical and health

5751 Cultural Background as Moderator of the Association Between Personal Bonding Social Capital and Well-Being: An Association Study in a Sample of Dutch and Turkish Older Adults in the Netherlands

Authors: Marianne Simons, Sinan Kurt, Marjolein Stefens, Kai Karos, Johan Lataster

Abstract:

As cultural diversity within older populations in European countries increases, the role of cultural background should be taken account of in aging studies. Bonding social capital (BSC), containing someone’s socio-emotional resources, is recognised as an important ingredient for wellbeing in old age and found to be associated with someone’s cultural background. The current study examined the association between BSC, loneliness and wellbeing in a sample including older Turkish migrants with a collectivistic cultural background and native Dutch older adults, both living in the Netherlands, characterised by an individualistic culture. A sample of 119 Turkish migrants (64.7% male; age 65-87, M(SD)=71.13(5.04) and 124 native Dutch adults (32.3% male, age 65-94, M(SD)= 71.9(5.32) filled out either an online or printed questionnaire measuring BSC, psychological, social and emotional well-being, loneliness and relevant demographic covariates. Regression analysis - including confounders age, gender, level of education, physical health and relationship - showed positive associations between BSC and respectively emotional, social and psychological well-being and a negative association with loneliness in both samples. Moderation analyses showed that these associations were significantly stronger for the Turkish older migrants than for their native peers. Measurement invariance analysis indicated partial metric invariance for the measurement of BSC and loneliness and non-invariance for wellbeing, calling for caution comparing means between samples. The results stress the importance of BSC for wellbeing of older migrants from collectivistic cultures living in individualistic countries. Previous research, shows a trend of older migrants displaying lower levels of BSC as well as associated variables, such as education, physical health, and financial income. This calls for more research of the interplay between demographic and psychosocial factors restraining mental wellbeing of older migrant populations. Measurement invariance analyses further emphasize the importance of taking cultural background into account in positive aging studies.

Keywords: positive aging, cultural background, wellbeing, social capital, loneliness

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5750 Using Photo-Elicitation to Explore the Cosmology of Personal Training

Authors: John Gray, Andy Smith, Hazel James

Abstract:

With the introduction of projects such as GP referral and other medical exercise schemes, there has been a shift in the cosmology underpinning exercise leadership. That is, the knowledge base of exercise leaders, specifically personal trainers, has moved from a cosmology based on aesthetic and physical fitness demands to one requiring interaction with the dominant biomedical model underpinning contemporary medicine. In line with this shift research has demonstrated that personal trainer education has aligned itself to a biotechnological model. However, whilst there is a need to examine exercise as medicine, and consider the role of personal trainers as prescribers of these interventions, the possible issues surrounding the growing medicalization of the exercise cosmology have not been explored. Using a phenomenological methodology, and the novel approach of photo-elicitation, this research examined the practices of successful personal trainers. The findings highlight that a growing focus on an iatro-biological based scientific process of exercise prescription may prove problematical. Through the development of a model of practitioner-based knowledge, it is argued there is a possible growing disconnection between the theoretical basis of exercise science and the working cosmology of exercise practitioners.

Keywords: biomedicine, cosmology, personal training, photo-elicitation

Procedia PDF Downloads 385
5749 Subway Ridership Estimation at a Station-Level: Focus on the Impact of Bus Demand, Commercial Business Characteristics and Network Topology

Authors: Jungyeol Hong, Dongjoo Park

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The primary purpose of this study is to develop a methodological framework to predict daily subway ridership at a station-level and to examine the association between subway ridership and bus demand incorporating commercial business facility in the vicinity of each subway station. The socio-economic characteristics, land-use, and built environment as factors may have an impact on subway ridership. However, it should be considered not only the endogenous relationship between bus and subway demand but also the characteristics of commercial business within a subway station’s sphere of influence, and integrated transit network topology. Regarding a statistical approach to estimate subway ridership at a station level, therefore it should be considered endogeneity and heteroscedastic issues which might have in the subway ridership prediction model. This study focused on both discovering the impacts of bus demand, commercial business characteristics, and network topology on subway ridership and developing more precise subway ridership estimation accounting for its statistical bias. The spatial scope of the study covers entire Seoul city in South Korea and includes 243 stations with the temporal scope set at twenty-four hours with one-hour interval time panels each. The data for subway and bus ridership was collected Seoul Smart Card data from 2015 and 2016. Three-Stage Least Square(3SLS) approach was applied to develop daily subway ridership model as capturing the endogeneity and heteroscedasticity between bus and subway demand. Independent variables incorporating in the modeling process were commercial business characteristics, social-economic characteristics, safety index, transit facility attributes, and dummies for seasons and time zone. As a result, it was found that bus ridership and subway ridership were endogenous each other and they had a significantly positive sign of coefficients which means one transit mode could increase another transportation mode’s ridership. In other words, two transit modes of subway and bus have a mutual relationship instead of the competitive relationship. The commercial business characteristics are the most critical dimension among the independent variables. The variables of commercial business facility rate in the paper containing six types; medical, educational, recreational, financial, food service, and shopping. From the model result, a higher rate in medical, financial buildings, shopping, and food service facility lead to increment of subway ridership at a station, while recreational and educational facility shows lower subway ridership. The complex network theory was applied for estimating integrated network topology measures that cover the entire Seoul transit network system, and a framework for seeking an impact on subway ridership. The centrality measures were found to be significant and showed a positive sign indicating higher centrality led to more subway ridership at a station level. The results of model accuracy tests by out of samples provided that 3SLS model has less mean square error rather than OLS and showed the methodological approach for the 3SLS model was plausible to estimate more accurate subway ridership. Acknowledgement: This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science and ICT (2017R1C1B2010175).

Keywords: subway ridership, bus ridership, commercial business characteristic, endogeneity, network topology

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5748 The Effects of Globalization on Health: A Case of Kenyatta National Hospital Healthcare Services

Authors: S. Ithai, A. Oloo

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The emergence of globalization has cultivated an international consensus that without economic development; it is very unlikely that a country may realize social or political development. It is equally important to note that the economic effect on social development automatically influence the country healthcare services as healthcare systems are improved and adopted. For decades and before 1980's, the colonial and the Governments of Kenya had pursued a goal to provide free healthcare services to its citizen with minimal success; but as population increased, this endeavor became almost a mirage. The challenge called for a change of strategy with introduction of cost sharing which also could not guarantee sustainability of healthcare services in the country due to increased number of poor people and poverty. An involvement of multisectral approach to provision of health individual, collaboration and adoption of all dimensions through globalization provides a ray of hope to not only economic, political and social development but also guaranteed equitable and reliable healthcare systems in Kenya and specifically referral healthcare services at KNH. With the advent of globalization, KNH has made positive strides that have guaranteed patients with reliable healthcare services. These include increased donor funding, collaboration levels, training and research as well as enhanced the hospital relations with international partners. During this period, the hospital has increased number of local doctors and nurses, enhanced transfer of skills, innovations and technologies which are driving forces to quality and efficient healthcare services. The period has also brought in challenges for the hospital which include increased competition, attraction of qualified nurses and doctors to international are some the issues that have made the hospital to spend more resources in research and development in order to stay afloat. This paper reveals the link between globalization and healthcare and its influence on institution policy choice. However, the process is not expected to take place automatically without institutional initiatives if KNH is to reap the benefits of globalization. KNH need to make use of the existing infrastructure, human resources and donor confidence, the opportunities that are indeed important in propelling KNH toward Vision 2030 and achieving the desired Millennium Development Goals (MDGs).

Keywords: globalization, Kenyatta National Hospital, native, healthcare

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5747 Preparations of Fruit Nectars from Fresh Fruit Juices-Analyses before and after Storage

Authors: Youcef Amir

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The consumption of beverages continues to grow worldwide due to increasing demography, but pure fruit juices and high-quality nectars can induce protective effects on human health because of their natural bioactive components. In contrast, sodas and gaseous drinks containing synthetic food additives are considered as responsible for consumers of several pathologies such as obesity, diabetes, and non-alcoholic fatty liver disease. The nutritional and therapeutic virtues of fruit juices are generally a remarkable antioxidant power, anti-cancer activity linked to their richness of indigestible and indigestible sugars, vitamins, mineral salts, carotenoids and phenolic compounds. The main reasons, which led us to produce these fruit derivatives, are the non-availability of the fresh fruits mentioned above all along the year and also the existence of variations in the chemical composition of these different fruits as well as for the major or minor components. We tested, therefore, the physicochemical characteristics of each fruit juice and pulp apart and afterward those of the cocktails formulated. The fresh juices used during our experiments were obtained from the following fruits from north-central Algeria: prickly pear, pomegranate, melon, red oranges. The formulations of these fruit juices were tested after several trials comprising sensorial analysis, physicochemical factors (pH, titratable acidity, Brix degree, formal index, water content, total ash, total and reducing sugars, vitamin C, carotenoids, phenolic compounds) and microbial analysis after a storage period. To the pure juices proportions, citric acid E330, sucrose, and water were added followed by pasteurisation. These products were analysed from the physicochemical, microbial and sensorial viewpoints after a storage period of one month according to national legislation to evaluate their stability. The results of the physicochemical parameters of the prepared beverages had shown good physicochemical results, acceptable sensorial characteristics and microbial stability and safety before and after a storage period. We measured appreciable amounts of minor compounds with health properties.

Keywords: fruit juices, microbial analyses, nectars, physico chemical characteristics, sensorial analysis, storage period

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5746 Antibiotic Prophylaxis Habits in Oral Implant Surgery in the Netherlands: A Cross-Sectional Survey

Authors: Fabio Rodriguez Sanchez, Josef Bruers, Iciar Arteagoitia, Carlos Rodriguez Andres

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Background: Oral implants are a routine treatment to replace lost teeth. Although they have a high rate of success, implant failures do occur. Perioperative antibiotics have been suggested to prevent postoperative infections and dental implant failures, but they remain a controversial treatment among healthy patients. The objective of this study was to determine whether antibiotic prophylaxis is a common treatment in the Netherlands among general dentists, maxillofacial-surgeons, periodontists and implantologists in conjunction with oral implant surgery among healthy patients and to assess the nature of antibiotics prescriptions in order to evaluate whether any consensus has been reached and the current recommendations are being followed. Methodology: Observational cross-sectional study based on a web-survey reported according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A validated questionnaire, developed by Deeb et al. (2015), was translated and slightly adjusted to circumstances in the Netherlands. It was used with the explicit permission of the authors. This questionnaire contained both close-ended and some open-ended questions in relation to the following topics: demographics, qualification, antibiotic type, prescription-duration and dosage. An email was sent February 2018 to a sample of 600 general dentists and all 302 oral implantologists, periodontists and maxillofacial surgeons who were recognized by the Dutch Association of Oral Implantology (NVOI) as oral health care providers placing oral implants. The email included a brief introduction about the study objectives and a link to the web questionnaire, which could be filled in anonymously. Overall, 902 questionnaires were sent. However, 29 questionnaires were not correctly received due to an incorrect email address. So a total number of 873 professionals were reached. Collected data were analyzed using SPSS (IBM Corp., released 2012, Armonk, NY). Results: The questionnaire was sent back by a total number of 218 participants (response rate=24.2%), 45 female (20.8%) and 171 male (79.2%). Two respondents were excluded from the study group because they were not currently working as oral health providers. Overall 151 (69.9%) placed oral implants on regular basis. Approximately 79 (52.7%) of these participants prescribed antibiotics only in determined situations, 66 (44.0%) prescribed antibiotics always and 5 dentists (3.3%) did not prescribe antibiotics at all when placing oral implants. Overall, 83 participants who prescribed antibiotics, did so both pre- and postoperatively (58.5%), 12 exclusively postoperative (8.5%), and 47 followed an exclusive preoperative regime (33.1%). A single dose of 2,000 mg amoxicillin orally 1-hour prior treatment was the most prescribed preoperative regimen. The most frequent prescribed postoperative regimen was 500 mg amoxicillin three times daily for 7 days after surgery. On average, oral health professionals prescribed 6,923 mg antibiotics in conjunction with oral implant surgery, varying from 500 to 14,600 mg. Conclusions: Antibiotic prophylaxis in conjunction with oral implant surgery is prescribed in the Netherlands on a rather large scale. Dutch professionals might prescribe antibiotics more cautiously than in other countries and there seems to be a lower range on the different antibiotic types and regimens being prescribed. Anyway, recommendations based on last-published evidence are frequently not being followed.

Keywords: clinical decision making, infection control, antibiotic prophylaxis, dental implants

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5745 Comparison of Air Quality in 2019 and 2020 in the Campuses of the University of the Basque Country

Authors: Elisabete Alberdi, Irantzu Álvarez, Nerea Astigarraga, Heber Hernández

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The purpose of this research work is to study the emissions of certain substances that contribute to air pollution and, as far as possible, to try to eliminate or reduce them, to avoid damage to both health and the environment. This work focuses on analyzing and comparing air quality in 2019 and 2020 in the Autonomous Community of the Basque Country, especially near the UPV/EHU campuses. We use Geostatistics to develop a spatial model and to analyse the levels of pollutants in those areas where the scope of the monitoring stations is limited. Finally, different more sustainable transport alternatives for users have been proposed.

Keywords: air quality, pollutants, monitoring stations, environment, geostatistics

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5744 A Sense of Belonging: Music Learning and School Connectedness

Authors: Johanna Gamboa-Kroesen

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School connectedness, or the sense of belonging at school, is a critical factor in adolescent health, academic achievement, and socioemotional well-being. In educational research, the construct of the psychological sense of school membership is often referred to as school engagement, school bonding, or school attachment. While current research recognizes school connectedness as integral to a child’s mental health and academic success, many schools have yet to develop adequate interventions to promote a child’s overall sense of belonging at school. However, prior researches in music education indicates that, among other benefits, music classrooms may provide an environment where students feel they belong. While studies indicates that music learning environments, specifically performing ensemble learning environments, instill a sense of school connectedness and, more broadly, contribute to a student’s socio-emotional development, there has been inadequate research on how the actions of music teachers contribute to this phenomenon. The purpose of this study was to examine the relationship between school connectedness and music learning environments with middle school music students enrolled in a school-based music ensemble. In addition, the study aimed to provide a descriptive analysis of the instructional practices that music teachers use to promote an inclusive environment in their classrooms and an overall sense of belonging in their students. Using 191 student surveys of school membership, student reflective writings, 5 teacher interviews, and 10 classroom observations, this study examined the relationship between 7th and 8th-grade student-reported levels of connectedness within their school-based music ensemble and teacher instructional practice. The study found that students reported high levels of positive school membership within their music classes. Students who participate in school-based orchestra ensembles reported a positive change in emotional state during music instruction. In addition, evidence in this study found that music teachers use instructional practices to build connectedness through de-emphasizing competition and strengthening a student’s sense of relational value within their music learning experience. The findings offer implications for future music teacher instruction to create environments of inclusion, strengthen student-teacher relationships, and promote strategies that enhance student connection to school.

Keywords: music education, belonging, instructional practice, school connectedness

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5743 Navigating through Organizational Change: TAM-Based Manual for Digital Skills and Safety Transitions

Authors: Margarida Porfírio Tomás, Paula Pereira, José Palma Oliveira

Abstract:

Robotic grasping is advancing rapidly, but transferring techniques from rigid to deformable objects remains a challenge. Deformable and flexible items, such as food containers, demand nuanced handling due to their changing shapes. Bridging this gap is crucial for applications in food processing, surgical robotics, and household assistance. AGILEHAND, a Horizon project, focuses on developing advanced technologies for sorting, handling, and packaging soft and deformable products autonomously. These technologies serve as strategic tools to enhance flexibility, agility, and reconfigurability within the production and logistics systems of European manufacturing companies. Key components include intelligent detection, self-adaptive handling, efficient sorting, and agile, rapid reconfiguration. The overarching goal is to optimize work environments and equipment, ensuring both efficiency and safety. As new technologies emerge in the food industry, there will be some implications, such as labour force, safety problems and acceptance of the new technologies. To overcome these implications, AGILEHAND emphasizes the integration of social sciences and humanities, for example, the application of the Technology Acceptance Model (TAM). The project aims to create a change management manual, that will outline strategies for developing digital skills and managing health and safety transitions. It will also provide best practices and models for organizational change. Additionally, AGILEHAND will design effective training programs to enhance employee skills and knowledge. This information will be obtained through a combination of case studies, structured interviews, questionnaires, and a comprehensive literature review. The project will explore how organizations adapt during periods of change and identify factors influencing employee motivation and job satisfaction. This project received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No101092043 (AGILEHAND).

Keywords: change management, technology acceptance model, organizational change, health and safety

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5742 Adapting to Rural Demographic Change: Impacts, Challenges and Opportunities for Ageing Farmers in Prachin Buri Province, Thailand

Authors: Para Jansuwan, Kerstin K. Zander

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Most people in rural Thailand still depend on agriculture. The rural areas are undergoing changes in their demographic structures with an increasing older population, out migration of younger people and a shift away from work in the agricultural sector towards manufacturing and service provisioning. These changes may lead to a decline in agricultural productivity and food insecurity. Our research aims to examine perceptions of older farmers on how rural demographic change affects them, to investigate how farmers may change their agricultural practices to cope with their ageing and to explore the factors affecting these changes, including the opportunities and challenges arising from them. The data were collected through a household survey with 368 farmers in the Prachin Buri province in central Thailand, the main area for agricultural production. A series of binomial logistic regression models were applied to analyse the data. We found that most farmers suffered from age-related diseases, which compromised their working capacity. Most farmers attempted to reduce labour intense work, by either stopping farming through transferring farmland to their children (41%), stopping farming by giving the land to the others (e.g., selling, leasing out) (28%) and continuing farming with making some changes (e.g., changing crops, employing additional workers) (24%). Farmers’ health and having a potential farm successor were positively associated with the probability of stopping farming by transferring the land to the children. Farmers with a successor were also less likely to stop farming by giving the land to the others. Farmers’ age was negatively associated with the likelihood of continuing farming by making some changes. The results show that most farmers base their decisions on the hope that their children will take over the farms, and that without successor, farmers lease out or sell the land. Without successor, they also no longer invest in expansion and improvement of their farm production, especially adoption of innovative technologies that could help them to maintain their farm productivity. To improve farmers’ quality of life and sustain their farm productivity, policies are needed to support the viability of farms, the access to a pension system and the smooth and successful transfer of the land to a successor of farmers.

Keywords: rural demographic change, older farmer, stopping farming, continuing farming, health and age, farm successor, Thailand

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5741 Prediction of Cardiovascular Markers Associated With Aromatase Inhibitors Side Effects Among Breast Cancer Women in Africa

Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

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5740 The Voice Rehabilitation Program Following Ileocolon Flap Transfer for Voice Reconstruction after Laryngectomy

Authors: Chi-Wen Huang, Hung-Chi Chen

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Total laryngectomy affects swallowing, speech functions and life quality in the head and neck cancer. Voice restoration plays an important role in social activities and communication. Several techniques have been developed for voice restoration and reported to improve the life quality. However, the rehabilitation program for voice reconstruction by using the ileocolon flap still unclear. A retrospective study was done, and the patients' data were drawn from the medical records between 2010 and 2016 who underwent voice reconstruction by ileocolon flap after laryngectomy. All of them were trained to swallow first; then, the voice rehabilitation was started. The outcome of voice was evaluated after 6 months using the 4-point scoring scale. In our result, 9.8% patients could give very clear voice so everyone could understand their speech, 61% patients could be understood well by families and friends, 20.2% patients could only talk with family, and 9% patients had difficulty to be understood. Moreover, the 57% patients did not need a second surgery, but in 43% patients voice was made clear by a second surgery. In this study, we demonstrated that the rehabilitation program after voice reconstruction with ileocolon flap for post-laryngectomy patients is important because the anatomical structure is different from the normal larynx.

Keywords: post-laryngectomy, ileocolon flap, rehabilitation, voice reconstruction

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5739 The Effect of the Variety and Harvesting Date on Polyphenol Composition of Haskap (Lonicera caerulea L.) and Anti-diabetic Properties of Haskap Polyphenols

Authors: Aruma Baduge Kithma De Silva

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Haskap (Lonicera caerulea L.), also known as blue honeysuckle, is a newly commercialized berry crop in Canada. Haskap berries are rich in polyphenols, including, anthocyanins, which are known for potential health-promoting properties. Cyanidin-3-O-glucoside (C3G) is the most abundant anthocyanin of haskap berries. The compound C3G has the ability to reduce the risk of type 2 diabetes (T2D), which has become an increasingly common health issue around the world. The T2D is characterized as a metabolic disorder of hyperglycemia and insulin resistance. It has been demonstrated that C3G has anti-diabetic effects through several ways, including inhibition of dipeptidyl peptidase-4 (DPP-4), reduction of gluconeogenesis, improvement in insulin sensitivity, and inhibition of activities of carbohydrate hydrolyzing enzymes, including α-amylase and α-glucosidase. The goal of this study was to investigate the influence of variety and harvests maturity of haskap on C3G, other fruit quality characteristics and anti-diabetic activities of haskap berries using in vitro studies. The polyphenols present in four commercially grown haskap cultivars, Aurora, Rebecca, Larissa, and Evie harvested at five harvesting dates (H1-H5) apart from 2-3 days, were extracted separately. High-performance liquid chromatography electrospray ionization mass spectrometry (HPLC-ESI-MS) analyzes of polyphenols revealed that haskap berries contain predominantly anthocyanins, flavonols, flavan-3-ols, and phenolic acids. The compound C3G was the most prominent anthocyanin, which is available in approximately 79% of total anthocyanin in four cultivars. The Larissa at H5 contained the highest C3G content. The antioxidant capacity of Evie at H5 was greater than other cultivars. Furthermore, Larissa H5 showed the greatest inhibition of carbohydrate hydrolyzing enzymes including alpha-glucosidase and alpha-amylase. In conclusion, the haskap variety and harvesting date influenced the polyphenol composition and biological properties. The variety Larissa, at H5 harvesting date, contained the highest polyphenol content and the ability of inhibition of the carbohydrate hydrolyzing enzyme as well as DPP4 enzyme in order to reduce type 2 diabetes.

Keywords: anthocyanin, Haskap, type 2 diabetes, polyphenol

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5738 Hemocompatible Thin-Film Materials Recreating the Structure of the Cell Niches with High Potential for Endothelialization

Authors: Roman Major, Klaudia Trembecka- Wojciga, Juergen Markus Lackner, Boguslaw Major

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The future and the development of science is therefore seen in interdisciplinary areas such as bio medical engineering. Self-assembled structures, similar to stem cell niches would inhibit fast division process and subsequently capture the stem cells from the blood flow. By means of surface topography and the stiffness as well as micro structure progenitor cells should be differentiated towards the formation of endothelial cells monolayer which effectively will inhibit activation of the coagulation cascade. The idea of the material surface development met the interest of the clinical institutions, which support the development of science in this area and are waiting for scientific solutions that could contribute to the development of heart assist systems. This would improve the efficiency of the treatment of patients with myocardial failure, supported with artificial heart assist systems. Innovative materials would enable the redesign, in the post project activity, construction of ventricular heart assist.

Keywords: bio-inspired materials, electron microscopy, haemocompatibility, niche-like structures, thin coatings

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5737 Resolving Problems Experienced by Involving Patients in the Development of Pharmaceutical Products at Post-Launch Stage of Pharmaceutical Product Development

Authors: Clara T. Fatoye, April Betts, Abayomi Odeyemi, Francis A. Fatoye, Isaac O. Odeyemi

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Background: The post-launch stage is the last stage in the development of a pharmaceutical product. It is important to involve patients in the development of pharmaceutical products at the post-launch stage, as patients are the end-users of pharmaceutical products. It is expected that involving them might ensure an effective working relationship among the various stakeholders. However, involving patients in the development of pharmaceutical products comes with its problems. Hence, this study examined how to resolve problems experienced by involving patients in the developments of pharmaceutical products’ at post-launch consisting of Positioning of pharmaceutical products (POPP), detailing of pharmaceutical products (DOPP) and reimbursement and Formulary Submission (R&FS). Methods: A questionnaire was used for the present study. It was administered at the ISPOR Glasgow 2017 to 104 participants, all of which were professionals from Market access (MA) and health economics and outcomes research (HEOR) backgrounds. They were asked how the issues experienced by patients can be resolved. Participants responded under six domains as follows: communication, cost, effectiveness, external factors, Quality of life (QoL) and safety. Thematic analysis was carried out to identify strategies to resolve issues experienced by patients at the post-launch stage. Results: Three (3) factors cut across at POPP, DOPP, and R&FS that is (external factors, communication and QoL). The first resolution method was an external factor that is, the relationship with stakeholders and policymakers. Communication was also identified as a resolution method that can help to resolve problems experienced by patients at the post-launch stage. The third method was QoL as perceived by the patients based on professionals’ opinions. Other strategies that could be used to resolve problems experienced were the effectiveness of pharmaceutical products at the DOPP level and cost at R&FS. Conclusion: The study showed that focusing on external factors, communication, and patients’ QoL are methods for resolving issues experienced by involving patients at the post-launch stage of pharmaceutical product development. Hence, effective working relationships between patients, policymakers and stakeholders may help to resolve problems experienced at the post-launch stage. Healthcare policymakers are to be aware of these findings as they may help them to put appropriate strategies in place to enhance the involvement of patients in pharmaceutical product development at the post-launch stage, thereby improving the health outcomes of the patients.

Keywords: patients, pharmaceutical products, post-launch stage, quality of life, QoL

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5736 An Exploratory Study of Wellbeing in Irish Primary Schools towards Developing a Shared Understanding amongst Teachers

Authors: Margaret Nohilly, Fionnuala Tynan

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Wellbeing in not only a national priority in Ireland but in the international context. A review of the literature highlights the consistent efforts of researchers to define the concept of wellbeing. This study sought to explore the understating of Wellbeing in Irish primary schools. National Wellbeing Guidelines in the Irish context frame the concept of wellbeing through a mental health paradigm, which is but one aspect of wellbeing. This exploratory research sought the views of Irish primary school teachers on their understanding of the concept of wellbeing and the practical application of strategies to promote wellbeing both in the classroom and across the school. Teacher participants from four counties in the West of Ireland were invited to participate in focus group discussion and workshops through the Education Centre Network. The purpose of this process was twofold; firstly to explore teachers’ understanding of wellbeing in the primary school context and, secondly, for teachers to be co-creators in the development of practical strategies for classroom and whole school implementation. The voice of the teacher participants was central to the research design. The findings of this study indicate that the definition of wellbeing in the Irish context is too abstract a definition for teachers and the focus on mental health dominates the discourse in relation to wellbeing. Few teachers felt that they were addressing wellbeing adequately in their classrooms and across the school. The findings from the focus groups highlighted that while teachers are incorporating a range of wellbeing strategies including mindfulness and positive psychology, there is a clear disconnect between the national definition and the implementation of national curricula which causes them concern. The teacher participants requested further practical strategies to promote wellbeing at whole school and classroom level within the framework of the Irish Primary School Curriculum and enable them to become professionally confident in developing a culture of wellbeing. In conclusion, considering wellbeing is a national priority in Ireland, this research promoted the timely discussion the wellbeing guidelines and the development of a conceptual framework to define wellbeing in concrete terms for practitioners. The centrality of teacher voices ensured the strategies proposed by this research is both practical and effective. The findings of this research have prompted the development of a national resource which will support the implementation of wellbeing in the primary school at both national and international level.

Keywords: definition, wellbeing, strategies, curriculum

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5735 Leveraging Community Partnerships for Social Impact

Authors: T. Moody, E. Mitchell, T. Dang, A. Barry, T. Proshan, S. Andrisse, V. Odero-Marah

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Women’s prison and reentry programs are focused primarily on reducing recidivism but neglect how an individual’s intersecting identities influence their risk of violence and ways that histories of gender-based violence (GBV) must be addressed for these women to recover from traumas. Light To Life (LTL) and From Prison Cells to Ph.D. (P2P) Womxn’s Cohort program recognizes this need; providing national gender-responsive programming (GRP), and trauma-informed programming to justice-impacted survivors through digital resources, leadership opportunities, educational workshops, and healing justice approaches for positive health outcomes. Through the support of a community-university partnership (CUP), a comparative evaluation study is being conducted among intimate-partner violence (IPV) survivors with histories of incarceration who have or have not participated in the cohort. The objectives of the partnership are to provide mutually beneficial training and consultation for evaluating GRP through a rigorously tested research methodology. This collaborative applies a rigorous methodology of semi-structured interviews with an intervention and control group to evaluate the impact of LTL’s programming in the P2P Womxn’s Cohort. The CUP is essential to achieve the expected results of the project. It will measure primary outcomes, including participants' level of engagement and satisfaction with programming, reduction in attitudes that accept violence in relationships, and increase in interpersonal and intrapersonal skills that lead to healthy relationships. This community-based approach will provide opportunities to evaluate the effectiveness of the program. The results addressed in the hypothesis will provide learning lessons to improve this program, to scale it up, and apply it to other similarly affected populations. The partnership experience and anticipated outcomes contribute to the knowledge in women’s health and criminal justice by fostering public awareness on the importance of developing new partnerships and fostering CUP to establish a framework to the leveraging of partnerships for social impact available to academic institutions.

Keywords: Community-university partnership, gender-responsive programming, incarceration, intimate-partner violence, POC, women

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5734 Effect of Psychosocial, Behavioural and Disease Characteristics on Health-Related Quality of Life after Breast Cancer Surgery: A Cross-Sectional Study of a Regional Australian Population

Authors: Lakmali Anthony, Madeline Gillies

Abstract:

Background Breast cancer (BC) is usually managed with surgical resection. Many outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO) such as Health-Related Quality of life (HRQoL) provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods Patients who had resection of BC in a regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Results Forty-six patients completed the survey. Clinically significant levels of FCR and emotional distress were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for BC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL for breast cancer. All psychosocial factors measured were associated with HRQoL. Conclusion HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative breast cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: breast cancer, surgery, quality of life, regional population

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5733 Impression Evaluation by Design Change of Anthropomorphic Agent

Authors: Kazuko Sakamoto

Abstract:

Anthropomorphic agents have been successful in areas where there are many human interactions, such as education and medical care. The persuasive effect is also expected in e-shopping sites on the web. This indicates that customer service is not necessarily human but can play that role. However, the 'humanity' in anthropomorphism sometimes has a risk of working negatively. In general, as the appearance of anthropomorphic agents approaches humans, it is thought that their affinity with humans increases. However, when the degree of similarity reaches a certain level, it gives the user a weird feeling. This is the 'eerie valley' phenomenon. This is a concept used in the world of robotics, but it seems to be applicable to anthropomorphic agents such as characters. Then what kind of design can you accept as an anthropomorphic agent that gives you a feeling of friendliness or good feeling without causing discomfort or fear to people? This study focused on this point and examined what design and characteristics would be effective for marketing communication. As a result of the investigation, it was found that there is no need for gaze and blinking, the size of the eyes is normal or large, and the impression evaluation is higher when the structure is as simple as possible. Conversely, agents with high eye-gaze and white-eye ratios had low evaluations, and the negative impact on eye-gaze was particularly large.

Keywords: anthropomorphicgents, design evaluation, marketing communication, customer service

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5732 Coronavirus Academic Paper Sorting Application

Authors: Christina A. van Hal, Xiaoqian Jiang, Luyao Chen, Yan Chu, Robert D. Jolly, Yaobin Lin, Jitian Zhao, Kang Lin Hsieh

Abstract:

The COVID-19 Literature Summary App was created for the primary purpose of enabling academicians and clinicians to quickly sort through the vast array of recent coronavirus publications by topics of interest. Multiple methods of summarizing and sorting the manuscripts were created. A summary page introduces the application function and capabilities, while an interactive map provides daily updates on infection, death, and recovery rates. A page with a pivot table allows publication sorting by topic, with an interactive data table that allows sorting topics by columns, as wells as the capability to view abstracts. Additionally, publications may be sorted by the medical topics they cover. We used the CORD-19 database to compile lists of publications. The data table can sort binary variables, allowing the user to pick desired publication topics, such as papers that describe COVID-19 symptoms. The application is primarily designed for use by researchers but can be used by anybody who wants a faster and more efficient means of locating papers of interest.

Keywords: COVID-19, literature summary, information retrieval, Snorkel

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5731 Regression-Based Approach for Development of a Cuff-Less Non-Intrusive Cardiovascular Health Monitor

Authors: Pranav Gulati, Isha Sharma

Abstract:

Hypertension and hypotension are known to have repercussions on the health of an individual, with hypertension contributing to an increased probability of risk to cardiovascular diseases and hypotension resulting in syncope. This prompts the development of a non-invasive, non-intrusive, continuous and cuff-less blood pressure monitoring system to detect blood pressure variations and to identify individuals with acute and chronic heart ailments, but due to the unavailability of such devices for practical daily use, it becomes difficult to screen and subsequently regulate blood pressure. The complexities which hamper the steady monitoring of blood pressure comprises of the variations in physical characteristics from individual to individual and the postural differences at the site of monitoring. We propose to develop a continuous, comprehensive cardio-analysis tool, based on reflective photoplethysmography (PPG). The proposed device, in the form of an eyewear captures the PPG signal and estimates the systolic and diastolic blood pressure using a sensor positioned near the temporal artery. This system relies on regression models which are based on extraction of key points from a pair of PPG wavelets. The proposed system provides an edge over the existing wearables considering that it allows for uniform contact and pressure with the temporal site, in addition to minimal disturbance by movement. Additionally, the feature extraction algorithms enhance the integrity and quality of the extracted features by reducing unreliable data sets. We tested the system with 12 subjects of which 6 served as the training dataset. For this, we measured the blood pressure using a cuff based BP monitor (Omron HEM-8712) and at the same time recorded the PPG signal from our cardio-analysis tool. The complete test was conducted by using the cuff based blood pressure monitor on the left arm while the PPG signal was acquired from the temporal site on the left side of the head. This acquisition served as the training input for the regression model on the selected features. The other 6 subjects were used to validate the model by conducting the same test on them. Results show that the developed prototype can robustly acquire the PPG signal and can therefore be used to reliably predict blood pressure levels.

Keywords: blood pressure, photoplethysmograph, eyewear, physiological monitoring

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5730 Resistance of Mycobacterium tuberculosis to Daptomycin

Authors: Ji-Chan Jang

Abstract:

Tuberculosis is still major health problem because there is an increase of multidrug-resistant and extensively drug-resistant forms of the disease. Therefore, the most urgent clinical need is to discover potent agents and develop novel drug combination capable of reducing the duration of MDR and XDR tuberculosis therapy. Three reference strains H37Rv, CDC1551, W-Beijing GC1237 and six clinical isolates of MDRTB were tested to daptomycin in the range of 0.013 to 256 mg/L. Daptomycin is resistant to all tested M. tuberculosis strains not only laboratory strains but also clinical MDR strains that were isolated at different source. Daptomycin will not be an antibiotic of choice for treating infection of Gram positive atypical slowly growing M. tuberculosis.

Keywords: tuberculosis, daptomycin, resistance, Mycobacterium tuberculosis

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5729 Exploring the Relationship Between Life Experiences and Early Relapse Among Imprisoned Users of Illegal Drugs in Oman: A Focused Ethnography

Authors: Hamida Hamed Said Al Harthi

Abstract:

Background: Illegal drug use is a rising problem that affects Omani youth. This research aimed to study a group of young Omani men who were imprisoned more than once for illegal drug use, focusing on exploring their lifestyle experiences inside and outside the prison and whether these contributed to their early relapse and re-imprisonment. This is the first study of its kind from Oman conducted in a prison setting. Methods: 19 Omani males aged 18–35 years imprisoned in Oman Central Prison were recruited using purposive sampling. Focused ethnography was conducted over 8 months to explore the drug-related experiences outside the prison and during imprisonment. Face-to-face semi-structured interviews with the participants yielded detailed transcripts and field notes. These were thematically analyzed, and the results were compared with the existing literature. Results: The participants’ voices yielded new insights into the lives of young Omani men imprisoned for illegal drug use, including their sufferings and challenges in prison. These included: entry shock, timing and boredom, drug trafficking in prison, as well as physical and psychological health issues. Overall, imprisonment was reported to have negatively impacted the participants’ health, personality, self-concept, emotions, attitudes, behavior and life expectations. The participants reported how their efforts to reintegrate into the Omani community after release from prison were rebuffed due to stigmatization and rejection from society and family. They also experienced frequent unemployment, police surveillance, accommodation problems and a lack of rehabilitation facilities. The immensity of the accumulated psychophysiological trauma contributed to their early relapse and re-imprisonment. Conclusion: This thesis concludes that imprisonment is largely ineffective in controlling drug use in Oman. Urgent action is required across multiple sectors to improve the lives and prospects of users of illegal drugs within and outside the prison to minimize factors contributing to early relapse. Key Words: illegal drugs, drug users, Oman, addiction, Omani culture, prisoners, relapse, re-imprisonment, qualitative research, ethnography.

Keywords: illigal drugs, Prison, Omani culture lifestyle, post prison life

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5728 Effects of Different Food Matrices on Viscosity and Protein Degradation during in vitro Digestion

Authors: Gulay Oncu Ince, Sibel Karakaya

Abstract:

Food is a worldwide concern. Among the factors that have influences on human health, food, nutrition and life style have been regarded as the most important factors since they can be intervened. While some parts of the world has been faced with food shortages and hence, chronic metabolic diseases, the other part of the world have been emerged from over consumption of food. Both situations can result in shorter life expectancy and represent a major global health problem. Hunger, satiety and appetite sensation form a balance ensures the operation of feeding behavior between food intake and energy consumption. Satiety is one of the approaches that is effective in ensuring weight control and avoid eating more in the postprandial period. By manipulating the microstructure of food macro and micronutrient bioavailability may be increased or reduced. For the food industry appearance, texture, taste structural properties as well as the gastrointestinal tract behavior of the food after the consumption is becoming increasingly important. Also, this behavior has been the subject of several researches in recent years by the scientific community. Numerous studies have been published about changing the food matrix in order to increase expected impacts. In this study, yogurts were enriched with caseinomacropeptide (CMP), whey protein (WP), CMP and sodium alginate (SA), and WP + SA in order to produce goat yogurts having different food matrices. SDS Page profiles of the samples after in vitro digestion and viscosities of the stomach digesta at different share rates were determined. Energy values were 62.11kcal/100 g, 70.27 kcal/100 g, 70.61 kcal/100 g, 71.20 kcal/100 g and 71.67 kcal/100 g for control, CMP added WP added, WP + SA added, and CMP + SA added yogurts respectively. The results of viscosity analysis showed that control yogurt had the lowest viscosity value and this was followed by CMP added, WP added, CMP + SA added and WP + SA added yogurts, respectively. Protein contents of the stomach and duedonal digests of the samples after subjected to two different in vitro digestion methods were changed between 5.34-5.91 mg protein / g sample and 16.93-19.75 mg protein /g of sample, respectively. Viscosity measurements of the stomach digests showed that CMP + SA added yogurt displayed the highest viscosity value in both in vitro digestion methods. There were differences between the protein profiles of the stomach and duedonal digests obtained by two different in vitro digestion methods (p<0.05).

Keywords: caseinomacropeptide, protein profile, whey protein, yogurt

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5727 Optimal Temperature and Duration for Dabbing Customers with the Massage Compressed Packs Reported from Customers' Perception

Authors: Wichan Lertlop, Boonyarat Chaleephay

Abstract:

The objective of this research was to study the appropriate thermal level and time for dabbing customers with the massage compressed pack reported from their perception. The investigation was conducted by comparing different angles of tilted heads done by the customers together with their perception before and after the dabbing. The variables included different temperature of the compressed packs and different dabbing duration. Samples in this study included volunteers who got massage therapy and dabbing with hot compressed packs by traditional Thai medical students. The experiment was conducted during January to June 2013. The research tool consisted of angle meters, stop watches, thermometers, and massage compressed packs. The customers were interviewed for their perceptions before and after the dabbing. The results showed that: 1. There was a difference of the average angles of tilted heads before and after the dabbing. 2. There was no difference of the average angles at different temperatures but constant duration. 3. There was no difference of the average angles at different durations. 4. The customers reported relaxation no matter what the various temperatures and various dabbing durations were. However, they reported too hot at the temperature 70 °C and over.

Keywords: massage, therapy, therapeutic systems, technologies

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5726 Artificial Intelligence and Distributed System Computing: Application and Practice in Real Life

Authors: Lai Junzhe, Wang Lihao, Burra Venkata Durga Kumar

Abstract:

In recent years, due to today's global technological advances, big data and artificial intelligence technologies have been widely used in various industries and fields, playing an important role in reducing costs and increasing efficiency. Among them, artificial intelligence has derived another branch in its own continuous progress and the continuous development of computer personnel, namely distributed artificial intelligence computing systems. Distributed AI is a method for solving complex learning, decision-making, and planning problems, characterized by the ability to take advantage of large-scale computation and the spatial distribution of resources, and accordingly, it can handle problems with large data sets. Nowadays, distributed AI is widely used in military, medical, and human daily life and brings great convenience and efficient operation to life. In this paper, we will discuss three areas of distributed AI computing systems in vision processing, blockchain, and smart home to introduce the performance of distributed systems and the role of AI in distributed systems.

Keywords: distributed system, artificial intelligence, blockchain, IoT, visual information processing, smart home

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5725 Effect of Mindfulness Training on Psychological Well-Being: An Experimental Study Using a Mobile App as Intervention

Authors: Beeto W. C. Leung, Nicole C. Y. Lee

Abstract:

It was well known that college students experienced a high level of stress and anxiety. College athletes, a special group of college students, may even encounter a higher level of pressure and distress due to their dual endeavors in academic and athletic settings. Due to the high demands and costs of mental health services, easily accessible, web-based self-help interventions are getting more popular. The aim of the present experimental study was to examine the potential intervention effect of a mindfulness-based self-help mobile App, called 'Smiling Mind', on mindfulness and psychological well-being. Forty-six college athletes, recruited from athletic teams of two local universities in Hong Kong, were randomly assigned to the Mindfulness App Group (MAG) and the Control Group (CG). All participants were administered the Mindful Attention Awareness Scale, Geriatric Depression Scale, and Perceived Stress Scale-10 before the study (Time 1, T1) and after the 4-week intervention (Time 2, T2). MAG was requested to use the app and follow the instructions every day for at least 5 days per week. Participants were also asked to record their daily app usage time. Results showed that, for MAG, from T1 to T2, mindfulness has been increased from 3.25 to 3.92; depressive symptoms and stress has been significantly decreased from 8.6 to 5.1 and 24.8 to 13.5 respectively while for the CG, mindfulness has been decreased slightly from 3.29 to 3.13; depressive symptoms and stress has been slightly increased from 7.1 to 7.3 and 24.1 to 27.1 respectively. Three mixed-design ANOVAs with time (T1, T2) as the within-subjects factor and intervention group (MAG, CG) as the between-subjects factor revealed a main effect of time on mindfulness, F(1, 41) = 10.28, p < 0.01, depressive symptoms, F(1, 41) = 6.55, p < 0.02 and stress, F(1, 41) = 16.96, p < 0.001 respectively. Both predicted interaction between time and intervention group on mindfulness, F(1, 41) = 26.6, p < 0.001, ηp 2 =0.39, depressive symptoms, F(1, 41) = 8.00, p < 0.01, ηp 2 =0.16 and Stress F(1, 41) = 49.3, p < 0.001, ηp 2 =0.55 were significant meaning that participants using the Mindfulness Mobile App in the intervention did experienced a significant increase in mindfulness and significant decrease in depressive symptoms and perceived level of stress after the 4-week intervention when compared with the control group. The present study provided encouraging empirical support for using Smiling Mind, a self-help mobile app, to promote mindfulness and mental health in a cost-effective way. Further studies should examine the potential use of Smiling Mind in different samples, including children and adolescence, as well as, investigate the lasting effects of using the app on other psychosocial outcomes such as emotional regulations.

Keywords: college athletes, experimental study, mindfulness mobile apps, psychological well-being

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5724 Influence of Radio Frequency Identification Technology at Cost of Supply Chain as a Driver for the Generation of Competitive Advantage

Authors: Mona Baniahmadi, Saied Haghanifar

Abstract:

Radio Frequency Identification (RFID) is regarded as a promising technology for the optimization of supply chain processes since it improves manufacturing and retail operations from forecasting demand for planning, managing inventory, and distribution. This study precisely aims at learning to know the RFID technology and at explaining how it can concretely be used for supply chain management and how it can help improving it in the case of Hejrat Company which is located in Iran and works on the distribution of medical drugs and cosmetics. This study uses some statistical analysis to calculate the expected benefits of an integrated RFID system on supply chain obtained through competitive advantages increases with decreasing cost factor. The study investigates how the cost of storage process, labor cost, the cost of missing goods, inventory management optimization, on-time delivery, order cost, lost sales and supply process optimization affect the performance of the integrated RFID supply chain regarding cost factors and provides a competitive advantage.

Keywords: cost, competitive advantage, radio frequency identification, supply chain

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5723 Predictive Factors of Exercise Behaviors of Junior High School Students in Chonburi Province

Authors: Tanida Julvanichpong

Abstract:

Exercise has been regarded as a necessary and important aspect to enhance physical performance and psychology health. Body weight statistics of students in junior high school students in Chonburi Province beyond a standard risk of obesity. Promoting exercise among Junior high school students in Chonburi Province, essential knowledge concerning factors influencing exercise is needed. Therefore, this study aims to (1) determine the levels of perceived exercise behavior, exercise behavior in the past, perceived barriers to exercise, perceived benefits of exercise, perceived self-efficacy to exercise, feelings associated with exercise behavior, influence of the family to exercise, influence of friends to exercise, and the perceived influence of the environment on exercise. (2) examine the predicting ability of each of the above factors while including personal factors (sex, educational level) for exercise behavior. Pender’s Health Promotion Model was used as a guide for the study. Sample included 652 students in junior high schools, Chonburi Provience. The samples were selected by Multi-Stage Random Sampling. Data Collection has been done by using self-administered questionnaires. Data were analyzed using descriptive statistics, Pearson’s product moment correlation coefficient, Eta, and stepwise multiple regression analysis. The research results showed that: 1. Perceived benefits of exercise, influence of teacher, influence of environmental, feelings associated with exercise behavior were at a high level. Influence of the family to exercise, exercise behavior, exercise behavior in the past, perceived self-efficacy to exercise and influence of friends were at a moderate level. Perceived barriers to exercise were at a low level. 2. Exercise behavior was positively significant related to perceived benefits of exercise, influence of the family to exercise, exercise behavior in the past, perceived self-efficacy to exercise, influence of friends, influence of teacher, influence of environmental and feelings associated with exercise behavior (p < .01, respectively) and was negatively significant related to educational level and perceived barriers to exercise (p < .01, respectively). Exercise behavior was significant related to sex (Eta = 0.243, p=.000). 3. Exercise behavior in the past, influence of the family to exercise significantly contributed 60.10 percent of the variance to the prediction of exercise behavior in male students (p < .01). Exercise behavior in the past, perceived self-efficacy to exercise, perceived barriers to exercise, and educational level significantly contributed 52.60 percent of the variance to the prediction of exercise behavior in female students (p < .01).

Keywords: predictive factors, exercise behaviors, Junior high school, Chonburi Province

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5722 A Generative Pretrained Transformer-Based Question-Answer Chatbot and Phantom-Less Quantitative Computed Tomography Bone Mineral Density Measurement System for Osteoporosis

Authors: Mian Huang, Chi Ma, Junyu Lin, William Lu

Abstract:

Introduction: Bone health attracts more attention recently and an intelligent question and answer (QA) chatbot for osteoporosis is helpful for science popularization. With Generative Pretrained Transformer (GPT) technology developing, we build an osteoporosis corpus dataset and then fine-tune LLaMA, a famous open-source GPT foundation large language model(LLM), on our self-constructed osteoporosis corpus. Evaluated by clinical orthopedic experts, our fine-tuned model outperforms vanilla LLaMA on osteoporosis QA task in Chinese. Three-dimensional quantitative computed tomography (QCT) measured bone mineral density (BMD) is considered as more accurate than DXA for BMD measurement in recent years. We develop an automatic Phantom-less QCT(PL-QCT) that is more efficient for BMD measurement since no need of an external phantom for calibration. Combined with LLM on osteoporosis, our PL-QCT provides efficient and accurate BMD measurement for our chatbot users. Material and Methods: We build an osteoporosis corpus containing about 30,000 Chinese literatures whose titles are related to osteoporosis. The whole process is done automatically, including crawling literatures in .pdf format, localizing text/figure/table region by layout segmentation algorithm and recognizing text by OCR algorithm. We train our model by continuous pre-training with Low-rank Adaptation (LoRA, rank=10) technology to adapt LLaMA-7B model to osteoporosis domain, whose basic principle is to mask the next word in the text and make the model predict that word. The loss function is defined as cross-entropy between the predicted and ground-truth word. Experiment is implemented on single NVIDIA A800 GPU for 15 days. Our automatic PL-QCT BMD measurement adopt AI-associated region-of-interest (ROI) generation algorithm for localizing vertebrae-parallel cylinder in cancellous bone. Due to no phantom for BMD calibration, we calculate ROI BMD by CT-BMD of personal muscle and fat. Results & Discussion: Clinical orthopaedic experts are invited to design 5 osteoporosis questions in Chinese, evaluating performance of vanilla LLaMA and our fine-tuned model. Our model outperforms LLaMA on over 80% of these questions, understanding ‘Expert Consensus on Osteoporosis’, ‘QCT for osteoporosis diagnosis’ and ‘Effect of age on osteoporosis’. Detailed results are shown in appendix. Future work may be done by training a larger LLM on the whole orthopaedics with more high-quality domain data, or a multi-modal GPT combining and understanding X-ray and medical text for orthopaedic computer-aided-diagnosis. However, GPT model gives unexpected outputs sometimes, such as repetitive text or seemingly normal but wrong answer (called ‘hallucination’). Even though GPT give correct answers, it cannot be considered as valid clinical diagnoses instead of clinical doctors. The PL-QCT BMD system provided by Bone’s QCT(Bone’s Technology(Shenzhen) Limited) achieves 0.1448mg/cm2(spine) and 0.0002 mg/cm2(hip) mean absolute error(MAE) and linear correlation coefficient R2=0.9970(spine) and R2=0.9991(hip)(compared to QCT-Pro(Mindways)) on 155 patients in three-center clinical trial in Guangzhou, China. Conclusion: This study builds a Chinese osteoporosis corpus and develops a fine-tuned and domain-adapted LLM as well as a PL-QCT BMD measurement system. Our fine-tuned GPT model shows better capability than LLaMA model on most testing questions on osteoporosis. Combined with our PL-QCT BMD system, we are looking forward to providing science popularization and early morning screening for potential osteoporotic patients.

Keywords: GPT, phantom-less QCT, large language model, osteoporosis

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