Search results for: Stephen H. Thomas

Authors: Portia Murphy, Danica Vasic, Anoja W. Gunaratne, Encarnita Sitchon, Teresita Tugonon, Marou Ison, Antoinette Le Busque, Christelle Pagonis, Thomas J. Borody

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Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects an estimated 11% of the population globally with the most predominant symptoms being abdominal pain, bloating and altered bowel movements. All age groups suffer from IBS although the prevalence of IBS decreases for age groups over 50 years. Women are more likely to suffer from IBS than men. IBS can be categorized into 3 groups based on the type of altered bowel movement: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). The contribution of the gut microbiome to the etiology of IBS is becoming increasingly recognized with rising use of anti-microbial agents. Previous studies on vancomycin and rifaximin used as monotherapy or in combination have been conducted mainly on IBS-C and showed marked improvements in the symptoms. According to our knowledge, no studies reported using these two combinations of antibiotics for IBS-D. Here, we report a consecutive cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients ages were between 24-74 years (mean 44 years) and 9 were female. Baseline all patients had diarrhea, 4 with mucus and one with blood. Patients reported other symptoms were abdominal pain (n=11) bloating (n=9), flatulence (n=7), fatigue (n=4) and nausea (n=3). Patients treatments were personalized according to their symptom severity and tolerability and were treated with combination of rifaximin (500 - 3000mg/d) and vancomycin (500mg - 1500mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks’ time. Of all patients, 89% patients reported improvement of the symptoms, 1 reported no change and 1 patient’s symptoms got worse. The mechanism of action for both vancomycin and rifaximin involves the inhibition of bacterial cell wall and protein synthesis respectively. The role of these medications in improving the symptoms of this cohort suggests that IBS-D may be microbiome infection driven. In this cohort, similar patient presentations to Clostridium difficile, as well as symptom improvement with the use of rifaximin and particularly vancomycin, suggest that the infectious agent may be an unidentified Clostridium. These preliminary results offer an alternative etiology for IBS-D not previously considered and open the avenue for new research.

Keywords: clostridium deficile, diarrhea predominant Irritable Bowel Syndrome, microbiome, vancomycin/rifaximin combination

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Authors: Syed A. Bukhari, Ankur Goswmai, Dale Hume, Thomas Thundat

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Here we demonstrate mechanical detection of photo-induced Insulator to metal transition (MIT) in ultra-thin vanadium dioxide (VO₂) micro strings by using < 100 µW of optical power. Highly focused laser beam heated the string locally resulting in through plane and along axial heat diffusion. Localized temperature increase can cause temperature rise > 60 ºC. The heated region of VO₂ can transform from insulating (monoclinic) to conducting (rutile) phase leading to lattice compressions and stiffness increase in the resonator. The mechanical frequency of the resonator can be tuned by changing optical power and wavelength. The first mode resonance frequency was tuned in three different ways. A decrease in frequency below a critical optical power, a large increase between 50-120 µW followed by a large decrease in frequency for optical powers greater than 120 µW. The dynamic mechanical response was studied as a function of incident optical power and gas pressure. The resonance frequency and amplitude of vibration were found to be decreased with increasing laser power from 25-38 µW and increased by1-2 % when the laser power was further increased to 52 µW. The transition in films was induced and detected by a single pump and probe source and by employing external optical sources of different wavelengths. This trend in dynamic parameters of the strings can be co-related with reversible Insulator to metal transition in VO₂ films which creates change in density of the material and hence the overall stiffness of the strings leading to changes in string dynamics. The increase in frequency at a particular optical power manifests a transition to a more ordered metallic phase which tensile stress onto the string. The decrease in frequency at higher optical powers can be correlated with poor phonon thermal conductivity of VO₂ in conducting phase. Poor thermal conductivity of VO₂ can force in-plane penetration of heat causing the underneath SiN supporting VO₂ which can result as a decrease in resonance frequency. This noninvasive, non-contact laser-based excitation and detection of Insulator to metal transition using micro strings resonators at room temperature and with laser power in few µWs is important for low power electronics, and optical switching applications.

Keywords: thermal conductivity, vanadium dioxide, MEMS, frequency tuning

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Authors: Melissa K. Hord, Stephen P. Whiteside

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With lifetime prevalence rates ranging from 6% to 15%, anxiety disorders are among the most common childhood mental health diagnoses. Anxiety disorders diagnosed in childhood generally show an unremitting course, lead to additional psychopathology and interfere with social, emotional, and academic development. Effective evidence-based treatments include cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRI’s). However, if anxious children receive any treatment, it is usually through primary care, typically consists of medication, and very rarely includes evidence-based psychotherapy. Despite the high prevalence of anxiety disorders, there have only been two independent research labs that have investigated long-term results for CBT treatment for all childhood anxiety disorders and two for specific anxiety disorders. Generally, the studies indicate that the majority of youth maintain gains up to 7.4 years after treatment. These studies have not been replicated. In addition, little is known about the additional mental health care received by these patients in the intervening years after anxiety treatment, which seems likely to influence maintenance of gains for anxiety symptoms as well as the development of additional psychopathology during the subsequent years. The original sample consisted of 335 children ages 7 to 17 years (mean 13.09, 53% female) diagnosed with an anxiety disorder in 2010. Medical record review included provider billing records for mental health appointments during the five years after anxiety treatment. The subsample for this study was classified into three groups: 64 children who received CBT in an anxiety disorders clinic, 56 who received treatment from a psychiatrist, and 10 who were seen in a primary care setting. Chi-square analyses resulted in significant differences in mental health care utilization across the five years after treatment. Youth receiving treatment in primary care averaged less than one appointment each year and the appointments continued at the same rate across time. Children treated by a psychiatrist averaged approximately 3 appointments in the first two years and 2 in the subsequent three years. Importantly, youth treated in the anxiety clinic demonstrated a gradual decrease in mental health appointments across time. The nuanced differences will be presented in greater detail. The results of the current study have important implications for developing dissemination materials to help guide parents when they are selecting treatment for their children. By including all mental health appointments, this study recognizes that anxiety is often comorbid with additional diagnoses and that receiving evidence-based treatment may have long-term benefits that are associated with improvements in broader mental health. One important caveat might be that the acuity of mental health influenced the level of care sought by patients included in this study; however, taking this possibility into account, it seems those seeking care in a primary care setting continued to require similar care at the end of the study, indicating little improvement in symptoms was experienced.

Keywords: anxiety, children, mental health, outcomes

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Authors: Aleksandr Kavetskiy, Galina Yakubova, Nikolay Sargsyan, Stephen A. Prior, H. Allen Torbert

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The carbon sequestration question of modern times requires the development of an in-situ method of measuring soil carbon over large landmasses. Traditional chemical analytical methods used to evaluate large land areas require extensive soil sampling prior to processing for laboratory analysis; collectively, this is labor-intensive and time-consuming. An alternative method is to apply nuclear physics analysis, primarily in the form of pulsed fast-thermal neutron-gamma soil carbon analysis. This method is based on measuring the gamma-ray response that appears upon neutron irradiation of soil. Specific gamma lines with energies of 4.438 MeV appearing from neutron irradiation can be attributed to soil carbon nuclei. Based on measuring gamma line intensity, assessments of soil carbon concentration can be made. This method can be done directly in the field using a specially developed pulsed fast-thermal neutron-gamma system (PFTNA system). This system conducts in-situ analysis in a scanning mode coupled with GPS, which provides soil carbon concentration and distribution over large fields. The system has radiation shielding to minimize the dose rate (within radiation safety guidelines) for safe operator usage. Questions concerning the effect of neutron irradiation on soil health will be addressed. Information regarding absorbed neutron and gamma dose received by soil and its distribution with depth will be discussed in this study. This information was generated based on Monte-Carlo simulations (MCNP6.2 code) of neutron and gamma propagation in soil. Received data were used for the analysis of possible induced irradiation effects. The physical, chemical and biological effects of neutron soil irradiation were considered. From a physical aspect, we considered neutron (produced by the PFTNA system) induction of new isotopes and estimated the possibility of increasing the post-irradiation gamma background by comparisons to the natural background. An insignificant increase in gamma background appeared immediately after irradiation but returned to original values after several minutes due to the decay of short-lived new isotopes. From a chemical aspect, possible radiolysis of water (presented in soil) was considered. Based on stimulations of radiolysis of water, we concluded that the gamma dose rate used cannot produce gamma rays of notable rates. Possible effects of neutron irradiation (by the PFTNA system) on soil biota were also assessed experimentally. No notable changes were noted at the taxonomic level, nor was functional soil diversity affected. Our assessment suggested that the use of a PFTNA system with a neutron flux of 1e7 n/s for soil carbon analysis does not notably affect soil properties or soil health.

Keywords: carbon sequestration, neutron gamma analysis, radiation effect on soil, Monte-Carlo simulation

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Authors: Mareli Fischer, Kevin G. F. Thomas

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Although Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood neurobehavioural disorders, little empirical research has been published on its clinical presentation in Africa, and, globally, few studies evaluate ADHD intervention programs that emphasize parent training. Hence, Stage 1 of this research programme aimed to describe the functional impairment of South African children with ADHD, and also sought to investigate the influence of sociodemographic variables (e.g., sex, age, socioeconomic status, family environment) and clinical variables (e.g., ADHD subtype and comorbidity) on the degree of that impairment. We used the Mini International Neuropsychiatric Interview for Children and Adolescents as a diagnostic tool, and the Child Behavior Checklist, the Strengths and Difficulties Questionnaire, and the Impairment Rating Scale as measures of functional impairment. Results from this stage of the research indicated that South African children and adolescents who meet diagnostic criteria for ADHD experience most functional impairment in the school domain, as well as in the area of social functioning. None of the measured sociodemographic variables had a significant detrimental or protective effect on how ADHD symptoms impacted on functioning. In terms of comorbidity, the presence of Major Depressive Disorder, Conduct Disorder, and Oppositional Defiant Disorder were all associated with significantly impaired overall functioning. Stage 2 of the research programme aimed to design, implement, and evaluate a child-specific intervention that targeted the primary areas of impairment identified in Stage 1. Existing literature suggests that a positive parent-training programme, in the group format, is one of the best options for cost-effective and successful ADHD intervention. Hence, the intervention took that form. Parents were taught basic behaviour analysis concepts within a supportive group context. Evaluation of the intervention’s efficacy used many of the same measures as in Stage 1, but also featured semi-structured interviews with participants and naturalistic observation of parent-child interaction. We will discuss preliminary results of that evaluation. Studying functional impairment and designing intervention plans in this way will pave the way for evidence-based treatment plans for children and adolescents diagnosed with ADHD.

Keywords: attention deficit/hyperactivity disorder, children, intervention, parenting groups

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Authors: Beatriz Salamanca

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In his public lecture ‘On the American Indians’ given at the University of Salamanca in 1538-39, Francisco de Vitoria presented an unsettling defense of freedom of movement, arguing that the Spanish had the right to travel and dwell in the New World, since it was considered part of the law of nations [ius gentium] that men enjoyed free mutual intercourse anywhere they went. The principle of freedom of movement brought hopeful expectations, promising to bring mankind together and strengthen the ties of fraternity. However, it led to polemical situations when those whose mobility was in question represented a harmful threat or was for some reason undesired. In this context, Vitoria’s argument has been seen on multiple occasions as a justification of the expansion of the Spanish empire. In order to examine the meaning of Vitoria’s defense of free mobility, a more detailed look at Vitoria’s text is required, together with the study of some of his earliest works, among them, his commentaries on Thomas Aquinas’s Summa Theologiae, where he presented relevant insights on the idea of the law of nations. In addition, it is necessary to place Vitoria’s work in the context of the intellectual tradition he belonged to and the responses he obtained from some of his contemporaries who were concerned with similar issues. The claim of this research is that the Spanish right to travel advocated by Vitoria was not intended to be interpreted in absolute terms, for it had to serve the purpose of bringing peace and unity among men, and could not contradict natural law. In addition, Vitoria explicitly observed that the right to travel was only valid if the Spaniards caused no harm, a condition that has been underestimated by his critics. Therefore, Vitoria’s legacy is of enormous value as it initiated a long lasting discussion regarding the question of the grounds under which human mobility could be restricted. Again, under Vitoria’s argument it was clear that this freedom was not absolute, but the controversial nature of his defense of Spanish mobility demonstrates how difficult it was and still is to address the issue of the circulation of peoples across frontiers, and shows the significance of this discussion in today’s globalized world, where the rights and wrongs of notions like immigration, international trade or foreign intervention still lack sufficient consensus. This inquiry about Vitoria’s defense of the principle of freedom of movement is being placed here against the background of the history of political thought, political theory, international law, and international relations, following the methodological framework of contextual history of the ‘Cambridge School’.

Keywords: Francisco de Vitoria, freedom of movement, law of nations, ius gentium, Spanish empire

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Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun

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Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.

Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning

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Authors: Rumeysa Gunduz, Dirk Koester, Thomas Schack

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Previous behavioral studies have shown that working memory (WM) and manual actions share limited capacity cognitive resources, which in turn results in execution costs of manual actions in WM. However, to the best of our knowledge, there is no study investigating the neurophysiology of execution costs. The current study aims to fill this research gap investigating the neurophysiology of execution costs of grasping in WM phases (encoding, maintenance, retrieval) considering verbal and visuospatial domains of WM. A WM-grasping dual task paradigm was implemented to examine execution costs. Baseline single task required performing verbal or visuospatial version of a WM task. Dual task required performing the WM task embedded in a high precision grasp to place task. 30 participants were tested in a 2 (single vs. dual task) x 2 (visuo-spatial vs. verbal WM) within subject design. Event related potentials (ERPs) were extracted for each WM phase separately in the single and dual tasks. Memory performance for visuospatial WM, but not for verbal WM, was significantly lower in the dual task compared to the single task. Encoding related ERPs in the single task revealed different ERPs of verbal WM and visuospatial WM at bilateral anterior sites and right posterior site. In the dual task, bilateral anterior difference disappeared due to bilaterally increased anterior negativities for visuospatial WM. Maintenance related ERPs in the dual task revealed different ERPs of verbal WM and visuospatial WM at bilateral posterior sites. There was also anterior negativity for visuospatial WM. Retrieval related ERPs in the single task revealed different ERPs of verbal WM and visuospatial WM at bilateral posterior sites. In the dual task, there was no difference between verbal WM and visuospatial WM. Behavioral and ERP findings suggest that execution of grasping shares cognitive resources only with visuospatial WM, which in turn results in domain specific execution costs. Moreover, ERP findings suggest unique patterns of costs in each WM phase, which supports the idea that each WM phase reflects a separate cognitive process. This study not only contributes to the understanding of cognitive principles of manual action control, but also contributes to the understanding of WM as an entity consisting of separate modalities and cognitive processes.

Keywords: dual task, grasping execution, neurophysiology, working memory domains, working memory phases

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Authors: Thomas Arink, Isam Janajreh

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The petroleum industry generates significant amounts of waste in the form of drill cuttings, contaminated soil and oily sludge. Drill cuttings are a product of the off-shore drilling rigs, containing wet soil and total petroleum hydrocarbons (TPH). Contaminated soil comes from different on-shore sites and also contains TPH. The oily sludge is mainly residue or tank bottom sludge from storage tanks. The two main treatment methods currently used are incineration and thermal desorption (TD). Thermal desorption is a method where the waste material is heated to 450ºC in an anaerobic environment to release volatiles, the condensed volatiles can be used as a liquid fuel. For the thermal desorption unit dry contaminated soil is mixed with moist drill cuttings to generate a suitable mixture. By thermo gravimetric analysis (TGA) of the TD feedstock it was found that less than 50% of the TPH are released, the discharged material is stored in landfill. This study proposes co-gasification of petroleum waste with waste tires as an alternative to thermal desorption. Co-gasification with a high-calorific material is necessary since the petroleum waste consists of more than 60 wt% ash (soil/sand), causing its calorific value to be too low for gasification. Since the gasification process occurs at 900ºC and higher, close to 100% of the TPH can be released, according to the TGA. This work consists of three parts: 1. a mathematical gasification model, 2. a reactive flow CFD model and 3. experimental work on a drop tube reactor. Extensive material characterization was done by means of proximate analysis (TGA), ultimate analysis (CHNOS flash analysis) and calorific value measurements (Bomb calorimeter) for the input parameters of the mathematical and CFD model. The mathematical model is a zero dimensional model based on Gibbs energy minimization together with Lagrange multiplier; it is used to find the product species composition (molar fractions of CO, H2, CH4 etc.) for different tire/petroleum feedstock mixtures and equivalence ratios. The results of the mathematical model act as a reference for the CFD model of the drop-tube reactor. With the CFD model the efficiency and product species composition can be predicted for different mixtures and particle sizes. Finally both models are verified by experiments on a drop tube reactor (1540 mm long, 66 mm inner diameter, 1400 K maximum temperature).

Keywords: computational fluid dynamics (CFD), drop tube reactor, gasification, Gibbs energy minimization, petroleum waste, waste tires

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Authors: Stephen L. Green, Alexander N. Gorban, Ivan Y. Tyukin

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Within the past decade, using Convolutional Neural Networks (CNN)’s to create Deep Learning systems capable of translating Sign Language into text has been a breakthrough in breaking the communication barrier for deaf-mute people. Conventional research on this subject has been concerned with training the network to recognize the fingerspelling gestures of a given language and produce their corresponding alphanumerics. One of the problems with the current developing technology is that images are scarce, with little variations in the gestures being presented to the recognition program, often skewed towards single skin tones and hand sizes that makes a percentage of the population’s fingerspelling harder to detect. Along with this, current gesture detection programs are only trained on one finger spelling language despite there being one hundred and forty-two known variants so far. All of this presents a limitation for traditional exploitation for the state of current technologies such as CNN’s, due to their large number of required parameters. This work aims to present a technology that aims to resolve this issue by combining a pretrained legacy AI system for a generic object recognition task with a corrector method to uptrain the legacy network. This is a computationally efficient procedure that does not require large volumes of data even when covering a broad range of sign languages such as American Sign Language, British Sign Language and Chinese Sign Language (Pinyin). Implementing recent results on method concentration, namely the stochastic separation theorem, an AI system is supposed as an operate mapping an input present in the set of images u ∈ U to an output that exists in a set of predicted class labels q ∈ Q of the alphanumeric that q represents and the language it comes from. These inputs and outputs, along with the interval variables z ∈ Z represent the system’s current state which implies a mapping that assigns an element x ∈ ℝⁿ to the triple (u, z, q). As all xi are i.i.d vectors drawn from a product mean distribution, over a period of time the AI generates a large set of measurements xi called S that are grouped into two categories: the correct predictions M and the incorrect predictions Y. Once the network has made its predictions, a corrector can then be applied through centering S and Y by subtracting their means. The data is then regularized by applying the Kaiser rule to the resulting eigenmatrix and then whitened before being split into pairwise, positively correlated clusters. Each of these clusters produces a unique hyperplane and if any element x falls outside the region bounded by these lines then it is reported as an error. As a result of this methodology, a self-correcting recognition process is created that can identify fingerspelling from a variety of sign language and successfully identify the corresponding alphanumeric and what language the gesture originates from which no other neural network has been able to replicate.

Keywords: convolutional neural networks, deep learning, shallow correctors, sign language

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Authors: Oris Tom-Lawyer, Michael Thomas

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This paper seeks to analyse the hegemony of the English language in Western Africa through the lens of educational policies and the socio-economic functions of the language. It is based on the premise that there is a positive link between the English language and development contexts. The study aims to fill a gap in the research literature by examining the usefulness of hegemony as a concept to explain the role of English language in the region, thus countering the negative connotations that often accompany it. The study identified four main research questions: i. What are the socio-economic functions of English in Francophone/lusophone countries? ii. What factors promote the hegemony of English in anglophone countries? iii. To what extent is the hegemony of English in West Africa? iv. What are the implications of the non-hegemony of English in Western Africa? Based on a meta-analysis of the research literature between 2003 and 2018, the findings of the study revealed that in francophone/lusophone countries, English functions in the following socio-economic domains; they are peace keeping missions, regional organisations, commercial and industrial sectors, as an unofficial international language and as a foreign language. The factors that promote linguistic hegemony of English in anglophone countries are English as an official language, a medium of instruction, lingua franca, cultural language, language of politics, language of commerce, channel of development and English for media and entertainment. In addition, the extent of the hegemony of English in West Africa can be viewed from the factors that contribute to the non-hegemony of English in the region; they are French language, Portuguese language, the French culture, neo-colonialism, level of poverty, and economic ties of French to its former colonies. Finally, the implications of the non-hegemony of English language in West Africa are industrial backwardness, poverty rate, lack of social mobility, drop out of school rate, growing interest in English, access to limited internet information and lack of extensive career opportunities. The paper concludes that the hegemony of English has resulted in the development of anglophone countries in Western Africa, while in the francophone/lusophone regions of the continent, industrial backwardness and low literacy rates have been consequences of English language marginalisation. In conclusion, the paper makes several recommendations, including the need for the early introduction of English into French curricula as part of a potential solution.

Keywords: developmental tool, English language, linguistic hegemony, West Africa

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Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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Authors: Benedict Ofori, Kwabena Sarpong, Stephen Antwi

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Background: Medicinal plants are utilized all around the world and are becoming increasingly important economically. The WHO notes that ‘inappropriate use of traditional medicines or practices can have negative or dangerous effects and that future research is needed to ascertain the efficacy and safety of such practices and medicinal plants used by traditional medicine systems. The poor around the world have limited access to palliative care or pain relief. Pharmacologists have been focused on developing safe and effective anti-inflammatory drugs. Most of the issues related to their use have been linked to the fact that numerous traditional and herbal treatments are classified in different nations as meals or dietary supplements. As a result, there is no need for evidence of the quality, efficacy, or safety of these herbal formulations before they are marketed. The fact that access to drugs meant for pain relief is limited in low-income countries means advanced studies should be done on home drugs meant for inflammation to close the gap. Methods: The ethanolic extracts of the plant were screened for the presence of 10 phytochemicals. The Pierce BCA Protein Assay Kit was used for the determination of the protein concentration of the egg white. The rats were randomly selected and put in 6 groups. The egg white was sub-plantar injected into the right-hand paws of the rats to induce inflammation. The animals were treated with the three plant extracts obtained from the root bark, stem, and leaves of the plant. The control groups were treated with normal saline, while the standard groups were treated with standard drugs indomethacin and celecoxib. Plethysmometer was used to measure the change in paw volume of the animals over the course of the experiment. Results: The results of the phytochemical screening revealed the presence of reducing sugars and saponins. Alkaloids were present in only R.L.S (1:1:1), and phytosterols were found in R.L(1:1) and R.L.S (1:1:1). The estimated protein concentration was found to be 103.75 mg/ml. The control group had an observable increase in paw volume, which indicated that inflammation was induced during the 5 hours. The increase in paw volume for the control group peaked at the 1st hour and decreased gradually throughout the experiment, with minimal changes in the paw volumes. The 2nd and 3rd groups were treated with 20 mg/kg of indomethacin and celecoxib. The anti-inflammatory activities of indomethacin and celecoxib were calculated to be 21.4% and 4.28%, respectively. The remaining 3 groups were treated with 2 dose levels of 200mg/kg plant extracts. R.L.S, R.L, and S.R.L had anti-inflammatory activities of 22.3%, 8.2%, and 12.07%, respectively. Conclusions: Egg albumin-induced paw model in rats can be used to evaluate the anti-inflammatory activity of herbs that might have potential anti-inflammatory activity. Herbal medications have potential anti-inflammatory activities and can be used to manage various inflammatory conditions if their efficacy and side effects are well studied. The three extracts all possessed anti-inflammatory activity, with R.L.S having the highest anti-inflammatory activity.

Keywords: inflammation, capparis erythrocarpos, anti-inflammatory activity, herbal medicine, paw volume, egg albumin

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Authors: Stephen Dankwa, Zheng Wenfeng, Xiaolu Li

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Climate change is recently gaining the attention of many countries across the world. Climate change, which is also known as global warming, referring to the increasing in average surface temperature has been a concern to the Environmental Protection Agency of Ghana. Recently, Ghana has become vulnerable to the effect of the climate change as a result of the dependence of the majority of the population on agriculture. The clearing down of trees to grow crops and burning of charcoal in the country has been a contributing factor to the rise in temperature nowadays in the country as a result of releasing of carbon dioxide and greenhouse gases into the air. Recently, petroleum stations across the cities have been on fire due to this climate changes and which have position Ghana in a way not able to withstand this climate event. As a result, the significant of this research paper is to project how the rise in the average surface temperature will be like at the end of the mid-21st century when agriculture and deforestation are allowed to continue for some time in the country. This study uses the Coupled Modeled Intercomparison Project phase 5 (CMIP5) experiment RCP 8.5 model output data to monitor the future climate changes from 2041-2050, at the end of the mid-21st century over the ten (10) major cities (Accra, Bolgatanga, Cape Coast, Koforidua, Kumasi, Sekondi-Takoradi, Sunyani, Ho, Tamale, Wa) in Ghana. In the models, Support Vector Machine and Random forest, where the cities as a function of heat wave metrics (minimum temperature, maximum temperature, mean temperature, heat wave duration and number of heat waves) assisted to provide more than 50% accuracy to predict and monitor the pattern of the surface air temperature. The findings identified were that the near-surface air temperature will rise between 1°C-2°C (degrees Celsius) over the coastal cities (Accra, Cape Coast, Sekondi-Takoradi). The temperature over Kumasi, Ho and Sunyani by the end of 2050 will rise by 1°C. In Koforidua, it will rise between 1°C-2°C. The temperature will rise in Bolgatanga, Tamale and Wa by 0.5°C by 2050. This indicates how the coastal and the southern part of the country are becoming hotter compared with the north, even though the northern part is the hottest. During heat waves from 2041-2050, Bolgatanga, Tamale, and Wa will experience the highest mean daily air temperature between 34°C-36°C. Kumasi, Koforidua, and Sunyani will experience about 34°C. The coastal cities (Accra, Cape Coast, Sekondi-Takoradi) will experience below 32°C. Even though, the coastal cities will experience the lowest mean temperature, they will have the highest number of heat waves about 62. Majority of the heat waves will last between 2 to 10 days with the maximum 30 days. The surface temperature will continue to rise by the end of the mid-21st century (2041-2050) over the major cities in Ghana and so needs to be addressed to the Environmental Protection Agency in Ghana in order to mitigate this problem.

Keywords: climate changes, CMIP5, Ghana, heat waves, random forest, SVM

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Authors: Thomas Rowan, Mohammed Seaid

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A fast finite volume solver for multi-layered shallow water flows with mass exchange and an erodible bed is developed. This enables the user to solve a number of complex sediment-based problems including (but not limited to), dam-break over an erodible bed, recirculation currents and bed evolution as well as levy and dyke failure. This research develops methodologies crucial to the under-standing of multi-sediment fluvial mechanics and waterway design. In this model mass exchange between the layers is allowed and, in contrast to previous models, sediment and fluid are able to transfer between layers. In the current study we use a two-step finite volume method to avoid the solution of the Riemann problem. Entrainment and deposition rates are calculated for the first time in a model of this nature. In the first step the governing equations are rewritten in a non-conservative form and the intermediate solutions are calculated using the method of characteristics. In the second stage, the numerical fluxes are reconstructed in conservative form and are used to calculate a solution that satisfies the conservation property. This method is found to be considerably faster than other comparative finite volume methods, it also exhibits good shock capturing. For most entrainment and deposition equations a bed level concentration factor is used. This leads to inaccuracies in both near bed level concentration and total scour. To account for diffusion, as no vertical velocities are calculated, a capacity limited diffusion coefficient is used. The additional advantage of this multilayer approach is that there is a variation (from single layer models) in bottom layer fluid velocity: this dramatically reduces erosion, which is often overestimated in simulations of this nature using single layer flows. The model is used to simulate a standard dam break. In the dam break simulation, as expected, the number of fluid layers utilised creates variation in the resultant bed profile, with more layers offering a higher deviation in fluid velocity . These results showed a marked variation in erosion profiles from standard models. The overall the model provides new insight into the problems presented at minimal computational cost.

Keywords: erosion, finite volume method, sediment transport, shallow water equations

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Authors: Qingqing Feng, S. Thomas Ng, Frank J. Xu, Jiduo Xing

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Faced with unprecedented challenges including aging assets, lack of maintenance budget, overtaxed and inefficient usage, and outcry for better service quality from the society, today’s infrastructure systems has become the main focus of many metropolises to pursue sustainable urban development and improve resilience. Digital twin, being one of the most innovative enabling technologies nowadays, may open up new ways for tackling various infrastructure asset management (IAM) problems. Digital twin application for IAM, as its name indicated, represents an evolving digital model of intended infrastructure that possesses functions including real-time monitoring; what-if events simulation; and scheduling, maintenance, and management optimization based on technologies like IoT, big data and AI. Up to now, there are already vast quantities of global initiatives of digital twin applications like 'Virtual Singapore' and 'Digital Built Britain'. With digital twin technology permeating the IAM field progressively, it is necessary to consider the maturity of the application and how those institutional or industrial digital twin application processes will evolve in future. In order to deal with the gap of lacking such kind of benchmark, a draft maturity model is developed for digital twin application in the IAM field. Firstly, an overview of current smart cities maturity models is given, based on which the draft Maturity Model of Digital Twin Application for Infrastructure Asset Management (MM-DTIAM) is developed for multi-stakeholders to evaluate and derive informed decision. The process of development follows a systematic approach with four major procedures, namely scoping, designing, populating and testing. Through in-depth literature review, interview and focus group meeting, the key domain areas are populated, defined and iteratively tuned. Finally, the case study of several digital twin projects is conducted for self-verification. The findings of the research reveal that: (i) the developed maturity model outlines five maturing levels leading to an optimised digital twin application from the aspects of strategic intent, data, technology, governance, and stakeholders’ engagement; (ii) based on the case study, levels 1 to 3 are already partially implemented in some initiatives while level 4 is on the way; and (iii) more practices are still needed to refine the draft to be mutually exclusive and collectively exhaustive in key domain areas.

Keywords: digital twin, infrastructure asset management, maturity model, smart city

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Authors: Felicia N. Obialo, Aliza Wingo, Thomas Wingo

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Psychosocial factors such as personality traits and social networks influence cognitive aging and dementia outcomes both positively and negatively. The inherent complexity of these factors makes defining the underlying mechanisms of their influence difficult; however, exploring their interactions affords promise in the field of cognitive aging. The objective of this study was to elucidate some of these interactions by determining the relationship between social network size and dementia outcomes and by determining whether personality traits mediate this relationship. The longitudinal Alzheimer’s Disease (AD) database provided by Rush University’s Religious Orders Study/Memory and Aging Project was utilized to perform retrospective regression and mediation analyses on 3,591 participants. Participants who were cognitively impaired at baseline were excluded, and analyses were adjusted for age, sex, common chronic diseases, and vascular risk factors. Dementia outcome measures included cognitive trajectory, clinical dementia diagnosis, and postmortem beta-amyloid plaque (AB), and neurofibrillary tangle (NT) accumulation. Personality traits included agreeableness (A), conscientiousness (C), extraversion (E), neuroticism (N), and openness (O). The results show a positive correlation between social network size and cognitive trajectory (p-value = 0.004) and a negative relationship between social network size and odds of dementia diagnosis (p = 0.024/ Odds Ratio (OR) = 0.974). Only neuroticism mediates the positive relationship between social network size and cognitive trajectory (p < 2e-16). Agreeableness, extraversion, and neuroticism all mediate the negative relationship between social network size and dementia diagnosis (p=0.098, p=0.054, and p < 2e-16, respectively). All personality traits are independently associated with dementia diagnosis (A: p = 0.016/ OR = 0.959; C: p = 0.000007/ OR = 0.945; E: p = 0.028/ OR = 0.961; N: p = 0.000019/ OR = 1.036; O: p = 0.027/ OR = 0.972). Only conscientiousness and neuroticism are associated with postmortem AD pathologies; specifically, conscientiousness is negatively associated (AB: p = 0.001, NT: p = 0.025) and neuroticism is positively associated with pathologies (AB: p = 0.002, NT: p = 0.002). These results support the study’s objectives, demonstrating that social network size and personality traits are strongly associated with dementia outcomes, particularly the odds of receiving a clinical diagnosis of dementia. Personality traits interact significantly and beneficially with social network size to influence the cognitive trajectory and future dementia diagnosis. These results reinforce previous literature linking social network size to dementia risk and provide novel insight into the differential roles of individual personality traits in cognitive protection.

Keywords: Alzheimer’s disease, cognitive trajectory, personality traits, social network size

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Authors: Wafaa Kamal Isaac

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This paper attempts to shed light upon the stereotypical images of marginalized black women as shown through the poetry of Rita Dove. Meanwhile, it explores how stereotypical images held by the society and public perceptions perpetuate the marginalization of black women. Dove is considered one of the most fundamental African-American poets who devoted her writings to explore the problem of identity that confronted marginalized women in America. Besides tackling the issue of black women’s stereotypical images, this paper focuses upon the psychological damage which the black women had suffered from due to their stripped identity. In ‘Thomas and Beulah’, Dove reflects the black woman’s longing for her homeland in order to make up for her lost identity. This poem represents atavistic feelings deal with certain recurrent images, both aural and visual, like the image of Beulah who represents the African-American woman who searches for an identity, as she is being denied and humiliated one in the newly founded society. In an attempt to protest against the stereotypical mule image that had been imposed upon black women in America, Dove in ‘On the Bus with Rosa Parks’ tries to ignite the beaten spirits to struggle for their own rights by revitalizing the rebellious nature and strong determination of the historical figure ‘Rosa Parks’ that sparked the Civil Rights Movement. In ‘Daystar’, Dove proves that black women are subjected to double-edged oppression; firstly, in terms of race as a black woman in an unjust white society that violates her rights due to her black origins and secondly, in terms of gender as a member of the female sex that is meant to exist only to serve man’s needs. Similarly, in the ‘Adolescence’ series, Dove focuses on the double marginalization which the black women had experienced. It concludes that the marginalization of black women has resulted from the domination of the masculine world and the oppression of the white world. Moreover, Dove’s ‘Beauty and the Beast’ investigates the African-American women’s problem of estrangement and identity crisis in America. It also sheds light upon the psychological consequences that resulted from the violation of marginalized women’s identity. Furthermore, this poem shows the black women’s self-debasement, helplessness, and double consciousness that emanate from the sense of uprootedness. Finally, this paper finds out that the negative, debased and inferior stereotypical image held by the society did not only contribute to the marginalization of black women but also silenced and muted their voices.

Keywords: stereotypical images, marginalized women, Rita Dove, identity

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Authors: Christoph Hacker, Zeynep Karahaliloglu, Gunnar Seide, Emir Baki Denkbas, Thomas Gries

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A wound dressing material is designed to facilitate wound healing and minimize scarring. An ideal wound dressing material should protect the wound from any contaminations of exogeneous microorganism. In addition, the dressing material should provide a moist environment through extraction of body fluid from the wound area. Recently, wound dressing electrospun nanofibrous membranes are produced by electrospinning from a polymer solution or a polymer melt. These materials have a great potential as dressing materials for wound healing because of superior properties such as high surface-to-volume ratio, high porosity with excellent pore interconnectivity. Melt electrospinning is an attractive tissue engineering scaffold manufacturing process which eliminated the health risk posed by organic solvents used in electrospinning process and reduced the production costs. In this study, antibacterial wound dressing materials were prepared from TPU (Elastollan 1185A) by a melt-electrospinning technique. The electrospinning parameters for an efficient melt-electrospinning process of TPU were optimized. The surface of the fibers was modified with poly(ethylene glycol) (PEG) by radio-frequency glow discharge plasma deposition method and with silver nanoparticles (nAg) to improve their wettability and antimicrobial properties. TPU melt-electrospun mats were characterized using SEM, DSC, TGA and XPS. The cell viability and proliferation on modified melt-electrospun TPU mats were evaluated using a mouse fibroblast cell line (L929). Antibacterial effects of theirs against both Staphylococcus aureus strain and Escherichia coli were investigated by disk-diffusion method. TPU was successfully processed into a porous, fibrous network of beadless fibers in the micrometer range (4.896±0.94 µm) with a voltage of 50 kV, a working distance of 6 cm, a temperature of the thermocouple and hot coil of 225–230ºC, and a flow rate of 0.1 mL/h. The antibacterial test indicated that PEG-modified nAg-loaded TPU melt-electrospun structure had excellent antibacterial effects and cell study results demonstrated that nAg-loaded TPU mats had no cytotoxic effect on the fibroblast cells. In this work, the surface of a melt-electrospun TPU mats was modified via PEG monomer and then nAg. Results showed melt-electrospun TPU mats modified with PEG and nAg have a great potential for use as an antibacterial wound dressing material and thus, requires further investigation.

Keywords: melt electrospinning, nanofiber, silver nanoparticles, wound dressing

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Authors: Stephen Kyakulumbye, Vivian Kobusingye

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Generally, World over, COVID-19 has had adverse effects on all sectors but with more debilitating effects on the education sector. After reactive lockdowns, education institutions that could continue teaching and learning had to go a distance mediated by digital technological tools. In Uganda, the Ministry of Education thereby issued COVID-19 Online Distance E-learning (ODeL) emergent guidelines. Despite such guidelines, academic institutions in Uganda and similar developing contexts with academically constrained resource environments were caught off-guard and ill-prepared to transform from face-to-face learning to online distance learning mode. Most academic institutions that migrated spontaneously did so with no deliberate tools, systems, strategies, or software to cause active, meaningful, and engaging learning for students. By experience, most of these academic institutions shifted to Zoom and WhatsApp and instead conducted online teaching in real-time than blended synchronous and asynchronous tools. This paper provides students’ experiences while blending synchronous and asynchronous content-creating and learning tools within a technological resource-constrained environment to navigate in such a challenging Uganda context. These conceptual case-based findings, using experience from Uganda Christian University (UCU), point at the design of learning activities with two certain characteristics, the enhancement of synchronous learning technologies with asynchronous ones to mitigate the challenge of system breakdown, passive learning to active learning, and enhances the types of presence (social, cognitive and facilitatory). The paper, both empirical and experiential in nature, uses online experiences from third-year students in Bachelor of Business Administration student lectured using asynchronous text, audio, and video created with Open Broadcaster Studio software and compressed with Handbrake, all open-source software to mitigate disk space and bandwidth usage challenges. The synchronous online engagements with students were a blend of zoom or BigBlueButton, to ensure that students had an alternative just in case one failed due to excessive real-time traffic. Generally, students report that compared to their previous face-to-face lectures, the pre-recorded lectures via Youtube provided them an opportunity to reflect on content in a self-paced manner, which later on enabled them to engage actively during the live zoom and/or BigBlueButton real-time discussions and presentations. The major recommendation is that lecturers and teachers in a resource-constrained environment with limited digital resources like the internet and digital devices should harness this approach to offer students access to learning content in a self-paced manner and thereby enabling reflective active learning through reflective and high-order thinking.

Keywords: synchronous learning, asynchronous learning, active learning, reflective learning, resource-constrained environment

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Authors: Harish Kuruva, Vedasri Bai Khavala, Tiju Thomas, K. Murugan, B. S. Murty

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Industries are growing day to day to increase the economy of the country. The biggest problem with industries is wastewater treatment. Releasing these wastewater directly into the river is more harmful to human life and a threat to aquatic life. These industrial effluents contain many dissolved solids, organic/inorganic compounds, salts, toxic metals, etc. Phenols, pesticides, dioxins, herbicides, pharmaceuticals, and textile dyes were the types of industrial effluents and more challenging to degrade eco-friendly. So many advanced techniques like electrochemical, oxidation process, and valorization have been applied for industrial wastewater treatment, but these are not cost-effective. Industrial effluent degradation is complicated compared to commercially available pollutants (dyes) like methylene blue, methylene orange, rhodamine B, etc. TiO₂ is one of the widely used photocatalysts which can degrade organic compounds using solar light and moisture available in the environment (organic compounds converted to CO₂ and H₂O). TiO₂ is widely studied in photocatalysis because of its low cost, non-toxic, high availability, and chemically and physically stable in the atmosphere. This study mainly focused on valorizing the mineralogical product TiO₂ (IREL, India). This mineralogical graded TiO₂ was characterized and compared with its structural and photocatalytic properties (industrial effluent degradation) with the commercially available Degussa P-25 TiO₂. It was testified that this mineralogical TiO₂ has the best photocatalytic properties (particle shape - spherical, size - 30±5 nm, surface area - 98.19 m²/g, bandgap - 3.2 eV, phase - 95% anatase, and 5% rutile). The industrial effluent was characterized by TDS (total dissolved solids), ICP-OES (inductively coupled plasma – optical emission spectroscopy), CHNS (Carbon, Hydrogen, Nitrogen, and sulfur) analyzer, and FT-IR (fourier-transform infrared spectroscopy). It was observed that it contains high sulfur (S=11.37±0.15%), organic compounds (C=4±0.1%, H=70.25±0.1%, N=10±0.1%), heavy metals, and other dissolved solids (60 g/L). However, the organo-sulfur industrial effluent was degraded by photocatalysis with the industrial mineralogical product TiO₂. In this study, the industrial effluent pH value (2.5 to 10), catalyst concentration (50 to 150 mg) were varied, and effluent concentration (0.5 Abs) and light exposure time (2 h) were maintained constant. The best degradation is about 80% of industrial effluent was achieved at pH 5 with a concentration of 150 mg - TiO₂. The FT-IR results and CHNS analyzer confirmed that the sulfur and organic compounds were degraded.

Keywords: wastewater treatment, industrial mineralogical product TiO₂, photocatalysis, organo-sulfur industrial effluent

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Authors: Stephen Bahooshy

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Co-producing services with the people that access them is considered best practice in the United Kingdom, with the Care Act 2014 arguing that people who access services and their carers should be involved in the design, commissioning and delivery of services. Co-production is a way of working with the community, breaking down barriers of access and providing meaningful opportunity for people to engage. Unfortunately, owing to a number of reported factors such as time constraints, practitioner experience and departmental budget restraints, this process is not always followed. In 2019, in a south London borough, d/Deaf people who access services were engaged in the design, commissioning and delivery of an information and advice service that would support their community to access local government services. To do this, sensory impairment social workers and commissioners collaborated to host a series of engagement events with the d/Deaf community. Interpreters were used to enable communication between the commissioners and d/Deaf participants. Initially, the community’s opinions, ideas and requirements were noted. This was then summarized and fed back to the community to ensure accuracy. Subsequently, a service specification was developed which included performance metrics, inclusive of qualitative and quantitative indicators, such as ‘I statements’, whereby participants respond on an adapted Likert scale how much they agree or disagree with a particular statement in relation to their experience of the service. The service specification was reviewed by a smaller group of d/Deaf residents and social workers, to ensure that it met the community’s requirements. The service was then tendered using the local authority’s e-tender process. Bids were evaluated and scored in two parts; part one was by commissioners and social workers and part two was a presentation by prospective providers to an evaluation panel formed of four d/Deaf residents. The internal evaluation panel formed 75% of the overall score, whilst the d/Deaf resident evaluation panel formed 25% of the overall tender score. Co-producing the evaluation panel with social workers and the d/Deaf community meant that commissioners were able to meet the requirements of this community by developing evaluation questions and tools that were easily understood and use by this community. For example, the wording of questions were reviewed and the scoring mechanism consisted of three faces to reflect the d/Deaf residents’ scores instead of traditional numbering. These faces were a happy face, a neutral face and a sad face. By making simple changes to the commissioning and tender evaluation process, d/Deaf people were able to have meaningful involvement in the design and commissioning process for a service that would benefit their community. Co-produced performance metrics means that it is incumbent on the successful provider to continue to engage with people accessing the service and ensure that the feedback is utilized. d/Deaf residents were grateful to have been involved in this process as this was not an opportunity that they had previously been afforded. In recognition of their time, each d/Deaf resident evaluator received a £40 gift voucher, bringing the total cost of this co-production to £160.

Keywords: co-production, community engagement, deaf and hearing impaired, service design

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Authors: Stephen Bahooshy

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Our understanding of gender inequality has advanced in recent years. Differences in pay and societal gendered behaviour expectations have been emphasized. It is acknowledged globally that gender shapes everyone’s experiences of health and social care, including access to care, use of services and products, and the interaction with care providers. NHS Digital in England collects data from local authorities on the number of carers and people with support needs and the services they access. This data does not provide a gender breakdown. Caring can have many positive and negative impacts on carers’ health and wellbeing. For example, caring can improve physical health, provide a sense of pride and purpose, and reduced stress levels for those who undertake a caring role by choice. Negatives of caring include financial concerns, social isolation, a reduction in earnings, and not being recognized as a carer or involved and consulted by health and social care professionals. Treating male and female carers differently is by definition unequitable and precludes one gender from receiving the benefits of caring whilst potentially overburdening the other with the negatives of caring. In order to explore the issue on a preliminary basis, five local authorities who provide statutory adult social care services in England were sent Freedom of Information requests in 2019. The authorities were selected to include county councils and London boroughs. The authorities were asked to provide data on the amount of money spent on care at home packages to people over 65 years, broken down by gender and carer gender for each financial year between 2013 and 2019. Results indicated that in each financial year, female carers supporting someone over 65 years received less financial support for care at home support packages than male carers. Over the six-year period, this difference equated to a £9.5k deficit in financial support received on average per female carer when compared to male carers. An example of a London borough with the highest disparity presented an average weekly spend on care at home for people over 65 with a carer of £261.35 for male carers and £165.46 for female carers. Consequently, female carers in this borough received on average £95.89 less per week in care at home support than male carers. This highlights a real and potentially detrimental disparity in the care support received to female carers in order to support them to continue to care in parts of England. More research should be undertaken in this area to better explore this issue and to understand if these findings are unique to these social care providers or part of a wider phenomenon. NHS Digital should request local authorities collect data on gender in the same way that large employers in the United Kingdom are required by law to provide data on staff salaries by gender. People who allocate social care packages of support should consider the impact of gender when allocating support packages to people with support needs and who have carers to reduce any potential impact of gender bias on their decision-making.

Keywords: caregivers, carers, gender equality, social care

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Authors: Saem Lee, Thanh Nguyen, Hio-Jung Shin, Thomas Koellner

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Land-use management has an influence on the provision of ecosystem service in dynamic, agricultural landscapes. Agricultural land use is important for maintaining the productivity and sustainability of agricultural ecosystems. However, in Korea, intensive farming activities in this highland agricultural zone, the upper stream of Soyang has led to contaminated soil caused by over-use pesticides and fertilizers. This has led to decrease in water and soil quality, which has consequences for ecosystem services and human wellbeing. Conventional farming has still high percentage in this area and there is no special measure to prevent low water quality caused by farming activities. Therefore, the adoption of environmentally friendly farming has been considered one of the alternatives that lead to improved water quality and increase in biomass production. Concurrently, farm households with environmentally friendly farming have occupied still low rates. Therefore, our research involved a farm household survey spanning conventional farming, the farm in transition and organic farming in Soyang watershed. Another purpose of our research was to compare economic advantage of the farmers adopting environmentally friendly farming and non-adaptors and to investigate the different factors by logistic regression analysis with socio-economic and benefit-cost ratio variables. The results found that farmers with environmentally friendly farming tended to be younger than conventional farming and farmer in transition. They are similar in terms of gender which was predominately male. Farmers with environmentally friendly farming were more educated and had less farming experience than conventional farming and farmer in transition. Based on the benefit-cost analysis, total costs that farm in transition farmers spent for one year are about two times as much as the sum of costs in environmentally friendly farming. The benefit of organic farmers was assessed with 2,800 KRW per household per year. In logistic regression, the factors having statistical significance are subsidy and district, residence period and benefit-cost ratio. And district and residence period have the negative impact on the practice of environmentally friendly farming techniques. The results of our research make a valuable contribution to provide important information to describe Korean policy-making for agricultural and water management and to consider potential approaches to policy that would substantiate ways beneficial for sustainable resource management.

Keywords: organic farming, logistic regression, profitability, agricultural land-use

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Authors: Volker Landersheim, Daria Manushyna, Thinh Pham, Dai-Duong Tran, Thomas Geury, Omar Hegazy, Steven Wilkins

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Air pollution is one of the emerging problems in our society. Targets of reduction of CO₂ emissions address low-carbon and resource-efficient transport. (Plug-in) hybrid electric propulsion concepts offer the possibility to reduce total cost of ownership (TCO) and emissions for public transport vehicles (e.g., bus application). In this context, typically, diesel engines are used to form the hybrid propulsion system of the vehicle. Though the technological development of diesel engines experience major advantages, some challenges such as the high amount of particle emissions remain relevant. Gaseous fuels (i.e., compressed natural gases (CNGs) or liquefied petroleum gases (LPGs) represent an attractive alternative to diesel because of their composition. In the framework of the research project 'Optimised Real-world Cost-Competitive Modular Hybrid Architecture' (ORCA), which was funded by the EU, two different hybrid-electric propulsion concepts have been investigated: one using a diesel engine as internal combustion engine and one using CNG as fuel. The aim of the current study is to analyze specific benefits for the aforementioned hybrid propulsion systems for predefined driving scenarios with regard to emissions and total cost of ownership in bus application. Engine models based on experimental data for diesel and CNG were developed. For the purpose of designing optimal energy management strategies for each propulsion system, maps-driven or quasi-static models for specific engine types are used in the simulation framework. An analogous modelling approach has been chosen to represent emissions. This paper compares the two concepts regarding their CO₂ and NOx emissions. This comparison is performed for relevant bus missions (urban, suburban, with and without zero-emission zone) and with different energy management strategies. In addition to the emissions, also the downsizing potential of the combustion engine has been analysed to minimize the powertrain TCO (pTCO) for plug-in hybrid electric buses. The results of the performed analyses show that the hybrid vehicle concept using the CNG engine shows advantages both with respect to emissions as well as to pTCO. The pTCO is 10% lower, CO₂ emissions are 13% lower, and the NOx emissions are more than 50% lower than with the diesel combustion engine. These results are consistent across all usage profiles under investigation.

Keywords: bus transport, emissions, hybrid propulsion, pTCO, CNG

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Authors: Qier Wu, Issam Takla, Thomas Rougelot, Nicolas Burlion

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In the framework of French underground disposal of intermediate level radioactive wastes, concrete is widely used as a construction material for containers and tunnels. Drying shrinkage is one of the most disadvantageous phenomena of concrete structures. Cracks generated by differential shrinkage could impair the mechanical behavior, increase the permeability of concrete and act as a preferential path for aggressive species, hence leading to an overall decrease in durability and serviceability. It is of great interest to understand the drying shrinkage phenomenon in order to predict and even to control the strains of concrete. The question is whether the results obtained from laboratory samples are in accordance with the measurements on a real structure. Another question concerns the influence of reinforcement on drying shrinkage of concrete. As part of a global project with Andra (French National Radioactive Waste Management Agency), the present study aims to experimentally investigate the scale effect as well as the influence of reinforcement on the development of drying shrinkage of two high performance concretes (based on CEM I and CEM V cements, according to European standards). Various sizes of samples are chosen, from ordinary laboratory specimens up to real-scale specimens: prismatic specimens with different volume-to-surface (V/S) ratios, thin slices (thickness of 2 mm), cylinders with different sizes (37 and 160 mm in diameter), hollow cylinders, cylindrical columns (height of 1000 mm) and square columns (320×320×1000 mm). The square columns have been manufactured with different reinforcement rates and can be considered as mini-structures, to approximate the behavior of a real voussoir from the waste disposal facility. All the samples are kept, in a first stage, at 20°C and 50% of relative humidity (initial conditions in the tunnel) in a specific climatic chamber developed by the Laboratory of Mechanics of Lille. The mass evolution and the drying shrinkage are monitored regularly. The obtained results show that the specimen size has a great impact on water loss and drying shrinkage of concrete. The specimens with a smaller V/S ratio and a smaller size have a bigger drying shrinkage. The correlation between mass variation and drying shrinkage follows the same tendency for all specimens in spite of the size difference. However, the influence of reinforcement rate on drying shrinkage is not clear based on the present results. The second stage of conservation (50°C and 30% of relative humidity) could give additional results on these influences.

Keywords: concrete, drying shrinkage, mass evolution, reinforcement, scale effect

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Authors: Jihane Saad, Thomas Lendormi, Caroline Le Marechal, Anne-marie Pourcher, Céline Druilhe, Jean-louis Lanoiselle

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Agricultural anaerobic digestion consists in the conversion of animal slurry and manure into biogas and digestate. They need, however, to be treated at 70 ºC during 60 min before anaerobic digestion according to the European regulation (EC n°1069/2009 & EU n°142/2011). The impact of such heat treatment on the outcome of bacteria has been poorly studied up to now. Moreover, a recent study¹ has shown that enterococci and clostridia are still detected despite the application of such thermal treatment, questioning the relevance of this approach for the hygienisation of digestate. The aim of this study is to establish the heat inactivation kinetics of two species of enterococci (Enterococcus faecalis and Enterococcus faecium) and two species of clostridia (Clostridioides difficile and Clostridium novyi as a non-toxic model for Clostridium botulinum of group III). A pure culture of each strain was prepared in a specific sterile medium at concentration of 10⁴ – 10⁷ MPN / mL (Most Probable number), depending on the bacterial species. Bacterial suspensions were then filled in sterilized capillary tubes and placed in a water or oil bath at desired temperature for a specific period of time. Each bacterial suspension was enumerated using a MPN approach, and tests were repeated three times for each temperature/time couple. The inactivation kinetics of the four indicator bacteria is described using the Weibull model and the classical Bigelow model of first-order kinetics. The Weibull model takes biological variation, with respect to thermal inactivation, into account and is basically a statistical model of distribution of inactivation times as the classical first-order approach is a special case of the Weibull model. The heat treatment at 70 ºC / 60 min contributes to a reduction greater than 5 log10 for E. faecium and E. faecalis. However, it results only in a reduction of about 0.7 log10 for C. difficile and an increase of 0.5 log10 for C. novyi. Application of treatments at higher temperatures is required to reach a reduction greater or equal to 3 log10 for C. novyi (such as 30 min / 100 ºC, 13 min / 105 ºC, 3 min / 110 ºC, and 1 min / 115 ºC), raising the question of the relevance of the application of heat treatment at 70 ºC / 60 min for these spore-forming bacteria. To conclude, the heat treatment (70 ºC / 60 min) defined by the European regulation is sufficient to inactivate non-sporulating bacteria. Higher temperatures (> 100 ºC) are required as far as spore-forming bacteria concerns to reach a 3 log10 reduction (sporicidal activity).

Keywords: heat treatment, enterococci, clostridia, inactivation kinetics

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Authors: Justin Fu, Thomas Mazzuchi, Shahram Sarkani

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A key factor in technological immaturity in defense weapons acquisition is lack of understanding critical integrations at the subsystem and component level. To address this shortfall, recent research in integration readiness level (IRL) combines with technology readiness level (TRL) to form a system readiness level (SRL). SRL can be enriched with more robust quantitative methods to provide the program manager a useful tool prior to committing to major weapons acquisition programs. This research harnesses previous mathematical models based on graph theory, Petri nets, and tropical algebra and proposes a modification of the desirable SRL mathematical properties such that a tightly integrated (multitude of interfaces) subsystem can display a lower SRL than an inherently less coupled subsystem. The synthesis of these methods informs an improved decision tool for the program manager to commit to expensive technology development. This research ties the separately developed manufacturing readiness level (MRL) into the network representation of the system and addresses shortfalls in previous frameworks, including the lack of integration weighting and the over-importance of a single extremely immature component. Tropical algebra (based on the minimum of a set of TRLs or IRLs) allows one low IRL or TRL value to diminish the SRL of the entire system, which may not be reflective of actuality if that component is not critical or tightly coupled. Integration connections can be weighted according to importance and readiness levels are modified to be a cardinal scale (based on an analytic hierarchy process). Integration arcs’ importance are dependent on the connected nodes and the additional integrations arcs connected to those nodes. Lack of integration is not represented by zero, but by a perfect integration maturity value. Naturally, the importance (or weight) of such an arc would be zero. To further explore the impact of grouping subsystems, a multi-objective genetic algorithm is then used to find various clusters or communities that can be optimized for the most representative subsystem SRL. This novel calculation is then benchmarked through simulation and using past defense acquisition program data, focusing on the newly introduced Middle Tier of Acquisition (rapidly field prototypes). The model remains a relatively simple, accessible tool, but at higher fidelity and validated with past data for the program manager to decide major defense acquisition program milestones.

Keywords: readiness, maturity, system, integration

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Authors: Ifeanyi Adigwe, Thomas Van der Walt

Abstract:

Digital media has been integrated into the social and entertainment life of young children, and as such, the impact of digital media appears to affect young people of all ages and it is believed that this will continue to shape the world of young children. Since, technological advancement of digital media presents adolescents with diverse contexts, platforms and avenues to engage with digital media outside the home environment and from parents' supervision, a wide range of new challenges has further complicated the already difficult tasks for parents and altered the landscape of parenting. Despite the fact that adolescents now have access to a wide range of digital media technologies both at home and in the learning environment, parenting practices such as active, restrictive, co-use, participatory and technical mediations are important in mitigating of online risks adolescents may encounter as a result of digital media use. However, these mediation practices only focus on the home environment including digital media present in the home and may not necessarily transcend outside the home and other learning environments where adolescents use digital media for school work and other activities. This poses the question of who mediates adolescent's digital media use outside the home environment. The learning environment could be a ''loose platform'' where an adolescent can maximise digital media use considering the fact that there is no restriction in terms of content and time allotted to using digital media during school hours. That is to say that an adolescent can play the ''bad boy'' online in school because there is little or no restriction of digital media use and be exposed to online risks and play the ''good boy'' at home because of ''heavy'' parental mediation. This is the reason why parent mediation practices have been ineffective because a parent may not be able to track adolescents digital media use considering the diversity of contexts, platforms and avenues adolescents use digital media. This study argues that due to the diverse nature of digital media technology, parents may not be able to monitor the 'whereabouts' of their children in the digital space. This is because adolescent digital media usage may not only be confined to the home environment but other learning environments like schools. This calls for urgent attention on the part of teachers to understand the intricacies of how digital media continue to shape the world in which young children are developing and learning. It is, therefore, imperative for parents to liaise with the schools of their children to mediate digital media use during school hours. The implication of parents- teachers mediation practices are discussed. The article concludes by suggesting that third party mediation by teachers in schools and other learning environments should be encouraged and future research needs to consider the emergent strategy of teacher-children mediation approach and the implication for policy for both the home and learning environments.

Keywords: digital media, digital age, parent mediation, third party mediation

Procedia PDF Downloads 149

Authors: Kieren Wilson, Gulnaz Majeed

Abstract:

NHS constitution gives rights to the patient with suspected cancer to be seen by a cancer specialist within 2 weeks of referral. Guys and St Thomas Hospital (GSTT) is one of the largest cancer centres in London. NICE guidelines have provided guidance for health professionals to refer patients appropriately to RAC. In GSTT suspected gynae cancer referrals are mostly by NHS e-Referral Service with some fax, emails as well as paper referrals. The objective of this study was to evaluate compliance with 2-week referral pathway with emphasis on one stop diagnostic service with supporting efficient pathways. A prospective evaluation over 3 months (1 Jan 2017 to 31 Mar 2017) was undertaken. There were 26 clinics, 761 patients were booked in the clinics with a DNA rate of 13% (n=101) hence 606 patients were seen. Majority of referrals were for post menopausal bleeding (PMB) 25% (n=194) followed by cervical, vaginal, vulval reasons 23% (n=179) (abnormal cytology excluded as patients directly referred to colposcopy unit in GSTT), ovarian 7% (n=54) and endometrial 5% (n=41). Women with new or previous established diagnosis of cancer were 24, cervical (n=17), vulva (n=6) and vagina (n=1). Multifocal preinvasive disease vulva (VIN), vagina (VAIN) and cervix (CIN) was confirmed in twenty-six patients 4% (high prevalence in HIV patients). Majority of cervical referrals: PCB (n=14), cervical erosion (n=7), polyps (n=9) and cervical cyst were benign. However, two women with PMB had cervical cancer. Only 2 out of 13 referrals with vaginal concerns had VAIN. One case with non-cervical glandular cytology was confirmed to have endometrial cancer. One stop service based on the diagnostic support of ultrasound, colposcopy and hysteroscopy was achieved in 54% (n=359). Patients were discharged to GP, benign gynaecology, endometriosis, combined vulval/dermatology clinic or gynae oncology. 33% (n=202) required a second visit, 12% (n=70) third visit, 3% (n=19) fourth visit, 1% (n=4) fifth visit and 1% (n=6) sixth visit. Main reasons for follow ups were the unavailability of diagnostic slots, patient choice, need for interpreters, the discussion following gynae MDM review for triage to benign gynae, delay in availability of diagnostic results like histology/MRI/CT. Recommendations following this study are multi disciplinary review of pathways with the availability of additional diagnostic procedure slots to aim for one stop service. Furthermore, establishment of virtual and telephone consultations to reduce follow ups.

Keywords: multifocal disease, post menopausal bleeding, preinvasive disease, rapid access clinic

Procedia PDF Downloads 181