Search results for: comprehensive care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6125

Search results for: comprehensive care

245 A Work-Individual-Family Inquiry on Mental Health and Family Responsibility of Dealers Employed in Macau Gaming Industry

Authors: Tak Mau Simon Chan

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While there is growing reflection of the adverse impacts instigated by the flourishing gaming industry on the physical health and job satisfaction of those who work in Macau casinos, there is also a critical void in our understanding of the mental health of croupiers and how casino employment interacts with the family system. From a systemic approach, it would be most effective to examine the ‘dealer issues’ collectively and offer assistance to both the individual dealer and the family system of dealers. Therefore, with the use of a mixed method study design, the levels of anxiety, depression and sleeping quality of a sample of 1124 dealers who are working in Macau casinos have been measured in the present study, and 113 dealers have been interviewed about the impacts of casino employment on their family life. This study presents some very important findings. First, the quantitative study indicates that gender is a significant predictor of depression and anxiety levels, whilst lower income means less quality sleep. The Pearson’s correlation coefficients show that as the Zung Self-rating Anxiety Scale (ZSAS) scores increase, the Zung Self-rating Depression Scale (ZSDS) and Pittsburgh Sleep Quality Index (PSQI) scores will also simultaneously increase. Higher income, therefore, might partly explain for the reason why mothers choose to work in the gaming industry even with shift work involved and a stressful work environment. Second, the findings from the qualitative study show that aside from the positive impacts on family finances, the shift work and job stress to some degree negatively affect family responsibilities and relationships. There are resultant family issues, including missed family activities, and reduced parental care and guidance, marital intimacy, and communication with family members. Despite the mixed views on the gender role differences, the respondents generally agree that female dealers have more family and child-minding responsibilities at home, and thus it is more difficult for them to balance work and family. Consequently, they may be more vulnerable to stress at work. Thirdly, there are interrelationships between work and family, which are based on a systemic inquiry that incorporates work- individual- family. Poor physical and psychological health due to shift work or a harmful work environment could affect not just work performance, but also life at home. Therefore, a few practice points about 1) work-family conflicts in Macau; 2) families-in- transition in Macau; and 3) gender and class sensitivity in Macau; are provided for social workers and family practitioners who will greatly benefit these families, especially whose family members are working in the gaming industry in Macau. It is concluded that in addressing the cultural phenomenon of “dealer’s complex” in Macau, a systemic approach is recommended that addresses both personal psychological needs and family issue of dealers.

Keywords: family, work stress, mental health, Macau, dealers, gaming industry

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244 Evaluation of Anti-inflammatory Activities of Extracts Obtained from Capparis Erythrocarpos In-Vivo

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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243 Italian Speech Vowels Landmark Detection through the Legacy Tool 'xkl' with Integration of Combined CNNs and RNNs

Authors: Kaleem Kashif, Tayyaba Anam, Yizhi Wu

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This paper introduces a methodology for advancing Italian speech vowels landmark detection within the distinctive feature-based speech recognition domain. Leveraging the legacy tool 'xkl' by integrating combined convolutional neural networks (CNNs) and recurrent neural networks (RNNs), the study presents a comprehensive enhancement to the 'xkl' legacy software. This integration incorporates re-assigned spectrogram methodologies, enabling meticulous acoustic analysis. Simultaneously, our proposed model, integrating combined CNNs and RNNs, demonstrates unprecedented precision and robustness in landmark detection. The augmentation of re-assigned spectrogram fusion within the 'xkl' software signifies a meticulous advancement, particularly enhancing precision related to vowel formant estimation. This augmentation catalyzes unparalleled accuracy in landmark detection, resulting in a substantial performance leap compared to conventional methods. The proposed model emerges as a state-of-the-art solution in the distinctive feature-based speech recognition systems domain. In the realm of deep learning, a synergistic integration of combined CNNs and RNNs is introduced, endowed with specialized temporal embeddings, harnessing self-attention mechanisms, and positional embeddings. The proposed model allows it to excel in capturing intricate dependencies within Italian speech vowels, rendering it highly adaptable and sophisticated in the distinctive feature domain. Furthermore, our advanced temporal modeling approach employs Bayesian temporal encoding, refining the measurement of inter-landmark intervals. Comparative analysis against state-of-the-art models reveals a substantial improvement in accuracy, highlighting the robustness and efficacy of the proposed methodology. Upon rigorous testing on a database (LaMIT) speech recorded in a silent room by four Italian native speakers, the landmark detector demonstrates exceptional performance, achieving a 95% true detection rate and a 10% false detection rate. A majority of missed landmarks were observed in proximity to reduced vowels. These promising results underscore the robust identifiability of landmarks within the speech waveform, establishing the feasibility of employing a landmark detector as a front end in a speech recognition system. The synergistic integration of re-assigned spectrogram fusion, CNNs, RNNs, and Bayesian temporal encoding not only signifies a significant advancement in Italian speech vowels landmark detection but also positions the proposed model as a leader in the field. The model offers distinct advantages, including unparalleled accuracy, adaptability, and sophistication, marking a milestone in the intersection of deep learning and distinctive feature-based speech recognition. This work contributes to the broader scientific community by presenting a methodologically rigorous framework for enhancing landmark detection accuracy in Italian speech vowels. The integration of cutting-edge techniques establishes a foundation for future advancements in speech signal processing, emphasizing the potential of the proposed model in practical applications across various domains requiring robust speech recognition systems.

Keywords: landmark detection, acoustic analysis, convolutional neural network, recurrent neural network

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242 Direct Integration of 3D Ultrasound Scans with Patient Educational Mobile Application

Authors: Zafar Iqbal, Eugene Chan, Fareed Ahmed, Mohamed Jama, Avez Rizvi

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Advancements in Ultrasound Technology have enabled machines to capture 3D and 4D images with intricate features of the growing fetus. Sonographers can now capture clear 3D images and 4D videos of the fetus, especially of the face. Fetal faces are often seen on the ultrasound scan of the third trimester where anatomical features become more defined. Parents often want 3D/4D images and videos of their ultrasounds, and particularly image that capture the child’s face. Sidra Medicine developed a patient education mobile app called 10 Moons to improve care and provide useful information during the length of their pregnancy. In addition to general information, we built the ability to send ultrasound images directly from the modality to the mobile application, allowing expectant mothers to easily store and share images of their baby. 10 Moons represent the length of the pregnancy on a lunar calendar, which has both cultural and religious significance in the Middle East. During the third trimester scan, sonographers can capture 3D pictures of the fetus. Ultrasound machines are connected with a local 10 Moons Server with a Digital Imaging and Communications in Medicine (DICOM) application running on it. Sonographers are able to send images directly to the DICOM server by a preprogrammed button on the ultrasound modality. Mothers can also request which pictures they would like to be available on the app. An internally built DICOM application receives the image and saves the patient information from DICOM header (for verification purpose). The application also anonymizes the image by removing all the DICOM header information and subsequently converts it into a lossless JPEG. Finally, and the application passes the image to the mobile application server. On the 10 Moons mobile app – patients enter their Medical Record Number (MRN) and Date of Birth (DOB) to receive a One Time Password (OTP) for security reasons to view the images. Patients can also share the images anonymized images with friends and family. Furthermore, patients can also request 3D printed mementos of their child through 10 Moons. 10 Moons is unique patient education and information application where expected mothers can also see 3D ultrasound images of their children. Sidra Medicine staff has the added benefit of a full content management administrative backend where updates to content can be made. The app is available on secure infrastructure with both local and public interfaces. The application is also available in both English and Arabic languages to facilitate most of the patients in the region. Innovation is at the heart of modern healthcare management. With Innovation being one of Sidra Medicine’s core values, our 10 Moons application provides expectant mothers with unique educational content as well as the ability to store and share images of their child and purchase 3D printed mementos.

Keywords: patient educational mobile application, ultrasound images, digital imaging and communications in medicine (DICOM), imaging informatics

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241 An Approach to Addressing Homelessness in Hong Kong: Life Story Approach

Authors: Tak Mau Simon Chan, Ying Chuen Lance Chan

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Homelessness has been a popular and controversial debate in Hong Kong, a city which is densely populated and well-known for very expensive housing. The constitution of the homeless as threats to the community and environmental hygiene is ambiguous and debatable in the Hong Kong context. The lack of an intervention model is the critical research gap thus far, aside from the tangible services delivered. The life story approach (LSA), with its unique humanistic orientation, has been well applied in recent decades to depict the needs of various target groups, but not the homeless. It is argued that the life story approach (LSA), which has been employed by health professionals in the landscape of dementia, and health and social care settings, can be used as a reference in the local Chinese context through indigenization. This study, therefore, captures the viewpoints of service providers and users by constructing an indigenous intervention model that refers to the LSA in serving the chronically homeless. By informing 13 social workers and 27 homeless individuals in 8 focus groups whilst 12 homeless individuals have participated in individual in-depth interviews, a framework of LSA in homeless people is proposed. Through thematic analysis, three main themes of their life stories was generated, namely, the family, negative experiences and identity transformation. The three domains solidified framework that not only can be applied to the homeless, but also other disadvantaged groups in the Chinese context. Based on the three domains of family, negative experiences and identity transformation, the model is applied in the daily practices of social workers who help the homeless. The domain of family encompasses familial relationships from the past to the present to the speculated future with ten sub-themes. The domain of negative experiences includes seven sub-themes, with reference to the deviant behavior committed. The last domain, identity transformation, incorporates the awareness and redefining of one’s identity and there are a total of seven sub-themes. The first two domains are important components of personal histories while the third is more of an unknown, exploratory and yet to-be-redefined territory which has a more positive and constructive orientation towards developing one’s identity and life meaning. The longitudinal temporal dimension of moving from the past – present - future enriches the meaning making process, facilitates the integration of life experiences and maintains a more hopeful dialogue. The model is tested and its effectiveness is measured by using qualitative and quantitative methods to affirm the extent that it is relevant to the local context. First, it contributes to providing a clear guideline for social workers who can use the approach as a reference source. Secondly, the framework acts as a new intervention means to address problem saturated stories and the intangible needs of the homeless. Thirdly, the model extends the application to beyond health related issues. Last but not least, the model is highly relevant to the local indigenous context.

Keywords: homeless, indigenous intervention, life story approach, social work practice

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240 Optimizing Productivity and Quality through the Establishment of a Learning Management System for an Agency-Based Graduate School

Authors: Maria Corazon Tapang-Lopez, Alyn Joy Dela Cruz Baltazar, Bobby Jones Villanueva Domdom

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The requisite for an organization implementing quality management system to sustain its compliance to the requirements and commitment for continuous improvement is even higher. It is expected that the offices and units has high and consistent compliance to the established processes and procedures. The Development Academy of the Philippines has been operating under project management to which is has a quality management certification. To further realize its mandate as a think-tank and capacity builder of the government, DAP expanded its operation and started to grant graduate degree through its Graduate School of Public and Development Management (GSPDM). As the academic arm of the Academy, GSPDM offers graduate degree programs on public management and productivity & quality aligned to the institutional trusts. For a time, the documented procedures and processes of a project management seem to fit the Graduate School. However, there has been a significant growth in the operations of the GSPDM in terms of the graduate programs offered that directly increase the number of students. There is an apparent necessity to align the project management system into a more educational system otherwise it will no longer be responsive to the development that are taking place. The strongly advocate and encourage its students to pursue internal and external improvement to cope up with the challenges of providing quality service to their own clients and to our country. If innovation will not take roots in the grounds of GSPDM, then how will it serve the purpose of “walking the talk”? This research was conducted to assess the diverse flow of the existing internal operations and processes of the DAP’s project management and GSPDM’s school management that will serve as basis to develop a system that will harmonize into one, the Learning Management System. The study documented the existing process of GSPDM following the project management phases of conceptualization & development, negotiation & contracting, mobilization, implementation, and closure into different flow charts of the key activities. The primary source of information as respondents were the different groups involved into the delivery of graduate programs - the executive, learning management team and administrative support offices. The Learning Management System (LMS) shall capture the unique and critical processes of the GSPDM as a degree-granting unit of the Academy. The LMS is the harmonized project management and school management system that shall serve as the standard system and procedure for all the programs within the GSPDM. The unique processes cover the three important areas of school management – student, curriculum, and faculty. The required processes of these main areas such as enrolment, course syllabus development, and faculty evaluation were appropriately placed within the phases of the project management system. Further, the research shall identify critical reports and generate manageable documents and records to ensure accuracy, consistency and reliable information. The researchers had an in-depth review of the DAP-GSDPM’s mandate, analyze the various documents, and conducted series of focused group discussions. A comprehensive review on flow chart system prior and various models of school management systems were made. Subsequently, the final output of the research is a work instructions manual that will be presented to the Academy’s Quality Management Council and eventually an additional scope for ISO certification. The manual shall include documented forms, iterative flow charts and program Gantt chart that will have a parallel development of automated systems.

Keywords: productivity, quality, learning management system, agency-based graduate school

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239 Well Inventory Data Entry: Utilization of Developed Technologies to Progress the Integrated Asset Plan

Authors: Danah Al-Selahi, Sulaiman Al-Ghunaim, Bashayer Sadiq, Fatma Al-Otaibi, Ali Ameen

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In light of recent changes affecting the Oil & Gas Industry, optimization measures have become imperative for all companies globally, including Kuwait Oil Company (KOC). To keep abreast of the dynamic market, a detailed Integrated Asset Plan (IAP) was developed to drive optimization across the organization, which was facilitated through the in-house developed software “Well Inventory Data Entry” (WIDE). This comprehensive and integrated approach enabled centralization of all planned asset components for better well planning, enhancement of performance, and to facilitate continuous improvement through performance tracking and midterm forecasting. Traditionally, this was hard to achieve as, in the past, various legacy methods were used. This paper briefly describes the methods successfully adopted to meet the company’s objective. IAPs were initially designed using computerized spreadsheets. However, as data captured became more complex and the number of stakeholders requiring and updating this information grew, the need to automate the conventional spreadsheets became apparent. WIDE, existing in other aspects of the company (namely, the Workover Optimization project), was utilized to meet the dynamic requirements of the IAP cycle. With the growth of extensive features to enhance the planning process, the tool evolved into a centralized data-hub for all asset-groups and technical support functions to analyze and infer from, leading WIDE to become the reference two-year operational plan for the entire company. To achieve WIDE’s goal of operational efficiency, asset-groups continuously add their parameters in a series of predefined workflows that enable the creation of a structured process which allows risk factors to be flagged and helps mitigation of the same. This tool dictates assigned responsibilities for all stakeholders in a method that enables continuous updates for daily performance measures and operational use. The reliable availability of WIDE, combined with its user-friendliness and easy accessibility, created a platform of cross-functionality amongst all asset-groups and technical support groups to update contents of their respective planning parameters. The home-grown entity was implemented across the entire company and tailored to feed in internal processes of several stakeholders across the company. Furthermore, the implementation of change management and root cause analysis techniques captured the dysfunctionality of previous plans, which in turn resulted in the improvement of already existing mechanisms of planning within the IAP. The detailed elucidation of the 2 year plan flagged any upcoming risks and shortfalls foreseen in the plan. All results were translated into a series of developments that propelled the tool’s capabilities beyond planning and into operations (such as Asset Production Forecasts, setting KPIs, and estimating operational needs). This process exemplifies the ability and reach of applying advanced development techniques to seamlessly integrated the planning parameters of various assets and technical support groups. These techniques enables the enhancement of integrating planning data workflows that ultimately lay the founding plans towards an epoch of accuracy and reliability. As such, benchmarks of establishing a set of standard goals are created to ensure the constant improvement of the efficiency of the entire planning and operational structure.

Keywords: automation, integration, value, communication

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238 Biotechnology Approach: A Tool of Enhancement of Sticky Mucilage of Pulicaria Incisa (Medicinal Plant) for Wounds Treatment

Authors: Djamila Chabane, Asma Rouane, Karim Arab

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Depending of the chemical substances responsible for the pharmacological effects, a future therapeutic drug might be produced by extraction from whole plants or by callus initiated from some parts. The optimized callus culture protocols now offer the possibility to use cell culture techniques for vegetative propagation and open minds for further studies on secondary metabolites and drug establishment. In Algerian traditional medicine, Pulicaria incisa (Asteraceae) is used in the treatment of daily troubles (stomachache, headhache., cold, sore throat and rheumatic arthralgia). Field findings revealed that many healers use some fresh parts (leaves, flowers) of this plant to treat skin wounds. This study aims to evaluate the healing efficiency of artisanal cream prepared from sticky mucilage isolated from calluses on dermal wounds of animal models. Callus cultures were initiated from reproductive explants (young inflorescences) excised from adult plants and transferred to a MS basal medium supplemented with growth regulators and maintained under dark for for months. Many calluses types were obtained with various color and aspect (friable, compact). Several subcultures of calli were performed to enhance the mucilage accumulation. After extraction, the mucilage extracts were tested on animal models as follows. The wound healing potential was studied by causing dermal wounds (1 cm diameter) at the dorsolumbar part of Rattus norvegicus; different samples of the cream were applied after hair removal on three rats each, including two controls (one treated by Vaseline and one without any treatment), two experimental groups (experimental group 1, treated with a reference ointment "Madecassol® and experimental group 2 treated by callus mucilage cream for a period of seventeen days. The evolution of the healing activity was estimated by calculating the percentage reduction of the area wounds treated by all compounds tested compared to the controls by using AutoCAD software. The percentage of healing effect of the cream prepared from callus mucilage was (99.79%) compared to that of Madecassol® (99.76%). For the treatment time, the significant healing activity was observed after 17 days compared to that of the reference pharmaceutical products without any wound infection. The healing effect of Madecassol® is more effective because it stimulates and regulates the production of collagen, a fibrous matrix essential for wound healing. Mucilage extracts also showed a high capacity to heal the skin without any infection. According to this pharmacological activity, we suggest to use calluses produced by in vitro culture to producing new compounds for the skin care and treatment.

Keywords: calluses, Pulicaria incisa, mucilage, Wounds

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237 A Preliminary Randomized Controlled Trial of Pure L-Ascorbic Acid with Using a Needle-Free and Micro-Needle Mesotherapy in Treatment of Anti-Aging Procedure

Authors: M. Zasada, A. Markiewicz, A. Erkiert-Polguj, E. Budzisz

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The epidermis is a keratinized stratified squamous epithelium covered by the hydro-lipid barrier. Therefore, active substances should be able to penetrate through this hydro-lipid coating. L-ascorbic acid is one of the vitamins which plays an important role in stimulation fibroblast to produce collagen type I and in hyperpigmentation lightening. Vitamin C is a water-soluble antioxidant, which protects skin from oxidation damage and rejuvenates photoaged skin. No-needle mesotherapy is a non-invasive rejuvenation technique depending on electric pulses, electroporation, and ultrasounds. These physicals factors result in deeper penetration of cosmetics. It is important to increase the penetration of L-ascorbic acid, thereby increasing the spectrum of its activity. The aim of the work was to assess the effectiveness of pure L-ascorbic acid activity in anti-aging therapy using a needle-free and micro-needling mesotherapy. The study was performed on a group of 35 healthy volunteers in accordance with the Declaration of Helsinki of 1964 and agreement of the Ethics Commissions no RNN/281/16/KE 2017. Women were randomized to mesotherapy or control group. Control group applied topically 2,5 ml serum containing 20% L-ascorbic acid with hydrate from strawberries, every 10 days for a period of 9 weeks. No-needle mesotherapy, on the left half of the face and micro-needling on the right with the same serum, was done in mesotherapy group. The pH of serum was 3.5-4, and the serum was prepared directly prior to the facial treatment. The skin parameters were measured at the beginning and before each treatment. The measurement of the forehead skin was done using Cutometer® (measurement of skin elasticity and firmness), Corneometer® (skin hydration measurement), Mexameter® (skin tone measurement). Also, the photographs were taken by Fotomedicus system. Additionally, the volunteers fulfilled the questionnaire. Serum was tested for microbiological purity and stability after the opening of the cosmetic. During the study, all of the volunteers were taken care of a dermatologist. The regular application of the serum has caused improvement of the skin parameters. Respectively, after 4 and 8 weeks improvement in hydration and elasticity has been seen (Corneometer®, Cutometer® results). Moreover, the number of hyper-pigmentated spots has decreased (Mexameter®). After 8 weeks the volunteers has claimed that the tested product has smoothing and moisturizing features. Subjective opinions indicted significant improvement of skin color and elasticity. The product containing the L-ascorbic acid used with intercellular penetration promoters demonstrates higher anti-aging efficiency than control. In vivo studies confirmed the effectiveness of serum and the impact of the active substance on skin firmness and elasticity, the degree of hydration and skin tone. Mesotherapy with pure L-ascorbic acid provides better diffusion of active substances through the skin.

Keywords: anti-aging, l-ascorbic acid, mesotherapy, promoters

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236 A Crowdsourced Homeless Data Collection System And Its Econometric Analysis: Strengthening Inclusive Public Administration Policies

Authors: Praniil Nagaraj

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This paper proposes a method to collect homeless data using crowdsourcing and presents an approach to analyze the data, demonstrating its potential to strengthen existing and future policies aimed at promoting socio-economic equilibrium. The 2022 Annual Homeless Assessment Report (AHAR) to Congress highlighted alarming statistics, emphasizing the need for effective decision-making and budget allocation within local planning bodies known as Continuums of Care (CoC). This paper's contributions can be categorized into three main areas. Firstly, a unique method for collecting homeless data is introduced, utilizing a user-friendly smartphone app (currently available for Android). The app enables the general public to quickly record information about homeless individuals, including the number of people and details about their living conditions. The collected data, including date, time, and location, is anonymized and securely transmitted to the cloud. It is anticipated that an increasing number of users motivated to contribute to society will adopt the app, thus expanding the data collection efforts. Duplicate data is addressed through simple classification methods, and historical data is utilized to fill in missing information. The second contribution of this paper is the description of data analysis techniques applied to the collected data. By combining this new data with existing information, statistical regression analysis is employed to gain insights into various aspects, such as distinguishing between unsheltered and sheltered homeless populations, as well as examining their correlation with factors like unemployment rates, housing affordability, and labor demand. Initial data is collected in San Francisco, while pre-existing information is drawn from three cities: San Francisco, New York City, and Washington D.C., facilitating the conduction of simulations. The third contribution focuses on demonstrating the practical implications of the data processing results. The challenges faced by key stakeholders, including charitable organizations and local city governments, are taken into consideration. Two case studies are presented as examples. The first case study explores improving the efficiency of food and necessities distribution, as well as medical assistance, driven by charitable organizations. The second case study examines the correlation between micro-geographic budget expenditure by local city governments and homeless information to justify budget allocation and expenditures. The ultimate objective of this endeavor is to enable the continuous enhancement of the quality of life for the underprivileged. It is hoped that through increased crowdsourcing of data from the public, the Generosity Curve and the Need Curve will intersect, leading to a better world for all.

Keywords: crowdsourcing, homelessness, socio-economic policies, statistical regression

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235 Analysis of Lesotho Wool Production and Quality Trends 2008-2018

Authors: Papali Maqalika

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Lesotho farmers produce significant quantities of Merino wool of a quality competitive on the global market and make a substantial impact on the economy of Lesotho. However, even with the economic contribution, the production and quality information and trends of this fibre has been recognised nor documented. This is a sombre shortcoming as Lesotho wool is unknown on international markets. The situation is worsened by the fact that Lesotho wool is auction together with South African wool, trading and benchmarking Lesotho wool are difficult not to mention attempts to advance its production and quality. Based on the information above, available data on Lesotho wool for 10 years were collected and analysed for trends to used in benchmarking where applicable. The fibre properties analysed include fibre diameter (fineness), vegetable matter and yield, application and price. These were selected because they are fundamental in determining fibre quality and price. Production of wool in Lesotho has increased slightly over the ten years covered by this study. It also became apparent that production and quality trends of Lesotho wool are greatly influenced by the farming practices, breed of sheep and climatic conditions. Greater adoption of the merino sheep breed, sheds/barns and sheep coats are suggested as ways to reduce mortality rate (due to extremely cold temperatures), to reduce the vegetable matter on the fibre thus improving the quality and increase yield per sheep and production as a whole. Some farming practices such as the lack of barns, supplementary feeding and veterinary care present constraints in wool production. The districts in the Highlands region were found to have the highest production of mostly wool, this being ascribed to better pastures, climatic, social and other conditions conducive to wool production. The production of Lesotho wool and its quality can be improved further, possibly because of the interventions the Ministry of Agriculture introduced through the Small Agricultural and Development Project (SADP) and other appropriate initiatives by the National Wool and Mohair Growers Association (NWMGA). The challenge however, remains the lack of direct involvement of the wool growers (farmers) in decisions making and policy development, this potentially influences and may lead to the reluctance to adopt the strategies. In some cases, the wool growers do not receive the benefits associated with the interventions immediately. Based on these discoveries; it is recommended that the relevant educators and researchers in wool and textile science, as well as the local wool farmers in Lesotho, be represented in policy and other decision making forums relating to these interventions. In this way, educational campaigns and training workshops will be demand driven with a better chance of adoption and success. This is because the direct beneficiaries will have been involved at inception and they will have a sense of ownership as well as intent to see them through successfully.

Keywords: lesotho wool, wool quality, wool production, lesotho economy, global market, apparel wool, database, textile science, exports, animal farming practices, intimate apparel, interventions

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234 Point-of-Decision Design (PODD) to Support Healthy Behaviors in the College Campuses

Authors: Michelle Eichinger, Upali Nanda

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Behavior choices during college years can establish the pattern of lifelong healthy living. Nearly 1/3rd of American college students are either overweight (25 < BMI < 30) or obese (BMI > 30). In addition, overweight/obesity contributes to depression, which is a rising epidemic among college students, affecting academic performance and college drop-out rates. Overweight and obesity result in an imbalance of energy consumption (diet) and energy expenditure (physical activity). Overweight/obesity is a significant contributor to heart disease, diabetes, stroke, physical disabilities and some cancers, which are the leading causes of death and disease in the US. There has been a significant increase in obesity and obesity-related disorders such as type 2 diabetes, hypertension, and dyslipidemia among people in their teens and 20s. Historically, the evidence-based interventions for obesity prevention focused on changing the health behavior at the individual level and aimed at increasing awareness and educating people about nutrition and physical activity. However, it became evident that the environmental context of where people live, work and learn was interdependent to healthy behavior change. As a result, a comprehensive approach was required to include altering the social and built environment to support healthy living. College campus provides opportunities to support lifestyle behavior and form a health-promoting culture based on some key point of decisions such as stairs/ elevator, walk/ bike/ car, high-caloric and fast foods/balanced and nutrient-rich foods etc. At each point of decision, design, can help/hinder the healthier choice. For example, stair well design and motivational signage support physical activity; grocery store/market proximity influence healthy eating etc. There is a need to collate the vast information that is in planning and public health domains on a range of successful point of decision prompts, and translate it into architectural guidelines that help define the edge condition for critical point of decision prompts. This research study aims to address healthy behaviors through the built environment with the questions, how can we make the healthy choice an easy choice through the design of critical point of decision prompts? Our hypothesis is that well-designed point of decision prompts in the built environment of college campuses can promote healthier choices by students, which can directly impact mental and physical health related to obesity. This presentation will introduce a combined health and architectural framework aimed to influence healthy behaviors through design applied for college campuses. The premise behind developing our concept, point-of-decision design (PODD), is healthy decision-making can be built into, or afforded by our physical environments. Using effective design intervention strategies at these 'points-of-decision' on college campuses to make the healthy decision the default decision can be instrumental in positively impacting health at the population level. With our model, we aim to advance health research by utilizing point-of-decision design to impact student health via core sectors of influences within college settings, such as campus facilities and transportation. We will demonstrate how these domains influence patterns/trends in healthy eating and active living behaviors among students. how these domains influence patterns/trends in healthy eating and active living behaviors among students.

Keywords: architecture and health promotion, college campus, design strategies, health in built environment

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233 21st-Century Middlebrow Film: A Critical Examination of the Spectator Experience in Malayalam Film

Authors: Anupama A. P.

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The Malayalam film industry, known as Mollywood, has a rich tradition of storytelling and cultural significance within Indian cinema. Middlebrow films have emerged as a distinct influential category, particularly in the 1980s, with directors like K.G. George, who engaged with female subjectivity and drew inspiration from the ‘women’s cinema’ of the 1950s and 1960s. In recent decades, particularly post-2010, the industry has transformed significantly with a new generation of filmmakers diverging from melodrama and new wave of the past, incorporating advanced technology and modern content. This study examines the evolution and impact of Malayalam middlebrow cinema in the 21st century, focusing on post-2000 films and their influence on contemporary spectator experiences. These films appeal to a wide range of audiences without compromising on their artistic integrity, tackling social issues and personal dramas with thematic and narrative complexity. Historically, middlebrow films in Malayalam cinema have portrayed realism and addressed the socio-political climate of Kerala, blending realism with reflexivity and moving away from traditional sentimentality. This shift is evident in the new generation of Malayalam films, which present a global representation of characters and a modern treatment of individuals. To provide a comprehensive understanding of this evolution, the study analyzes a diverse selection of films such as Kerala Varma Pazhassi Raja (2009), Drishyam (2013), Maheshinte Prathikaaram (2016), Take Off (2017), and Thondimuthalum Driksakshiyum (2017) and Virus (2019) illustrating the broad thematic range and innovative narrative techniques characteristic of this genre. These films exemplify how middlebrow cinema continues to evolve, adapting to changing societal contexts and audience expectations. This research employs a theoretical methodology, drawing on cultural studies and audience reception theory, utilizing frameworks such as Bordwell’s narrative theory, Deleuze’s concept of deterritorialization, and Hall’s encoding/decoding model to analyze the changes in Malayalam middlebrow cinema and interpret the storytelling methods, spectator experience, and audience reception of these films. The findings indicate that Malayalam middlebrow cinema post-2010 offers a spectator experience that is both intellectually stimulating and broadly appealing. This study highlights the critical role of middlebrow cinema in reflecting and shaping societal values, making it a significant cultural artefact within the broader context of Indian and global cinema. By bridging entertainment with thought-provoking narratives, these films engage audiences and contribute to wider cultural discourse, making them pivotal in contemporary cinematic landscapes. To conclude, this study highlights the importance of Malayalam middle-brow cinema in influencing contemporary cinematic tastes. The nuanced and approachable narratives of post-2010 films are posited to assume an increasingly pivotal role in the future of Malayalam cinema. By providing a deeper understanding of Malayalam middlebrow cinema and its societal implications, this study enriches theoretical discourse, promotes regional cinema, and offers valuable insights into contemporary spectator experiences and the future trajectory of Malayalam cinema.

Keywords: Malayalam cinema, middlebrow cinema, spectator experience, audience reception, deterritorialization

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232 The Lived Experiences and Coping Strategies of Women with Attention Deficit and Hyperactivity Disorder (ADHD)

Authors: Oli Sophie Meredith, Jacquelyn Osborne, Sarah Verdon, Jane Frawley

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PROJECT OVERVIEW AND BACKGROUND: Over one million Australians are affected by ADHD at an economic and social cost of over $20 billion per annum. Despite health outcomes being significantly worse compared with men, women have historically been overlooked in ADHD diagnosis and treatment. While research suggests physical activity and other non-prescription options can help with ADHD symptoms, the frontline response to ADHD remains expensive stimulant medications that can have adverse side effects. By interviewing women with ADHD, this research will examine women’s self-directed approaches to managing symptoms, including alternatives to prescription medications. It will investigate barriers and affordances to potentially helpful approaches and identify any concerning strategies pursued in lieu of diagnosis. SIGNIFICANCE AND INNOVATION: Despite the economic and societal impact of ADHD on women, research investigating how women manage their symptoms is scant. This project is significant because although women’s ADHD symptoms are markedly different to those of men, mainstream treatment has been based on the experiences of men. Further, it is thought that in developing nuanced coping strategies, women may have masked their symptoms. Thus, this project will highlight strategies which women deem effective in ‘thriving’ rather than just ‘hiding’. By investigating the health service use, self-care and physical activity of women with ADHD, this research aligns with a priority research areas as identified by the November 2023 senate ADHD inquiry report. APPROACH AND METHODS: Semi-structured interviews will be conducted with up to 20 women with ADHD. Interviews will be conducted in person and online to capture experience across rural and metropolitan Australia. Participants will be recruited in partnership with the peak representative body, ADHD Australia. The research will use an intersectional framework, and data will be analysed thematically. This project is led by an interdisciplinary and cross-institutional team of women with ADHD. Reflexive interviewing skills will be employed to help interviewees feel more comfortable disclosing their experiences, especially where they share common ground ENGAGEMENT, IMPACT AND BENEFIT: This research will benefit women with ADHD by increasing knowledge of strategies and alternative treatments to prescription medications, reducing the social and economic burden of ADHD on Australia and on individuals. It will also benefit women by identifying risks involved with some self-directed approaches in lieu of medical advice. The project has an accessible impact plan to directly benefit end-users, which includes the development of a podcast and a PDF resource translating findings. The resources will reach a wide audience through ADHD Australia’s extensive national networks. We will collaborate with Charles Sturt’s Accessibility and Inclusion Division of Safety, Security and Well-being to create a targeted resource for students with ADHD.

Keywords: ADHD, women's health, self-directed strategies, health service use, physical activity, public health

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231 Comparative Economic Evaluation of Additional Respiratory Resources Utilized after Methylxanthine Initiation for the Treatment of Apnea of Prematurity in a South Asian Country

Authors: Shivakumar M, Leslie Edward S Lewis, Shashikala Devadiga, Sonia Khurana

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Introduction: Methylxanthines are used for the treatment of AOP, to facilitate extubation and as a prophylactic agent to prevent apnea. Though the popularity of Caffeine has risen, it is expensive in a resource constrained developing countries like India. Objective: To evaluate the cost-effectiveness of Caffeine compared with Aminophylline treatment for AOP with respect to additional ventilatory resource utilized in different birth weight categorization. Design, Settings and Participants – Single centered, retrospective economic evaluation was done. Participants included preterm newborns with < 34 completed weeks of gestation age that were recruited under an Indian Council of Medical Research funded randomized clinical trial. Per protocol data was included from Neonatal Intensive Care Unit, Kasturba Hospital, Manipal, India between April 2012 and December 2014. Exposure: Preterm neonates were randomly allocated to either Caffeine or Aminophylline as per the trial protocol. Outcomes and Measures – We assessed surfactant requirement, duration of Invasive and Non-Invasive Ventilation, Total Methylxanthine cost and additional cost for respiratory support bared by the payers per day during hospital stay. For the purpose of this study Newborns were stratified as Category A – < 1000g, Category B – 1001 to 1500g and Category C – 1501 to 2500g. Results: Total 146 (Caffeine -72 and Aminophylline – 74) babies with Mean ± SD gestation age of 29.63 ± 1.89 weeks were assessed. 32.19% constitute of Category A, 55.48% were B and 12.33% were C. The difference in median duration of additional NIV and IMV support was statistically insignificant. However 60% of neonates who received Caffeine required additional surfactant therapy (p=0.02). The total median (IQR) cost of Caffeine was significantly high with Rs.10535 (Q3-6317.50, Q1-15992.50) where against Aminophylline cost was Rs.352 (Q3-236, Q1-709) (p < 0.001). The additional costs spent on respiratory support per day in neonates on either Methylxanthines were found to be statistically insignificant in the entire weight based category of our study. Whereas in Category B, the median O2 charges per day were found to have more in Caffeine treated newborns (p=0.05) with border line significance. In category A, providing one day NIV or IMV support significantly increases the unit log cost of Caffeine by 13.6% (CI – 95% ranging from 4 to 24; p=0.005) over log cost of Aminophylline. Conclusion: Cost of Caffeine is expensive than Aminophylline. It was found to be equally efficacious in reducing the number duration of NIV or IMV support. However adjusted with the NIV and IMV days of support, neonates fall in category A and category B who were on Caffeine pays excess amount of respiratory charges per day over aminophylline. In perspective of resource poor settings Aminophylline is cost saving and economically approachable.

Keywords: methylxanthines include caffeine and aminophylline, AOP (apnea of prematurity), IMV (invasive mechanical ventilation), NIV (non invasive ventilation), category a – <1000g, category b – 1001 to 1500g and category c – 1501 to 2500g

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230 Diagnostic Yield of CT PA and Value of Pre Test Assessments in Predicting the Probability of Pulmonary Embolism

Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

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Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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229 Data Quality on Regular Childhood Immunization Programme at Degehabur District: Somali Region, Ethiopia

Authors: Eyob Seife

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Immunization is a life-saving intervention which prevents needless suffering through sickness, disability, and death. Emphasis on data quality and use will become even stronger with the development of the immunization agenda 2030 (IA2030). Quality of data is a key factor in generating reliable health information that enables monitoring progress, financial planning, vaccine forecasting capacities, and making decisions for continuous improvement of the national immunization program. However, ensuring data of sufficient quality and promoting an information-use culture at the point of the collection remains critical and challenging, especially in hard-to-reach and pastoralist areas where Degehabur district is selected based on a hypothesis of ‘there is no difference in reported and recounted immunization data consistency. Data quality is dependent on different factors where organizational, behavioral, technical, and contextual factors are the mentioned ones. A cross-sectional quantitative study was conducted on September 2022 in the Degehabur district. The study used the world health organization (WHO) recommended data quality self-assessment (DQS) tools. Immunization tally sheets, registers, and reporting documents were reviewed at 5 health facilities (2 health centers and 3 health posts) of primary health care units for one fiscal year (12 months) to determine the accuracy ratio. The data was collected by trained DQS assessors to explore the quality of monitoring systems at health posts, health centers, and the district health office. A quality index (QI) was assessed, and the accuracy ratio formulated were: the first and third doses of pentavalent vaccines, fully immunized (FI), and the first dose of measles-containing vaccines (MCV). In this study, facility-level results showed both over-reporting and under-reporting were observed at health posts when computing the accuracy ratio of the tally sheet to health post reports found at health centers for almost all antigens verified where pentavalent 1 was 88.3%, 60.4%, and 125.6% for Health posts A, B, and C respectively. For first-dose measles-containing vaccines (MCV), similarly, the accuracy ratio was found to be 126.6%, 42.6%, and 140.9% for Health posts A, B, and C, respectively. The accuracy ratio for fully immunized children also showed 0% for health posts A and B and 100% for health post-C. A relatively better accuracy ratio was seen at health centers where the first pentavalent dose was 97.4% and 103.3% for health centers A and B, while a first dose of measles-containing vaccines (MCV) was 89.2% and 100.9% for health centers A and B, respectively. A quality index (QI) of all facilities also showed results between the maximum of 33.33% and a minimum of 0%. Most of the verified immunization data accuracy ratios were found to be relatively better at the health center level. However, the quality of the monitoring system is poor at all levels, besides poor data accuracy at all health posts. So attention should be given to improving the capacity of staff and quality of monitoring system components, namely recording, reporting, archiving, data analysis, and using information for decision at all levels, especially in pastoralist areas where such kinds of study findings need to be improved beside to improving the data quality at root and health posts level.

Keywords: accuracy ratio, Degehabur District, regular childhood immunization program, quality of monitoring system, Somali Region-Ethiopia

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228 A Systemic Review and Comparison of Non-Isolated Bi-Directional Converters

Authors: Rahil Bahrami, Kaveh Ashenayi

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This paper presents a systematic classification and comparative analysis of non-isolated bi-directional DC-DC converters. The increasing demand for efficient energy conversion in diverse applications has spurred the development of various converter topologies. In this study, we categorize bi-directional converters into three distinct classes: Inverting, Non-Inverting, and Interleaved. Each category is characterized by its unique operational characteristics and benefits. Furthermore, a practical comparison is conducted by evaluating the results of simulation of each bi-directional converter. BDCs can be classified into isolated and non-isolated topologies. Non-isolated converters share a common ground between input and output, making them suitable for applications with minimal voltage change. They are easy to integrate, lightweight, and cost-effective but have limitations like limited voltage gain, switching losses, and no protection against high voltages. Isolated converters use transformers to separate input and output, offering safety benefits, high voltage gain, and noise reduction. They are larger and more costly but are essential for automotive designs where safety is crucial. The paper focuses on non-isolated systems.The paper discusses the classification of non-isolated bidirectional converters based on several criteria. Common factors used for classification include topology, voltage conversion, control strategy, power capacity, voltage range, and application. These factors serve as a foundation for categorizing converters, although the specific scheme might vary depending on contextual, application, or system-specific requirements. The paper presents a three-category classification for non-isolated bi-directional DC-DC converters: inverting, non-inverting, and interleaved. In the inverting category, converters produce an output voltage with reversed polarity compared to the input voltage, achieved through specific circuit configurations and control strategies. This is valuable in applications such as motor control and grid-tied solar systems. The non-inverting category consists of converters maintaining the same voltage polarity, useful in scenarios like battery equalization. Lastly, the interleaved category employs parallel converter stages to enhance power delivery and reduce current ripple. This classification framework enhances comprehension and analysis of non-isolated bi-directional DC-DC converters. The findings contribute to a deeper understanding of the trade-offs and merits associated with different converter types. As a result, this work aids researchers, practitioners, and engineers in selecting appropriate bi-directional converter solutions for specific energy conversion requirements. The proposed classification framework and experimental assessment collectively enhance the comprehension of non-isolated bi-directional DC-DC converters, fostering advancements in efficient power management and utilization.The simulation process involves the utilization of PSIM to model and simulate non-isolated bi-directional converter from both inverted and non-inverted category. The aim is to conduct a comprehensive comparative analysis of these converters, considering key performance indicators such as rise time, efficiency, ripple factor, and maximum error. This systematic evaluation provides valuable insights into the dynamic response, energy efficiency, output stability, and overall precision of the converters. The results of this comparison facilitate informed decision-making and potential optimizations, ensuring that the chosen converter configuration aligns effectively with the designated operational criteria and performance goals.

Keywords: bi-directional, DC-DC converter, non-isolated, energy conversion

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227 Vieira Da Silva's Tiles at Universidade Federal Rural Do Rio de Janeiro: A Conservation and Restoration Project

Authors: Adriana Anselmo Oliveira

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The present project showcases a tile work from the Franco-Portuguese artist Maria Helena Vieira da Silva (1908-1992). It is a set of 8 panels composed of figurative and geometric tiles, with extra tiles framing nearby doors and windows in a study room in the (UFRRJ, Universidade Federal Rural do Rio de Janeiro). The aforementioned work was created between 1942 and 1943, during the artist's 6 year exile in the Brazilian city. This one-of-a-kind tileset was designed and made by Vieira da Silva between 1942 and 1943. Over the years, several units were lost, which led to their replacement in the nineties. However, these replacements don't do justice to the original work of art. In 2007, a project was initiated to fully repair and maintain the set. Three panels are removed and restored, but the project is halted. To this day, the three fully restored panels remain in boxes. In 2016 a new restoration project is submitted by the (Faculdade de Belas Artes da Universidade de Lisboa) in collaboration with de (Fundacão Árpád Szenes-Vieira da Silva). There are many varied opinions on restoring and conserving older pieces of art, however, we have the moral duty to safeguard the original materials used by the artist along with the artists original vision and also to care for the future generations of students who will use the space in which the tile-work was inserted. Many tiles have been replaced by white tiles, tiles with a divergent colour pallet and technique, and in a few cases, the incorrect place or way around. These many factors make it increasingly difficult to maintain the artists original vision and destroy and chance of coherence within the artwork itself. The conservative technician cannot make new images to fill the empty spaces or mark the remaining images with their own creative input. with reliable photographic documentation that can provide us with the necessary vision to allow us to proceed with an accurate reconstruction, we have the obligation to proceed and return the piece of art to its true form, as in its current state, it is impossible to maintain its original glory. Using the information we have, we must find a way to differentiate the original tiles from the reconstructions in order to recreate and reclaim the original message from the artist. The objective of this project is to understand the significance of tiles in Vieira da Silva's art as well as the influence they had on the artist's pictorial language since the colour definition on tile work is vastly different from the painting process as the materials change during their merger. Another primary goal is to understand what the previous interventions achieved besides increasing the artworks durability. The main objective is to submit a proposal that can salvage the artist's visual intention and supports it for posteriority. In summary, this proposal goes further than the usual conservative interventions as it intends to recreate the original artistic worth, prioritising the aesthetics and keeping its soul alive.

Keywords: Vieira da Silva, tiles, conservation, restoration

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226 An Explorative Analysis of Effective Project Management of Research and Research-Related Projects within a recently Formed Multi-Campus Technology University

Authors: Àidan Higgins

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Higher education will be crucial in the coming decades in helping to make Ireland a nation is known for innovation, competitive enterprise, and ongoing academic success, as well as a desirable location to live and work with a high quality of life, vibrant culture, and inclusive social structures. Higher education institutions will actively connect with each student community, society, and business; they will help students develop a sense of place and identity in Ireland and provide the tools they need to contribute significantly to the global community. It will also serve as a catalyst for novel ideas through research, many of which will become the foundation for long-lasting inventive businesses in the future as part of the 2030 National Strategy on Education focuses on change and developing our education system with a focus on how we carry out Research. The emphasis is central to knowledge transfer and a consistent research framework with exploiting opportunities and having the necessary expertise. The newly formed Technological Universities (TU) in Ireland are based on a government initiative to create a new type of higher education institution that focuses on applied and industry-focused research and education. The basis of the TU is to bring together two or more existing institutes of technology to create a larger and more comprehensive institution that offers a wider range of programs and services to students and industry partners. The TU model aims to promote collaboration between academia, industry, and community organizations to foster innovation, research, and economic development. The TU model also aims to enhance the student experience by providing a more seamless pathway from undergraduate to postgraduate studies, as well as greater opportunities for work placements and engagement with industry partners. Additionally, the TUs are designed to provide a greater emphasis on applied research, technology transfer, and entrepreneurship, with the goal of fostering innovation and contributing to economic growth. A project is a collection of organised tasks carried out precisely to produce a singular output (product or service) within a given time frame. Project management is a set of activities that facilitates the successful implementation of a project. The significant differences between research and development projects are the (lack of) precise requirements and (the inability to) plan an outcome from the beginning of the project. The evaluation criteria for a research project must consider these and other "particularities" in works; for instance, proving something cannot be done may be a successful outcome. This study intends to explore how a newly established multi-campus technological university manages research projects effectively. The study will identify the potential and difficulties of managing research projects, the tools, resources and processes available in a multi-campus Technological University context and the methods and approaches employed to deal with these difficulties. Key stakeholders like project managers, academics, and administrators will be surveyed as part of the study, which will also involve an explorative investigation of current literature and data. The findings of this study will contribute significantly to creating best practices for project management in this setting and offer insightful information about the efficient management of research projects within a multi-campus technological university.

Keywords: project management, research and research-related projects, multi-campus technology university, processes

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225 Neuropsychological Aspects in Adolescents Victims of Sexual Violence with Post-Traumatic Stress Disorder

Authors: Fernanda Mary R. G. Da Silva, Adriana C. F. Mozzambani, Marcelo F. Mello

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Introduction: Sexual assault against children and adolescents is a public health problem with serious consequences on their quality of life, especially for those who develop post-traumatic stress disorder (PTSD). The broad literature in this research area points to greater losses in verbal learning, explicit memory, speed of information processing, attention and executive functioning in PTSD. Objective: To compare the neuropsychological functions of adolescents from 14 to 17 years of age, victims of sexual violence with PTSD with those of healthy controls. Methodology: Application of a neuropsychological battery composed of the following subtests: WASI vocabulary and matrix reasoning; Digit subtests (WISC-IV); verbal auditory learning test RAVLT; Spatial Span subtest of the WMS - III scale; abbreviated version of the Wisconsin test; concentrated attention test - D2; prospective memory subtest of the NEUPSILIN scale; five-digit test - FDT and the Stroop test (Trenerry version) in adolescents with a history of sexual violence in the previous six months, referred to the Prove (Violence Care and Research Program of the Federal University of São Paulo), for further treatment. Results: The results showed a deficit in the word coding process in the RAVLT test, with impairment in A3 (p = 0.004) and A4 (p = 0.016) measures, which compromises the verbal learning process (p = 0.010) and the verbal recognition memory (p = 0.012), seeming to present a worse performance in the acquisition of verbal information that depends on the support of the attentional system. A worse performance was found in list B (p = 0.047), a lower priming effect p = 0.026, that is, lower evocation index of the initial words presented and less perseveration (p = 0.002), repeated words. Therefore, there seems to be a failure in the creation of strategies that help the mnemonic process of retention of the verbal information necessary for learning. Sustained attention was found to be impaired, with greater loss of setting in the Wisconsin test (p = 0.023), a lower rate of correct responses in stage C of the Stroop test (p = 0.023) and, consequently, a higher index of erroneous responses in C of the Stroop test (p = 0.023), besides more type II errors in the D2 test (p = 0.008). A higher incidence of total errors was observed in the reading stage of the FDT test p = 0.002, which suggests fatigue in the execution of the task. Performance is compromised in executive functions in the cognitive flexibility ability, suggesting a higher index of total errors in the alternating step of the FDT test (p = 0.009), as well as a greater number of persevering errors in the Wisconsin test (p = 0.004). Conclusion: The data from this study suggest that sexual violence and PTSD cause significant impairment in the neuropsychological functions of adolescents, evidencing risk to quality of life in stages that are fundamental for the development of learning and cognition.

Keywords: adolescents, neuropsychological functions, PTSD, sexual violence

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224 Critiquing Israel as Child Abuse: How Colonial White Feminism Disrupts Critical Pedagogies of Culturally Responsive and Relevant Practices and Inclusion through Ongoing and Historical Maternalism and Neoliberal Settler Colonialism

Authors: Wafaa Hasan

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In May of 2022, Palestinian parents in Toronto, Canada, became aware that educators and staff in the Toronto District School Board were attempting to include the International Holocaust and Remembrance Definition of Antisemitism (IHRA) in The Child Abuse and Neglect Policy of the largest school board in Canada, The Toronto District School Board (TDSB). The idea was that if students were to express any form of antisemitism, as defined by the IHRA, then an investigation could follow with Child Protective Services (CPS). That is, the student’s parents could be reported to the state and investigated for custodial rights to their children. The TDSB has set apparent goals for “Decolonizing Pedagogy” (“TDSB Equity Leadership Competencies”), Culturally Responsive and Relevant Practices (CRRP) and inclusive education. These goals promote the centering of colonized, racialized and marginalized voices. CRRP cannot be effective without the application of anti-racist and settler colonial analyses. In order for CRRP to be effective, school boards need a comprehensive understanding of the ways in which the vilification of Palestinians operates through anti-indigenous and white supremacist systems and logic. Otherwise, their inclusion will always be in tension with the inclusion of settler colonial agendas and worldviews. Feminist maternalism frames racial mothering as degenerate (viewing the contributions of racialized students and their parents as products of primitive and violent cultures) and also indirectly inhibits the actualization of the tenets of CRRP and inclusive education through its extensions into the welfare state and public education. The contradiction between the tenets of CRRP and settler colonial systems of erasure and repression is resolved by the continuation of tactics to 1) force assimilation, 2) punish those who push back on that assimilation and 3) literally fragment familial and community structures of racialized students, educators and parents. This paper draws on interdisciplinary (history, philosophy, anthropology) critiques of white feminist “maternalism” from the 19th century onwards in North America and Europe (Jacobs, Weber), as well as “anti-racist education” theory (Dei), and more specifically,” culturally responsive learning,” (Muhammad) and “bandwidth” pedagogy theory (Verschelden) to make its claims. This research contributes to vibrant debates about anti-racist and decolonial pedagogies in public education systems globally. This paper also documents first-hand interviews and experiences of diasporic Palestinian mothers and motherhoods and situates their experiences within longstanding histories of white feminist maternalist (and eugenicist) politics. This informal qualitative data from "participatory conversations" (Swain) is situated within a set of formal interview data collected with Palestinian women in the West Bank (approved by the McMaster University Humanities Research Ethics Board) relating to white feminist maternalism in the peace and dialogue industry.

Keywords: decolonial feminism, maternal feminism, anti-racist pedagogies, settler colonial studies, motherhood studies, pedagogy theory, cultural theory

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223 Conceptual Design of a Residential House Based on IDEA 4E - Discussion of the Process of Interdisciplinary Pre-Project Research and Optimal Design Solutions Created as Part of Project-Based Learning

Authors: Dorota Winnicka-Jasłowska, Małgorzata Jastrzębska, Jan Kaczmarczyk, Beata Łaźniewska-Piekarczyk, Piotr Skóra, Beata Kobiałko, Agata Kołodziej, Błażej Mól, Ewelina Lasyk, Karolina Brzęczek, Michał Król

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Creating economical, comfortable, and healthy buildings which respect the environment is a necessity resulting from legal regulations, but it is also a response to the expectations of a modern investor. Developing the concept of a residential house based on the 4E and the 2+2+(1) IDEAs is a complex process that requires specialist knowledge of many trades and requires adaptation of comprehensive solutions. IDEA 4E assumes the use of energy-saving, ecological, ergonomics, and economic solutions. In addition, IDEA 2+2+(1) assuming appropriate surface and functional-spatial solutions for a family at different stages of a building's life, i.e. 2, 4, or 5 members, enforces certain flexibility of the designed building, which may change with the number and age of its users. The building should therefore be easy to rearrange or expand. The task defined in this way was carried out by an interdisciplinary team of students of the Silesian University of Technology as part of PBL. The team consisted of 6 undergraduate and graduate students representing the following faculties: 3 students of architecture, 2 civil engineering students, and 1 student of environmental engineering. The work of the team was supported by 3 academic teachers representing the above-mentioned faculties and additional experts. The project was completed in one semester. The article presents the successive stages of the project. At first pre-design studies were carried out. They allowed to define the guidelines for the project. For this purpose, the "Model house" questionnaire was developed. The questions concerned determining the utility needs of a potential family that would live in a model house - specifying the types of rooms, their size, and equipment. A total of 114 people participated in the study. The answers to the questions in the survey helped to build the functional programme of the designed house. Other research consisted in the search for optimal technological and construction solutions and the most appropriate building materials based mainly on recycling. Appropriate HVAC systems responsible for the building's microclimate were also selected, i.e. low, temperature heating, mechanical ventilation, and the use of energy from renewable sources was planned so as to obtain a nearly zero-energy building. Additionally, rainwater retention and its local use were planned. The result of the project was a design of a model residential building that meets the presented assumptions. A 3D VR spatial model of the designed building and its surroundings was also made. The final result was the organization of an exhibition for students and the academic community. Participation in the interdisciplinary project allowed the project team members to better understand the consequences of the adopted solutions for achieving the assumed effect and the need to work out a compromise. The implementation of the project made all its participants aware of the importance of cooperation as well as systematic and clear communication. The need to define milestones and their consistent enforcement is an important element guaranteeing the achievement of the intended end result. The implementation of PBL enables students to the acquire competences important in their future professional work.

Keywords: architecture and urban planning, civil engineering, environmental engineering, project-based learning, sustainable building

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222 Neoliberal Settler City: Socio-Spatial Segregation, Livelihood of Artists/Craftsmen in Delhi

Authors: Sophy Joseph

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The study uses the concept of ‘Settler city’ to understand the nature of peripheralization that a neoliberal city initiates. The settler city designs powerless communities without inherent rights, title and sovereignty. Kathputli Colony, home to generations of artists/craftsmen, who have kept heritage of arts/crafts alive, has undergone eviction of its population from urban space. The proposed study, ‘Neoliberal Settler City: Socio-spatial segregation and livelihood of artists/craftsmen in Delhi’ would problematize the settler city as a colonial technology. The colonial regime has ‘erased’ the ‘unwanted’ as primitive and swept them to peripheries in the city. This study would also highlight how structural change in political economy has undermined their crafts/arts by depriving them from practicing/performing it with dignity in urban space. The interconnections between citizenship and In-Situ Private Public Partnership in Kathputli rehabilitation has become part of academic exercise. However, a comprehensive study connecting inherent characteristics of neoliberal settler city, trajectory of political economy of unorganized workers - artists/craftsmen and legal containment and exclusion leading to dispossession and marginalization of communities from the city site, is relevant to contextualize the trauma of spatial segregation. This study would deal with political, cultural, social and economic dominant behavior of the structure in the state formation, accumulation of property and design of urban space, fueled by segregation of marginalized/unorganized communities and disowning the ‘footloose proletariat’, the migrant workforce. The methodology of study involves qualitative research amongst communities and the field work-oral testimonies and personal accounts- becomes the primary material to theorize the realities. The secondary materials in the forms of archival materials about historical evolution of Delhi as a planned city from various archives, would be used. As the study also adopt ‘narrative approach’ in qualitative study, the life experiences of craftsmen/artists as performers and emotional trauma of losing their livelihood and space forms an important record to understand the instability and insecurity that marginalization and development attributes on urban poor. The study attempts to prove that though there was a change in political tradition from colonialism to constitutional democracy, new state still follows the policy of segregation and dispossession of the communities. It is this dispossession from the space, deprivation of livelihood and non-consultative process in rehabilitation that reflects the neoliberal approach of the state and also critical findings in the study. This study would entail critical spatial lens analyzing ethnographic and sociological data, representational practices and development debates to understand ‘urban otherization’ against craftsmen/artists. This seeks to develop a conceptual framework for understanding the resistance of communities against primitivity attached with them and to decolonize the city. This would help to contextualize the demand for declaring Kathputli Colony as ‘heritage artists village’. The conceptualization and contextualization would help to argue for right to city of the communities, collective rights to property, services and self-determination. The aspirations of the communities also help to draw normative orientation towards decolonization. It is important to study this site as part of the framework, ‘inclusive cities’ because cities are rarely noted as important sites of ‘community struggles’.

Keywords: neoliberal settler city, socio-spatial segregation, the livelihood of artists/craftsmen, dispossession of indigenous communities, urban planning and cultural uprooting

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221 Benefits of The ALIAmide Palmitoyl-Glucosamine Co-Micronized with Curcumin for Osteoarthritis Pain: A Preclinical Study

Authors: Enrico Gugliandolo, Salvatore Cuzzocrea, Rosalia Crupi

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Osteoarthritis (OA) is one of the most common chronic pain conditions in dogs and cats. OA pain is currently viewed as a mixed phenomenon involving both inflammatory and neuropathic mechanisms at the peripheral (joint) and central (spinal and supraspinal) levels. Oxidative stress has been implicated in OA pain. Although nonsteroidal anti-inflammatory drugs are commonly prescribed for OA pain, they should be used with caution in pets because of adverse effects in the long term and controversial efficacy on neuropathic pain. An unmet need remains for safe and effective long-term treatments for OA pain. Palmitoyl-glucosamine (PGA) is an analogue of the ALIAamide palmitoylethanolamide, i.e., a body’s own endocannabinoid-like compound playing a sentinel role in nociception. PGA, especially in the micronized formulation, was shown safe and effective in OA pain. The aim of this study was to investigate the effect of a co-micronized formulation of PGA with the natural antioxidant curcumin (PGA-cur) on OA pain. Ten Sprague-Dawley male rats were used for each treatment group. The University of Messina Review Board for the care and use of animals authorized the study. On day 0, rats were anesthetized (5.0% isoflurane in 100% O2) and received intra-articular injection of MIA (3 mg in 25 μl saline) in the right knee joint, with the left being injected an equal volume of saline. Starting the third day after MIA injection, treatments were administered orally three times per week for 21 days, at the following doses: PGA 20 mg/kg, curcumin 10 mg/kg, PGA-cur (2:1 ratio) 30 mg/kg. On day 0 and 3, 7, 14 and 21 days post-injection, mechanical allodynia was measured using a dynamic plantar Von Frey hair aesthesiometer and expressed as paw withdrawal threshold (PWT) and latency (PWL). Motor functional recovery of the rear limb was evaluated on the same time points by walking track analysis using the sciatic functional index. On day 21 post-MIA injection, the concentration of the following inflammatory and nociceptive mediators was measured in serum using commercial ELISA kits: tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), nerve growth factor (NGF) and matrix metalloproteinase-1-3-9 (MMP-1, MMP-3, MMP-9). The results were analyzed by ANOVA followed by Bonferroni post-hoc test for multiple comparisons. Micronized PGA reduced neuropathic pain, as shown by the significant higher PWT and PWL values compared to vehicle group (p < 0.0001 for all the evaluated time points). The effect of PGA-cur was superior at all time points (p < 0.005). PGA-cur restored motor function already on day 14 (p < 0.005), while micronized PGA was effective a week later (D21). MIA-induced increase in the serum levels of all the investigated mediators was inhibited by PGA-cur (p < 0.01). PGA was also effective, except on IL-1 and MMP-3. Curcumin alone was inactive in all the experiments at any time point. The encouraging results suggest that PGA-cur may represent a valuable option in OA pain management and warrant further confirmation in well-powered clinical trials.

Keywords: ALIAmides, curcumin, osteoarthritis, palmitoyl-glucosamine

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220 Case Report: A Case of Confusion with Review of Sedative-Hypnotic Alprazolam Use

Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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219 Improving Fingerprinting-Based Localization System Using Generative AI

Authors: Getaneh Berie Tarekegn, Li-Chia Tai

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With the rapid advancement of artificial intelligence, low-power built-in sensors on Internet of Things devices, and communication technologies, location-aware services have become increasingly popular and have permeated every aspect of people’s lives. Global navigation satellite systems (GNSSs) are the default method of providing continuous positioning services for ground and aerial vehicles, as well as consumer devices (smartphones, watches, notepads, etc.). However, the environment affects satellite positioning systems, particularly indoors, in dense urban and suburban cities enclosed by skyscrapers, or when deep shadows obscure satellite signals. This is because (1) indoor environments are more complicated due to the presence of many objects surrounding them; (2) reflection within the building is highly dependent on the surrounding environment, including the positions of objects and human activity; and (3) satellite signals cannot be reached in an indoor environment, and GNSS doesn't have enough power to penetrate building walls. GPS is also highly power-hungry, which poses a severe challenge for battery-powered IoT devices. Due to these challenges, IoT applications are limited. Consequently, precise, seamless, and ubiquitous Positioning, Navigation and Timing (PNT) systems are crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarms, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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218 Restless Leg Syndrome as the Presenting Symptom of Neuroendocrine Tumor

Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

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Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

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217 Impact Analysis of a School-Based Oral Health Program in Brazil

Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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216 A System for Preventing Inadvertent Exposition of Staff Present outside the Operating Theater: Description and Clinical Test

Authors: Aya Al Masri, Kamel Guerchouche, Youssef Laynaoui, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: Mobile C-arms move throughout operating rooms of the operating theater. Being designed to move between rooms, they are not equipped with relays to retrieve the exposition information and export it outside the room. Therefore, no light signaling is available outside the room to warn the X-ray emission for staff. Inadvertent exposition of staff outside the operating theater is a real problem for radiation protection. The French standard NFC 15-160 require that: (1) access to any room containing an X-ray emitting device must be controlled by a light signage so that it cannot be inadvertently crossed, and (2) setting up an emergency button to stop the X-ray emission. This study presents a system that we developed to meet these requirements and the results of its clinical test. Materials and methods: The system is composed of two communicating boxes: o The "DetectBox" is to be installed inside the operating theater. It identifies the various operation states of the C-arm by analyzing its power supply signal. The DetectBox communicates (in wireless mode) with the second box (AlertBox). o The "AlertBox" can operate in socket or battery mode and is to be installed outside the operating theater. It detects and reports the state of the C-arm by emitting a real time light signal. This latter can have three different colors: red when the C-arm is emitting X-rays, orange when it is powered on but does not emit X-rays, and green when it is powered off. The two boxes communicate on a radiofrequency link exclusively carried out in the ‘Industrial, Scientific and Medical (ISM)’ frequency bands and allows the coexistence of several on-site warning systems without communication conflicts (interference). Taking into account the complexity of performing electrical works in the operating theater (for reasons of hygiene and continuity of medical care), this system (having a size <10 cm²) works in complete safety without any intrusion in the mobile C-arm and does not require specific electrical installation work. The system is equipped with emergency button that stops X-ray emission. The system has been clinically tested. Results: The clinical test of the system shows that: it detects X-rays having both high and low energy (50 – 150 kVp), high and low photon flow (0.5 – 200 mA: even when emitted for a very short time (<1 ms)), Probability of false detection < 10-5, it operates under all acquisition modes (continuous, pulsed, fluoroscopy mode, image mode, subtraction and movie mode), it is compatible with all C-arm models and brands. We have also tested the communication between the two boxes (DetectBox and AlertBox) in several conditions: (1) Unleaded room, (2) leaded room, and (3) rooms with particular configuration (sas, great distances, concrete walls, 3 mm of lead). The result of these last tests was positive. Conclusion: This system is a reliable tool to alert the staff present outside the operating room for X-ray emission and insure their radiation protection.

Keywords: Clinical test, Inadvertent staff exposition, Light signage, Operating theater

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