Search results for: Bankole Wright

Authors: Jihene Bettaieb, Ghassen kharroubi, Rym mallekh, Ines Cherif, Taoufik Atawa, Kaouther Harrabech

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Brucellosis is a major worldwide zoonosis. It is a reportable condition in Tunisia where the disease remains endemic, especially in rural areas. The aim of this study was to describe the epidemiological, clinical, and bacteriological profile of human brucellosis cases notified in the district of Tunis. It was a retrospective descriptive study of cases reported in the district of Tunis through the national surveillance system between the 1st January and 31th December 2017. During the study period, 133 brucellosis confirmed cases were notified. The mean age was 37.5 ± 18.0 years, and 54.9% of cases were males. More than four-fifths (82.7%) of cases were reported in spring and summer with a peak in the month of May (36 cases). Fever and sweats were the most common symptoms; they occurred in 95% and 72% of cases, respectively. Osteoarticular complications occurred in 10 cases, meningitis in one case and endocarditis in one other case. Wright agglutination test and Rose Bengale test were positive in 100% and 91% of cases, respectively. While blood culture was positive in 9 cases and PCR in 2 cases. Brucella melitensis was the only identified specie (9 cases). Almost all cases (99.2%) reported the habit of consuming raw dairy products. Only 5 cases had a suspect contact with animals; among them, 3 persons were livestock breeders. The transmission was essentially due to raw dairy product consumption. It is important to enhance preventive measures to control animal Brucellosis and to educate the population regarding the risk factors of the disease.

Keywords: brucellosis, risk factors, surveillance system, Tunisia

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Authors: Nia McRae, Robert Wright, Ghalib Bello

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Introduction: Postpartum depression is a prevalent mood disorder that is detrimental to the mental and physical health of mothers and their newborns. Lead (Pb) is a toxic metal that is associated with hormonal imbalance and mental impairments. The hormone changes that accompany pregnancy and childbirth may be exacerbated by Pb and increase new mothers’ susceptibility to postpartum depression. To the best of the author’s knowledge, this is the only study that investigates the association between prenatal Pb exposure and postpartum depression. Identifying risk factors can contribute to improved prevention and treatment strategies for postpartum depression. Methods: Data was derived from the Programming Research in Obesity, Growth, Environment and Social Stress (PROGRESS) study which is an ongoing longitudinal birth cohort. Postpartum depression was identified by a score of 13 or above on the 10-Item Edinburg Postnatal Depression Scale (EPDS) 6-months and 12-months postpartum. Pb was measured in the blood (BPb) in the second and third trimester and in the tibia and patella 1-month postpartum. Quantile regression models were used to assess the relationship between BPb and postpartum depression. Results: BPb in the second trimester was negatively associated with the 80th percentile of depression 6-months postpartum (β: -0.26; 95% CI: -0.51, -0.01). No significant association was found between BPb in the third trimester and depression 6-months postpartum. BPb in the third trimester exhibited an inverse relationship with the 60th percentile (β: -0.23; 95% CI: -0.41, -0.06), 70th percentile (β: -0.31; 95% CI: -0.52, -0.10), and 90th percentile of depression 12-months postpartum (β: -0.36; 95% CI: -0.69, -0.03). There was no significant association between BPb in the second trimester and depression 12-months postpartum. Bone Pb concentrations were not significantly associated with postpartum depression. Conclusion: The negative association between BPb and postpartum depression may support research which demonstrates lead is a nontherapeutic stimulant. Further research is needed to verify these results and identify effect modifiers.

Keywords: depression, lead, postpartum, prenatal

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Authors: Mohamad Shariff Nurasikin, Paul Crawford, Nicola Wright

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People with any mental disorder can get benefit from the spiritual aspects of life for recovery, particularly in searching for the meaning of life and engaging in meaningful activities. However, little is known about such effects in the population of bipolar disorder. The concepts of spirituality are highly contestable, as they are too broad and removed from the original religious understanding. The concepts are more notable as encompassing multi-dimensional aspects of people’s lives such as social, emotional, and psychological. Viewing that Western or secular worldview dominates most of the literature in spirituality, it is time to explore the concept of spirituality from the Eastern and religious worldview, such as the Malaysian view. Thus, the aim of this study is to provide a conceptual understanding of people with bipolar disorder with a religious affiliation in Malaysia. This study employs a Grounded Theory and explores the narratives from the interviews of 25 participants. The narratives strongly suggest the salient resources or can be referred to as various forms of capital, as in the capital theory, namely, religious, social, psychological, and medicinal. More important is how these capitals are the enablers for recovery in mental health and well-being, where the participants in the sample engage in a more meaningful life and positive adaptations. This study also extends the Bourdieusian spiritual capital, in which the salient resources are termed as the capital bundle. More significant is how the capital bundles are working contiguously in building and accumulating the spiritual capital. This process is conducive to recovery within the social life of people with bipolar disorder or perhaps other mental disorders.

Keywords: bipolar, Bourdeau, recovery, spiritual

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Authors: Xiaolin Li, Terence Turney, John Forsythe, Bryce Feltis, Paul Wright, Vinh Truong, Will Gates

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Clay-hydrogel nanocomposites have attracted great attention recently, mainly because of their enhanced mechanical properties and ease of fabrication. Moreover, the unique platelet structure of clay nanoparticles enables the incorporation of bioactive molecules, such as proteins or drugs, through ion exchange, adsorption or intercalation. This study seeks to improve the mechanical and rheological properties of a novel hydrogel system, copolymerized from a tetrapodal polyethylene glycol (PEG) thiol and a linear, triblock PEG-PPG-PEG (PPG: polypropylene glycol) α,ω-bispropynoate polymer, with the simultaneous incorporation of various amounts of Na-saturated, montmorillonite clay (MMT) platelets (av. lateral dimension = 200 nm), to form a bioactive three-dimensional network. Although the parent hydrogel has controlled swelling ability and its PEG groups have good affinity for the clay platelets, it suffers from poor mechanical stability and is currently unsuitable for potential applications. Nanocomposite hydrogels containing 4wt% MMT showed a twelve-fold enhancement in compressive strength, reaching 0.75MPa, and also a three-fold acceleration in gelation time, when compared with the parent hydrogel. Interestingly, clay nanoplatelet incorporation into the hydrogel slowed down the rate of its dehydration in air. Preliminary results showed that protein binding by the MMT varied with the nature of the protein, as horseradish peroxidase (HRP) was more strongly bound than bovine serum albumin. The HRP was no longer active when bound, presumably as a result of extensive structural refolding. Further work is being undertaken to assess protein binding behaviour within the nanocomposite hydrogel for potential diabetic wound healing applications.

Keywords: hydrogel, nanocomposite, small molecule, wound healing

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Authors: J. Miranda, D. Chavarría-Barrientos, M. Ramírez-Cadena, M. E. Macías, P. Ponce, J. Noguez, R. Pérez-Rodríguez, P. K. Wright, A. Molina

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Higher education methods need to evolve because the new generations of students are learning in different ways. One way is by adopting emergent technologies, new learning methods and promoting the maker movement. As a result, Tecnologico de Monterrey is developing Open Innovation Laboratories as an immediate response to educational challenges of the world. This paper presents an Open Innovation Laboratory for Rapid Realization of Sensing, Smart and Sustainable Products (S³ Products). The Open Innovation Laboratory is composed of a set of specific resources where students and teachers use them to provide solutions to current problems of priority sectors through the development of a new generation of products. This new generation of products considers the concepts Sensing, Smart, and Sustainable. The Open Innovation Laboratory has been implemented in different courses in the context of New Product Development (NPD) and Integrated Manufacturing Systems (IMS) at Tecnologico de Monterrey. The implementation consists of adapting this Open Innovation Laboratory within the course’s syllabus in combination with the implementation of specific methodologies for product development, learning methods (Active Learning and Blended Learning using Massive Open Online Courses MOOCs) and rapid product realization platforms. Using the concepts proposed it is possible to demonstrate that students can propose innovative and sustainable products, and demonstrate how the learning process could be improved using technological resources applied in the higher educational sector. Finally, examples of innovative S³ products developed at Tecnologico de Monterrey are presented.

Keywords: active learning, blended learning, maker movement, new product development, open innovation laboratory

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Authors: Michael Wright, Tiago Costa

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The construction industry in SE Asia has been relying on S355 MPa “as rolled” H-beams for many years now. It is an easily sourced, metallurgically simple, reliable product that all designers, fabricators and constructors are familiar with. However, as the Global demand to better use our finite resources gets stronger, the need for an as-rolled S460 MPa H-Beam is becoming more apparent. The Financial benefits of an “as-rolled” S460 MPa H-beam are obvious. The S460 MPa beam which is currently available and used is fabricated from rolled strip. However, making H-beam from 3 x 460 MPa strips requires costly equipment, valuable welding skills & production time, all of which can be in short supply or better used for other purposes. The Metallurgical benefits of an “as-rolled” S460 MPa H-beam are consistency in the product. Fabricated H-beams have inhomogeneous areas where the strips have been welded together - parent metal, heat affected zone and weld metal all in the one body. They also rely heavily on the skill of the welder to guarantee a perfect, defect free weld. If this does not occur, the beam is intrinsically flawed and could lead to failure in service. An as-rolled beam is a relatively homogenous product, with the optimum strength and ductility produced by delivering steel with as fine as possible uniform cross sectional grain size. This is done by cost effective alloy design coupled with proper metallurgical process control implemented into an existing mill’s equipment capability and layout. This paper is designed to highlight the benefits of bring an “as-rolled” S460 MPa H-beam to the construction market place in SE Asia, and hopefully encourage the current “as-rolled” H-beam producers to rise to the challenge and produce an innovative high quality product for the local market.

Keywords: fine grained, As-rolled, long products, process control, metallurgy

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Authors: Mammar Khames, Mustapha Oumouna

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Brucellosis is one of the most common zoonoses in the world. It represents a serious threat to human health; the existence of brucellosis in Algeria dates back to the beginning of the 19th century. Its transmission to humans is through coccobacilli of the genus Brucella following direct contact with contaminated animals or indirectly through the consumption of their unpasteurized dairy products. The present investigation covers a retrospective study on human brucellosis in the district of Medea over a period from 2011 to 2021 at the level of two public health establishments. In the first place, it is at the level of the Directorate of Public Health and in the infectious department level at Medea Hospital, and at the level of the directorate of agricultural services in the third place. The results showed that during these eleven years of study, 795 cases were collected from the department of health and population, and 141 cases were collected from the infectious department of the district of Medea. A total of 56 cases of bovine brucellosis were obtained from the directorate of agricultural services of the district of Medea. Human brucellosis affects all age groups with different percentages, but the rate has been higher in the 20-44 age group, with a predominance of men. However, the geographic distribution map of the cases shows that the western part of the district was the most affected. A cohort of 141 cases was hospitalized at the infectious service level of Medea Hospital. They were 89 men and 52 women. The most common age reached is [20-44] years. The majority were of rural origin. Two serological reactions were performed for diagnosis: the buffered antigen test and Wright's serodiagnosis. Bovine brucellosis affects all age groups with different percentages, but the rate was higher in the 2-to-4-year age group, with a predominance of females. From these data, we conclude that brucellosis has a strong spread in the region studied.

Keywords: human brucellosis, serology, Medea, Algeria

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Authors: Timothy Scheinert, Eliza Wright

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Background: Link Health is a Boston-based non-profit leveraging in-person and digital platforms to promote health equity. Its primary aim is to financially support low-income individuals through enrollment in federal benefit programs. This study examines the monetary impact of enrollment in several benefit programs. Methodologies: Approximately 17,000 individuals have been screened for eligibility via digital outreach, community events, and in-person clinics. Enrollment and financial distributions are evaluated across programs, including the Affordable Connectivity Program (ACP), Lifeline, LIHEAP, Transitional Aid to Families with Dependent Children (TAFDC), and the Supplemental Nutrition Assistance Program (SNAP). Major Findings: A total of 1,895 individuals have successfully applied, collectively distributing an estimated $1,288,152.00 in aid. The largest contributors to this sum include: ACP: 1,149 enrollments, $413,640 distributed annually. Child Care Financial Assistance (CCFA): 15 enrollments, $240,000 distributed annually. Lifeline: 602 enrollments, $66,822 distributed annually. LIHEAP: 25 enrollments, $48,750 distributed annually. SNAP: 41 enrollments, $123,000 distributed annually. TAFDC: 21 enrollments, $341,760 distributed annually. Conclusions: These results highlight the role of targeted outreach and effective enrollment processes in promoting access to federal benefit programs. High enrollment rates in ACP and Lifeline demonstrate a considerable need for affordable broadband and internet services. Programs like CCFA and TAFDC, despite lower enrollment numbers, provide sizable support per individual. This analysis advocates for continued funding of federal benefit programs. Future efforts can be made to develop screening tools that identify eligibility for multiple programs and reduce the complexity of enrollment.

Keywords: benefits, childcare, connectivity, equity, nutrition

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Authors: Nataliya Apanovich, Mark Wright

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Uganda is among the poorest but fastest growing populations in the world. Its annual population growth of 3% puts additional stress through land fragmentation, agricultural intensification, and deforestation on already highly weathered tropical (Ferralsol) soils. All of these factors lead to decreased agricultural yields and consequently diminished food security. The central region of Uganda, Buganda Kingdom, is especially vulnerable in terms of food security as its high population density coupled with mismanagement of natural resources led to gradual loss of its soil and even changes in microclimate. These changes are negatively affecting livelihoods of smallholder farmers who comprise 80% of all population in Uganda. This research focuses on biochar for soil remediation in Masaka District, Uganda. If produced on a small scale from locally sourced materials, biochar can increase the quality of soil in a cost and time effective manner. To assess biochar potential, 151 smallholder farmers were interviewed on the types of crops grown, agricultural residues produced and their use, as well as on attitudes towards biochar use and its production on a small scale. The interviews were conducted in 7 sub-counties, 32 parishes, and 92 villages. The total farmland covered by the study was 606.2 kilometers. Additional information on the state of agricultural development and environmental degradation in the district was solicited from four local government officials via informal interviews. This project has been conducted in collaboration with the international agricultural research institution, Makerere University in Kampala, Uganda. The results of this research can have implications on the way farmers perceive the value of their agricultural residues and what they decide to do with them. The underlying objective is to help smallholders in degraded soils increase their agricultural yields through the use of biochar without diverting the already established uses of agricultural residues to a new soil management practice.

Keywords: agricultural residues, biochar, central Uganda, food security, soil erosion, soil remediation

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Authors: Siddhant Yadav, Ann Vincent, Sanjeev Nanda, Karen M. Fischer, Jessica A. Wright

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Statement of the Problem: Despite the growing popularity of cannabis in the general population, there are several unknowns regarding its use, specific reasons for use, patient’s choice of products, health benefits, and adverse effects. The aim of our study was to evaluate patient-reported information related to cannabis use that was recorded in the electronic medical records. Methodology & Theoretical Orientation: We manually reviewed the electronic medical records of cannabis users who were part of a large pharmacogenomic study. Data abstracted included demographics, level of education, concurrent alcohol and tobacco use, type of cannabis utilized, formulation, indication, symptomatic improvement, or adverse effects reported. Following this, we did a descriptive statistical analysis. Findings: Our sample of 164 cannabis users were predominantly female (73.2%); 66% of users reported using cannabis for medical indications. Of the 109 patients who recorded information pertaining to alcohol/tobacco use, two-thirds of cannabis users reported concurrent use of alcohol, and about half of them were former or current tobacco users. The mean age of cannabis use was 66 years. Regarding the type of cannabis, 34.1% reported using marijuana, 32.3% reported CBD use, 1.8% reported using THC, and 1.2% reported using Marinol. Oral formulations (capsules, oils, suspensions, brownies, cakes, and tea) were the most common route (44 %). Indications for use included chronic pain (n=76), anxiety (n=9), counteracting side effects of chemotherapy (n=4), and palliative reasons (n=2). Fifty-eight of the 76 users endorsed improvement in chronic pain (80%), 5 users reported improvement in anxiety, and 2 reported improvement in side effects of chemotherapy. Conclusion & Significance: The majority of our cannabis users were Caucasian females, and there was a high likelihood of coinciding use of alcohol/tobacco in patients using cannabis. Most of our patients used the oral formulation for chronic pain. Importantly, a considerable number of patients reported improvements in chronic pain, anxiety, and side effects of chemotherapy.

Keywords: cannabis use, adverse effects, medical practice, indications

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Authors: Enes Gunaltili, Burak Dam

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The airplane history started with the Wright brothers' aircraft and improved day by day. With the help of this advancements, big aircrafts replace with small and unmanned air vehicles, so in this study we design this type of air vehicles. First of all, aircrafts mainly divided into two main parts in our day as a rotary and fixed wing aircrafts. The fixed wing aircraft generally use for transport, cargo, military and etc. The rotary wing aircrafts use for same area but there are some superiorities from each other. The rotary wing aircraft can take off vertically from the ground, and it can use restricted area. On the other hand, rotary wing aircrafts generally can fly lower range than fixed wing aircraft. There are one kind of aircraft consist of this two types specifications. It is named as VTOL (vertical take-off and landing) type aircraft. VTOLs are able to takeoff and land vertically and fly horizontally. The VTOL aircrafts generally can fly higher range from the rotary wings but can fly lower range from the fixed wing aircraft but it gives beneficial range between them. There are many other advantages of VTOL aircraft from the rotary and fixed wing aircraft. Because of that, VTOLs began to use for generally military, cargo, search, rescue and mapping areas. Within this framework, this study answers the question that how can we design VTOL as a small unmanned aircraft systems for search and rescue application for benefiting the advantages of fixed wing and rotary wing aircrafts by eliminating the disadvantages of them. To answer that question and design VTOL aircraft, multidisciplinary design optimizations (MDO), some theoretical terminologies, formulations, simulations and modelling systems based on CFD (Computational Fluid Dynamics) is used in same time as design methodology to determine design parameters and steps. As a conclusion, based on tests and simulations depend on design steps, suggestions on how the VTOL aircraft designed and advantages, disadvantages, and observations for design parameters are listed, then VTOL is designed and presented with the design parameters, advantages, and usage areas.

Keywords: airplane, rotary, fixed, VTOL, CFD

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Authors: Sunantha Teyarachakul

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We consider the worker-learning Newsvendor Model, under the case of lost-sales for unmet demand, with the research objective of proposing the cost-minimization order policy and lot size, scheduled to arrive at the beginning of the selling-period. In general, the New Vendor Model is used to find the optimal order quantity for the perishable items such as fashionable products or those with seasonal demand or short-life cycles. Technically, it is used when the product demand is stochastic and available for the single selling-season, and when there is only a one time opportunity for the vendor to purchase, with possibly of long ordering lead-times. Our work differs from the classical Newsvendor Model in that we incorporate the human factor (specifically worker learning) and its influence over the costs of processing units into the model. We describe this by using the well-known Wright’s Learning Curve. Most of the assumptions of the classical New Vendor Model are still maintained in our work, such as the constant per-unit cost of leftover and shortage, the zero initial inventory, as well as the continuous time. Our problem is challenging in the way that the best order quantity in the classical model, which is balancing the over-stocking and under-stocking costs, is no longer optimal. Specifically, when adding the cost-saving from worker learning to such expected total cost, the convexity of the cost function will likely not be maintained. This has called for a new way in determining the optimal order policy. In response to such challenges, we found a number of characteristics related to the expected cost function and its derivatives, which we then used in formulating the optimal ordering policy. Examples of such characteristics are; the optimal order quantity exists and is unique if the demand follows a Uniform Distribution; if the demand follows the Beta Distribution with some specific properties of its parameters, the second derivative of the expected cost function has at most two roots; and there exists the specific level of lot size that satisfies the first order condition. Our research results could be helpful for analysis of supply chain coordination and of the periodic review system for similar problems.

Keywords: inventory management, Newsvendor model, order policy, worker learning

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Authors: Kerry Hull, Mark Wright

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This paper brings light to ethnobotanical medicines used by the Maya of Belize to treat snake bites. The varying ecological zones of Belize boast over fifty species of snakes, nine of which are poisonous and dangerous to humans. Two distinct Maya groups occupy neighboring regions of Belize, the Q’eqchi’ and the Mopan. With Western medical care often far from their villages, what traditional methods are used to treat poisonous snake bites? Based primarily on data gathered with native consultants during the authors’ fieldwork with both groups, this paper details the ethnobotanical resources used by the Q’eqchi’ and Mopan traditional healers. The Q’eqchi’ and Mopan most commonly rely on traditional ‘bush doctors’ (ilmaj in Mopan), both male and female, and specialized ‘snake doctors’ to heal bites from venomous snakes. First, this paper presents each plant employed by healers for bites for the nine poisonous snakes in Belize along with the specific botanical recipes and methods of application for each remedy. Individual chemical and therapeutic qualities of some of those plants are investigated in an effort to explain their possible medicinal value for different toxins or the symptoms caused by those toxins. In addition, this paper explores mythological associations with certain snakes that inform local understanding regarding which plants are considered efficacious in each case, arguing that numerous oral traditions (recorded by the authors) help to link botanical medicines to episodes within their mythic traditions. Finally, the use of plants to counteract snakebites brought about through sorcery is discussed inasmuch as some snakes are seen as ‘helpers’ of sorcerers. Snake bites given under these circumstances can only be cured by those who know both the proper corresponding plant(s) and ritual prayer(s). This paper provides detailed documentation of traditional ethnomedicines and practices from the dying art of traditional Maya healers and argues for multi-faceted diagnostic techniques to determine toxin severity, the presence or absence of sorcery, and the appropriate botanical remedy.

Keywords: ethnobotany, Maya, medicine, snake bites

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Authors: O. Wright, N. Perkins, M. Donn, M. Halstead

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This research responded to anecdotal evidence that suggested inefficiencies within the Architect and Acoustician relationship may lead to ineffective acoustic design decisions.  The acoustician spoken to believed that he was approached too late in the design phase. The approached architect valued acoustical qualities, yet, struggled to interpret common measurement parameters. The preliminary investigation of these opinions indicated a gap in the current New Zealand Architectural discourse and currently informs the creation of a 2016 Master of Architecture (Prof) thesis research. Little meaningful information about acoustic intervention in the early design phase could be found from past literature. In the information that was sourced, authors focus on software as an incorporation tool without investigating why the flaws in the relationship originally exist. To further explore this relationship, a survey was designed. It underwent three phases to ensure its consistency, and was delivered to a group of 51 acousticians from one international Acoustics company. The results were then separated between New Zealand and off-shore to identify trends. The survey results suggest that 75% of acousticians meet the architect less than 5 times per project. Instead of regular contact, a mediated method is adopted though a mix of telecommunication and written reports. Acousticians tend to be introduced later into New Zealand building project than the corresponding off-shore building. This delay corresponds to an increase in remedial action for each of the building types in the survey except Auditoria and Office Buildings. 31 participants have had their specifications challenged by an architect. Furthermore, 71% of the acousticians believe that architects do not have the knowledge to understand why the acoustic specifications are in place. The issues raised in this investigation align to the colloquial evidence expressed by the two consultants. It identifies a larger gap in the industry were acoustics is remedially treated rather than identified as a possible design driver. Further research through design is suggested to understand the role of acoustics within architectural design and potential tools for its inclusion during, not after, the design process.

Keywords: architectural acoustics, early-design, interdisciplinary communication, remedial response

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Authors: Kiatkulchai Jitt-Aer, Graham Wall, Dylan Jones

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As a result of the Indian Ocean tsunami in 2004, logistics applied to disaster relief operations has received great attention in the humanitarian sector. As learned from such disaster, preparing and responding to the aspect of delivering essential items from distribution centres to affected locations are of the importance for relief operations as the nature of disasters is uncertain especially in suffering figures, which are normally proportional to quantity of supplies. Thus, this study proposes a spatial decision support system (SDSS) for humanitarian logistics by integrating Geographical Information Systems (GIS) and the capacitated vehicle routing problem (CVRP). The GIS is utilised for acquiring demands simulated from the tsunami flooding model of the affected area in the first stage, and visualising the simulation solutions in the last stage. While CVRP in this study encompasses designing the relief routes of a set of homogeneous vehicles from a relief centre to a set of geographically distributed evacuation points in which their demands are estimated by using both simulation and randomisation techniques. The CVRP is modeled as a multi-objective optimization problem where both total travelling distance and total transport resources used are minimized, while demand-cost efficiency of each route is maximized in order to determine route priority. As the model is a NP-hard combinatorial optimization problem, the Clarke and Wright Saving heuristics is proposed to solve the problem for the near-optimal solutions. The real-case instances in the coastal area of Phuket, Thailand are studied to perform the SDSS that allows a decision maker to visually analyse the simulation scenarios through different decision factors.

Keywords: demand simulation, humanitarian logistics, geographical information systems, relief operations, capacitated vehicle routing problem

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Authors: Patarasuda Chaisupa, R. Clay Wright

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The selection of appropriate biomolecular targets is a crucial aspect of biopharmaceutical development. The Auxin-Inducible Degron Degradation (AID) technology has demonstrated remarkable potential in efficiently and rapidly degrading target proteins, thereby enabling the identification and acquisition of drug targets. The AID system also offers a viable method to deplete specific proteins, particularly in cases where the degradation pathway has not been exploited or when the adaptation of proteins, including the cell environment, occurs to compensate for the mutation or gene knockout. In this study, we have engineered an improved AID system tailored to deplete proteins of interest. This AID construct combines the auxin-responsive E3 ubiquitin ligase binding domain, AFB2, and the substrate degron, IAA17, fused to the target genes. Essential genes of fungi with the lowest percent amino acid similarity to human and plant orthologs, according to the Basic Local Alignment Search Tool (BLAST), were cloned into the AID construct in S. cerevisiae (AID-tagged strains) using a modular yeast cloning toolkit for multipart assembly and direct genetic modification. Each E3 ubiquitin ligase and IAA17 degron was fused to a fluorescence protein, allowing for real-time monitoring of protein levels in response to different auxin doses via cytometry. Our AID system exhibited high sensitivity, with an EC50 value of 0.040 µM (SE = 0.016) for AFB2, enabling the specific promotion of IAA17::target protein degradation. Furthermore, we demonstrate how this improved AID system enhances quantitative functional studies of various proteins in fungi. The advancements made in auxin-inducible protein degradation in this study offer a powerful approach to investigating critical target protein viability in fungi, screening protein targets for drugs, and regulating intracellular protein abundance, thus revolutionizing the study of protein function underlying a diverse range of biological processes.

Keywords: synthetic biology, bioengineering, molecular biology, biotechnology

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Authors: Komal Khan, Hafsa Zaneb, Saima Masood, Muhammad Younus, Sanan Raza

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Cigarette smoke induces many physiological and pathological changes in respiratory tract like goblet cell hyperplasia and regional distention of airspaces. It is also associated with elevation of inflammatory profiles in different airway compartments. As probiotics are generally known to promote mucosal tolerance, it was postulated that prophylactic use of probiotics can be helpful in reduction of respiratory damage induced by cigarette smoke exposure. Twenty-four adult mice were randomly divided into three groups (cigarette-smoke (CS) group, cigarette-smoke+ Lactobacillus (CS+ P) group, control (Cn) group), each having 8 mice. They were exposed to cigarette smoke for 28 days (6 cigarettes/ day for 6 days/week). Wright-Giemsa staining of bronchoalveolar lavage fluid (BALF) was performed in three mice per group. Tissue samples of trachea and lungs of 7 mice from each group were processed by paraffin embedding technique for haematoxylin & eosin (H & E) and alcian blue- periodic acid-Schiff (AB-PAS) staining. Then trachea (goblet cell number, ratio and loss of cilia) and lungs (airspace distention) were studied. The results showed that the number of goblet cells was increased in CS group as a result of defensive mechanism of the respiratory system against irritating substances. This study also revealed that the cells of CS group having acidic glycoprotein were found to be higher in quantity as compared to those containing neutral glycoprotein. However, CS + P group showed a decrease in goblet cell index due to enhanced immunity by prophylactically used probiotics. Moreover, H & E stained tracheas showed significant loss of cilia in CS group due to propelling of mucous but little loss in CS + P group because of having good protective tracheal epithelium. In lungs, protection of airspaces was also much more evident in CS+ P group as compared to CS group having distended airspaces, especially at 150um distance from terminal bronchiole. In addition, a comprehensive analysis of inflammatory cells population of BALF showed neutrophilia and eosinophilia was significantly reduced in CS+ P group. This study proved that probiotics are found to be useful for reduction of changes in micro-architecture of the respiratory system. Thus, dietary supplementation of probiotic as prophylactic measure can be useful in achieving immunomodulatory effects.

Keywords: cigarette smoke, probiotics, goblet cells, airspace enlargement, BALF

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Authors: H. Arzani, Z. Arzani

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

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

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Authors: J. N. Bardi, N. Wright, S. Timmons, P. Crawford

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Introduction: In the United Kingdom (UK), the transfer of care from the asylums to the community has meant that some people with mental health problems (MHP) may not have access to suitable or adequate statutory community mental health services (CMHS). However, in addition to statutory CMHS, there are informal CMHS that provide spaces where people with MHP can attend such as faith communities, clubhouses, user-led organisations, day centres including drop-in-centres and community hubs and community mental health cafés (CMHCs). Aim: To qualitatively understand what happens in a community mental health café in relation to the place, people and processes, from the participant's perspective. Methodology: Ethnography Methods: Data collection will be field notes from observations written as thick description and interviews with participants. Data analysis will be thematic and narrative analysis. Relevance: The study seeks to observe what happens in a user-led community mental health café and explore if it provides the services that it claims to offer. Therefore, a literature review was conducted to examine the research evidence related to informal CMHS, focusing on similarities and differences. Results indicated that informal CMHS differ with regards to why, how, who set them up and who funds them, but they are similar because people with MHP who attend them report related psychological, vocational, and social interaction benefits. In addition to the differences listed above, CMHCs differ in their adoption of the commercial café model of social space and some CMHCs claim to address needs of social isolation and loneliness which they assert are not properly addressed by statutory CMHS and some informal CMHS. Therefore, CMHCs explicitly differentiate themselves from statutory CMHS and some informal CMHS such as day centres, hospitals and social services. However, CMHCs were found to be like drop-in-centres and community hubs which are also free for MHP to attend without the need for assessments, membership or appointments. To situate community mental health café within other informal CMHS and provide a rationale for the proposed study a scoping review was conducted to determine the scope of available research evidence on CMHCs. Findings from the scoping review reflected the literature review findings with regards to the benefits of attending informal CMHCs for people with MHP. Of the ten studies included in the scoping review, seven were on CMHCs for people living with dementia and two were on CMHCs for people with a broader range of MHP. The researcher hopes that findings from the proposed PhD study will build on the existing understanding of informal CMHS, extend the research evidence on CMHCs and address any gap in the literature.

Keywords: cafe, community, ethnography, mental health

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Authors: Eszter J. Tóth, Alexandra Hoffmann, Csaba Vágvölgyi, Tamás Papp

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Members of the genera Curvularia and Bipolaris are closely related melanin producing filamentous fungi; both of them have the teleomorph states in genus Cochliobolus. While Bipolaris species infect only plants and may cause serious agriculture damages, some Curvularia species was recovered from opportunistic human infections. The human pathogenic species typically cause phaeohyphomycoses, i.e. mould infections caused by melanised fungi, which can manifest as invasive mycoses with frequent involvement of the central nervous system in immunocompromised patients or as local infections (e.g. keratitis, sinusitis, and cutaneous lesions) in immunocompetent people. Although their plant-fungal interactions have been intensively studied, there is only little information available about the human pathogenic feature of these fungi. The aim of this study was to investigate the neutrophil granulocytes’ response to hyphal forms of Curvularia and Bipolaris in comparison with the response to Aspergillus. In the present study Curvularia lunata SZMC 23759 and Aspergillus fumigatus SZMC 23245 both isolated from human eye infection, and Bipolaris zeicola BRIP 19582b isolated from plant leaf were examined. Neutrophils were isolated from heparinised venous blood of healthy donors with dextran sedimentation followed by centrifugation over Ficoll and hypotonic lysis of erythrocytes. Viability and purity of the cells were checked with trypan blue and Wright staining, respectively. Infection of neutrophils was carried out with germinated conidia in a ratio of 5:1. Production of hydrogen peroxide, superoxide anion, and nitrogen monoxide was measured both intracellularly and extracellularly in response to the germinated spores with or without the supernatant and after serum treatment. ROS and NOS production of neutrophils in interaction with the three fungi were compared. It is already known that Aspergillus species induce ROS production of neutrophils only after serum treatment. Although, in case of C. lunata, serum opsonisation also induced an intensive production of reactive species, lower level of production was measured in the lack of serum as well. After interaction with the plant pathogenic B. zeicola, amount of reactive species found to be similar with and without serum treatment. The presence of germination supernatant decreased the reactive species production in case of each fungus. Interaction with Curvularia, Bipolaris and Aspergillus species induced different response of neutrophils. It seems that recognition of C. lunata and B. zeicola is independent of serum opsonisation, albeit it increases the level of the produced reactive species in response for C. lunata. The study was supported by the grant LP2016-8/2016.

Keywords: Curvularia, neutrophils, NOS, ROS, serum opsonisation

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Jennifer Wright

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The recent rise of powerful terrorist groups such as ISIS and Al-Qaeda brings up concerns about nuclear terrorism as well as a focus on nuclear security, specifically the physical security of nuclear weapons and fissile material storage sites in countries where powerful nonstate actors are present. Particularly because these non-state actors, who lack their own sovereign territory, cannot be ‘deterred’ in the traditional sense. In light of the current threat environment, it’s necessary to now rethink these strategies in the 21st century – a multipolar world with the presence of powerful non-state actors. As a country in the spotlight for its low ranking on the Nuclear Threat Initiative’s (NTI) Nuclear Security Index, Pakistan is a relevant example to explore the question of whether the presence of non-state actors poses a real risk to nuclear security today. It’s necessary to take a look at their nuclear security policies to determine if they’re robust enough to deal with political instability and violence in the country. After carrying out interviews with experts in May 2017 in Islamabad on nuclear security and nuclear terrorism, this paper aims to highlight findings by providing a Pakistan-centric view on the subject and give experts there a chance to counter criticism. Western media would have us fearful of nuclear security mechanisms in Pakistan after reports that areas such as cybersecurity and accounting and control of materials are weak, as well as sensitive nuclear material being transported in unmarked, unguarded vehicles. Also reported are cases where terrorist groups carried out targeted attacks against Pakistani military bases or secure sites where nuclear material is stored. One specific question asked of each interviewee in Islamabad was Do you feel the threat of nuclear terrorism calls into question the reliance on deterrence? Their responses will be elaborated on in the longer paper, but overall they demonstrate views that deterrence still serves a purpose for state-to-state security strategy, but not for a state in countering nonstate threats. If nuclear security is lax enough for these non-state actors to get their hands on either an intact nuclear weapon or enough military-grade fissile material to build a nuclear weapon, then what would stop them from launching a nuclear attack? As deterrence is a state-centric strategy, it doesn’t work to deter non-state actors from carrying out an attack on another state, as they lack their own territory, and as such, are not fearful of a reprisal attack. Deterrence will need to be addressed, and its relevance analyzed to determine its utility in the current security environment. The aim of this research is to demonstrate the real risk of nuclear terrorism by pointing to weaknesses in global nuclear security, particularly in Pakistan. The research also aims to provoke thought on the weaknesses of deterrence as a whole. Original thinking is needed as we attempt to adequately respond to the 21st century’s current threat environment.

Keywords: deterrence, non-proliferation, nuclear security, nuclear terrorism

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Authors: Donald Wright

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The ultimate goal of this study is to reinvigorate the philosophical underpinnings the study of urbanization with scientific data with the goal of circumventing what seems an inevitable future clash between rural and urban populations. To that end urban infrastructure must be sustainable economically, politically and ecologically over the course of several generations as cities continue to grow with the incorporation of climate refugees. Our research will provide data concerning the projected increase in population over the coming two decades in Morocco, and the population will shift from rural areas to urban centers during that period of time. As a result, urban infrastructure will need to be adapted, developed or built to fit the demand of future internal migrations from rural to urban centers in Morocco. This paper will also examine how past experiences of internally displaced people give insight into the challenges faced by future migrants and, beyond the gathering of data, how people react to internal migration. This study employs four different sets of research tools. First, a large part of this study is archival, which involves compiling the relevant literature on the topic and its complex history. This step also includes gathering data bout migrations in Morocco from public data sources. Once the datasets are collected, the next part of the project involves populating the attribute fields and preprocessing the data to make it understandable and usable by machine learning algorithms. In tandem with the mathematical interpretation of data and projected migrations, this study benefits from a theoretical understanding of the critical apparatus existing around urban development of the 20th and 21st centuries that give us insight into past infrastructure development and the rationale behind it. Once the data is ready to be analyzed, different machine learning algorithms will be experimented (k-clustering, support vector regression, random forest analysis) and the results compared for visualization of the data. The final computational part of this study involves analyzing the data and determining what we can learn from it. This paper helps us to understand future trends of population movements within and between regions of North Africa, which will have an impact on various sectors such as urban development, food distribution and water purification, not to mention the creation of public policy in the countries of this region. One of the strengths of this project is the multi-pronged and cross-disciplinary methodology to the research question, which enables an interchange of knowledge and experiences to facilitate innovative solutions to this complex problem. Multiple and diverse intersecting viewpoints allow an exchange of methodological models that provide fresh and informed interpretations of otherwise objective data.

Keywords: climate change, machine learning, migration, Morocco, urban development

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Authors: Mohammed AL-Hasani

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The Pandemic COVID-19 altered the daily habits and affected the functional performance of the cities after this crisis leaving remarkable impacts on many metropolises worldwide. It is so obvious that having more densification in the city leads to more threats altering this main approach that was called for achieving sustainable development. The main goal to achieve resiliency in the cities, especially in forcing risks, is to deal with a planning system that is able to resist, absorb, accommodate and recover from the impacts that had been affected. Many Cities in London, Wuhan, New York, and others worldwide carried different planning approaches and varied in reaction to safeguard the impacts of the pandemic. The cities globally varied from the radiant pattern predicted by Le Corbusier, or having multi urban centers more like the approach of Frank Lloyd Wright’s Broadacre City, or having linear growth or gridiron expansion that was common by Doxiadis, compact pattern, and many other hygiene patterns. These urban patterns shape the spatial distribution and Identify both open and natural spaces with gentrified and gentrifying areas. This crisis paid attention to reassess many planning approaches and examine the existing urban patterns focusing more on the aim of continuity and resiliency in managing the crises within the rapid transformation and the power of market forces. According to that, this paper hypothesized that those urban planning patterns determine the method of reaction in assuring quarantine for the inhabitance and the performance of public services and need to be updated through carrying out an innovative urban management system and adopt further resilience patterns in prospective urban planning approaches. This paper investigates the adaptivity and resiliency of variant urban planning patterns regarding selected cities worldwide that affected by COVID-19 and their role in applying certain management strategies in controlling the pandemic spread, finding out the main potentials that should be included in prospective planning approaches. The examination encompasses the spatial arrangement, blocks definition, plots arrangement, and urban space typologies. This paper aims to investigate the urban patterns to deliberate also the debate between densification as one of the more sustainable planning approaches and disaggregation tendency that was followed after the pandemic by restructuring and managing its application according to the assessment of the spatial distribution and urban patterns. The biggest long-term threat to dense cities proves the need to shift to online working and telecommuting, creating a mixture between using cyber and urban spaces to remobilize the city. Reassessing spatial design and growth, open spaces, urban population density, and public awareness are the main solutions that should be carried out to face the outbreak in our current cities that should be managed from global to tertiary levels and could develop criteria for designing the prospective cities

Keywords: COVID-19, densification, resiliency, urban patterns

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Authors: Laura Villamizar, David Wright, Claudia Baena, Marie Foxwell, Maureen O'Callaghan

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Leguminous crops can be self-sufficient for their nitrogen requirements when their roots are nodulated with an effective Rhizobium strain and for this reason seed or soil inoculation is practiced worldwide to ensure nodulation and nitrogen fixation in grain and forage legumes. The most widely used method of applying commercially available inoculants is using peat cultures which are coated onto seeds prior to sowing. In general, rhizobia survive well in peat, but some species die rapidly after inoculation onto seeds. The development of improved formulation methodology is essential to achieve extended persistence of rhizobia on seeds, and improved efficacy. Formulations could be solid or liquid. Most popular solid formulations or delivery systems are: wettable powders (WP), water dispersible granules (WG), and granules (DG). Liquid formulation generally are: suspension concentrates (SC) or emulsifiable concentrates (EC). In New Zealand, R. leguminosarum bv. trifolii strain TA1 has been used as a commercial inoculant for white clover over wide areas for many years. Seeds inoculation is carried out by mixing the seeds with inoculated peat, some adherents and lime, but rhizobial populations on stored seeds decline over several weeks due to a number of factors including desiccation and antibacterial compounds produced by the seeds. In order to develop a more stable and suitable delivery system to incorporate rhizobia in pastures, two strains of R. leguminosarum (TA1 and CC275e) and several formulations and processes were explored (peat granules, self-sticky peat for seed coating, emulsions and a powder containing spray dried microcapsules). Emulsions prepared with fresh broth of strain TA1 were very unstable under storage and after seed inoculation. Formulations where inoculated peat was used as the active ingredient were significantly more stable than those prepared with fresh broth. The strain CC275e was more tolerant to stress conditions generated during formulation and seed storage. Peat granules and peat inoculated seeds using strain CC275e maintained an acceptable loading of 108 CFU/g of granules or 105 CFU/g of seeds respectively, during six months of storage at room temperature. Strain CC275e inoculated on peat was also microencapsulated with a natural biopolymer by spray drying and after optimizing operational conditions, microparticles containing 107 CFU/g and a mean particle size between 10 and 30 micrometers were obtained. Survival of rhizobia during storage of the microcapsules is being assessed. The development of a stable product depends on selecting an active ingredient (microorganism), robust enough to tolerate some adverse conditions generated during formulation, storage, and commercialization and after its use in the field. However, the design and development of an adequate formulation, using compatible ingredients, optimization of the formulation process and selecting the appropriate delivery system, is possibly the best tool to overcome the poor survival of rhizobia and provide farmers with better quality inoculants to use.

Keywords: formulation, Rhizobium leguminosarum, storage stability, white clover

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Authors: Amber Hatch, Eric Wright, Feihong Wang

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Research suggests that attachment in close relationships affects one’s emotional processes, mindfulness, conflict-management behaviors, and interpersonal interactions. Attachment insecurity is often associated with maladaptive social interactions and suboptimal relationship qualities. Past studies have considered how the nature of emotion regulation and mindfulness in teachers may be related to student or classroom outcomes. Still, no research has examined how the relationship between such internal experiences and classroom management outcomes may also be related to teachers’ attachment insecurity. This study examined the interrelationships between teachers’ attachment insecurity, mindfulness tendencies, emotion regulation abilities, and classroom management efficacy as indexed by students’ classroom behavior and teachers’ response effectiveness. Teachers’ attachment insecurity was evaluated using the global ECRS-SF, which measures both attachment anxiety and avoidance. The present study includes a convenient sample of 357 American elementary school teachers who responded to a survey regarding their classroom management efficacy, attachment in/security, dispositional mindfulness, emotion regulation strategies, and difficulties in emotion regulation, primarily assessed via pre-existing instruments. Good construct validity was demonstrated for all scales used in the survey. Sample demographics, including gender (94% female), race (92% White), age (M = 41.9 yrs.), years of teaching experience (M = 15.2 yrs.), and education level were similar to the population from which it was drawn, (i.e., American elementary school teachers). However, white women were slightly overrepresented in our sample. Correlational results suggest that teacher attachment insecurity is associated with poorer classroom management efficacy as indexed by students’ disruptive behavior and teachers’ response effectiveness. Attachment anxiety was a much stronger predictor of adverse student behaviors and ineffective teacher responses to adverse behaviors than attachment avoidance. Mindfulness, emotion regulation abilities, and years of teaching experience predicted positive classroom management outcomes. Attachment insecurity and mindfulness were more strongly related to frequent adverse student behaviors, while emotion regulation abilities were more strongly related to teachers’ response effectiveness. The teaching experience was negatively related to attachment insecurity and positively related to mindfulness and emotion regulation abilities. Although the data were cross-sectional, path analyses revealed that attachment insecurity is directly related to classroom management efficacy. Through two routes, this relationship is further mediated by emotion regulation and mindfulness in teachers. The first route of indirect effect suggests double mediation by teacher’s emotion regulation and then teacher mindfulness in the relationship between teacher attachment insecurity and classroom management efficacy. The second indirect effect suggests mindfulness directly mediated the relationship between attachment insecurity and classroom management efficacy, resulting in improved model fit statistics. However, this indirect effect is much smaller than the double mediation route through emotion regulation and mindfulness in teachers. Given the significant predication of teacher attachment insecurity, mindfulness, and emotion regulation on teachers’ classroom management efficacy both directly and indirectly, the authors recommend improving teachers’ classroom management efficacy via a three-pronged approach aiming at enhancing teachers’ secure attachment and supporting their learning adaptive emotion regulation strategies and mindfulness techniques.

Keywords: Classroom management efficacy, student behavior, teacher attachment, teacher emotion regulation, teacher mindfulness

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Authors: Breanna Wright, Peter Bragge

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Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.

Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error

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Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper

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Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.

Keywords: patient safety, quality improvement, serious incidents, falls, clinical care

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Authors: Nancy Mackin

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Historically, architects from Aalto to Gaudi to Wright have looked to the architectural knowledge of long-resident peoples for forms and structural principles specifically adapted to the regional climate, geology, materials availability, and culture. In this research, structures traditionally built by Inuit peoples in a remote region of the Canadian high Arctic provides a folio of architectural ideas that are increasingly relevant during these times of escalating carbon emissions and climate change. ‘Green architecture from the Thawing Arctic’ researches, draws, models, and reconstructs traditional buildings of Inuit (Eskimo) peoples in three remote, often inaccessible Arctic communities. Structures verified in pre-contact oral history and early written history are first recorded in architectural drawings, then modeled and, with the participation of Inuit young people, local scientists, and Elders, reconstructed as emergency shelters. Three full-sized building types are constructed: a driftwood and turf-clad A-frame (spring/summer); a stone/bone/turf house with inwardly spiraling walls and a fan-shaped floor plan (autumn); and a parabolic/catenary arch-shaped dome from willow, turf, and skins (autumn/winter). Each reconstruction is filmed and featured in a short video. Communities found that the reconstructed buildings and the method of involving young people and Elders in the reconstructions have on-going usefulness, as follows: 1) The reconstructions provide emergency shelters, particularly needed as climate change worsens storms, floods, and freeze-thaw cycles and scientists and food harvesters who must work out of the land become stranded more frequently; 2) People from the communities re-learned from their Elders how to use materials from close at hand to construct impromptu shelters; 3) Forms from tradition, such as windbreaks at entrances and using levels to trap warmth within winter buildings, can be adapted and used in modern community buildings and housing; and 4) The project initiates much-needed educational and employment opportunities in the applied sciences (engineering and architecture), construction, and climate change monitoring, all offered in a culturally-responsive way. Elders, architects, scientists, and young people added innovations to the traditions as they worked, thereby suggesting new sustainable, culturally-meaningful building forms and materials combinations that can be used for modern buildings. Adding to the growing interest in bio-mimicry, participants looked at properties of Arctic and subarctic materials such as moss (insulation), shrub bark (waterproofing), and willow withes (parabolic and catenary arched forms). ‘Green Architecture from the Thawing Arctic’ demonstrates the effective, useful architectural oeuvre of a resilient northern people. The research parallels efforts elsewhere in the world to revitalize long-resident peoples’ architectural knowledge, in the interests of designing sustainable buildings that reflect culture, heritage, and identity.

Keywords: architectural culture and identity, climate change, forms from nature, Inuit architecture, locally sourced biodegradable materials, traditional architectural knowledge, traditional Inuit knowledge

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Authors: Georgina Cherry, Taranpreet Rai, Luke Boyden, Sitira Williams, Andrea Wright, Richard Brown, Viva Chu, Alasdair Cook, Kevin Wells

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Estimating population-level burden, abilities of pet-parents to identify disease and demand for veterinary services worldwide is challenging. The purpose of this study is to compare a feline pruritus survey with social media listening (SML) data discussing this condition. Surveys are expensive and labour intensive to analyse, but SML data is freeform and requires careful filtering for relevancy. This study considers data from a survey of owner-observed symptoms of 156 pruritic cats conducted using Pet Parade® and SML posts collected through web-scraping to gain insights into the characterisation and management of feline pruritus. SML posts meeting a feline body area, behaviour and symptom were captured and reviewed for relevance representing 1299 public posts collected from 2021 to 2023. The survey involved 1067 pet-parents who reported on pruritic symptoms in their cats. Among the observed cats, approximately 18.37% (n=196) exhibited at least one symptom. The most frequently reported symptoms were hair loss (9.2%), bald spots (7.3%) and infection, crusting, scaling, redness, scabbing, scaling, or bumpy skin (8.2%). Notably, bald spots were the primary symptom reported for short-haired cats, while other symptoms were more prevalent in medium and long-haired cats. Affected body areas, according to pet-parents, were primarily the head, face, chin, neck (27%), and the top of the body, along the spine (22%). 35% of all cats displayed excessive behaviours consistent with pruritic skin disease. Interestingly, 27% of these cats were perceived as non-symptomatic by their owners, suggesting an under-identification of itch-related signs. Furthermore, a significant proportion of symptomatic cats did not receive any skin disease medication, whether prescribed or over the counter (n=41). These findings indicate a higher incidence of pruritic skin disease in cats than recognized by pet owners, potentially leading to a lack of medical intervention for clinically symptomatic cases. The comparison between the survey and social media listening data revealed bald spots were reported in similar proportions in both datasets (25% in the survey and 28% in SML). Infection, crusting, scaling, redness, scabbing, scaling, or bumpy skin accounted for 31% of symptoms in the survey, whereas it represented 53% of relevant SML posts (excluding bumpy skin). Abnormal licking or chewing behaviours were mentioned by pet-parents in 40% of SML posts compared to 38% in the survey. The consistency in the findings of these two disparate data sources, including a complete overlap in affected body areas for the top 80% of social media listening posts, indicates minimal biases in each method, as significant biases would likely yield divergent results. Therefore, the strong agreement across pruritic symptoms, affected body areas, and reported behaviours enhances our confidence in the reliability of the findings. Moreover, the small differences identified between the datasets underscore the valuable insights that arise from utilising multiple data sources. These variations provide additional depth in characterising and managing feline pruritus, allowing for more comprehensive understanding of the condition. By combining survey data and social media listening, researchers can obtain a nuanced perspective and capture a wider range of experiences and perspectives, supporting informed decision-making in veterinary practice.

Keywords: social media listening, feline pruritus, surveys, felines, cats, pet owners

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