Search results for: G. Infante Dennis

Authors: Adriana C. Panayi, Riaz A. Agha, Brady A. Sieber, Dennis P. Orgill

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Background: Increased rates of both breast cancer and obesity have resulted in more women seeking breast reconstruction. These women may be at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who have undergone breast reconstruction following mastectomy. Methods: Cochrane, PUBMED and EMBASE electronic databases were screened and data was extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate and patient satisfaction. Results: 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71368 patients, 20061 of which were obese). Obese women were 2.3 times more likely to experience surgical complications (95 percent CI 2.19 to 2.39; P < 0.00001), 2.8 times more likely to have medical complications (95 percent CI 2.41 to 3.26; P < 0.00001) and had a 1.9 times higher risk of reoperation (95 percent CI 1.75 to 2.07; P < 0.00001). The most common complication, wound dehiscence, was 2.5 times more likely in obese women (95 percent CI 1.80 to 3.52; P < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (RR 2.36, 95% CI 2.22–2.52; P < 0.00001). Conclusions: This study provides evidence that obesity increases the risk of complications in both implant and autologous reconstruction. Additional prospective and observational studies are needed to determine if weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.

Keywords: autologous reconstruction, breast cancer, breast reconstruction, literature review, obesity, oncology, prosthetic reconstruction

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Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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Authors: Nathen A. Spitz, Dennis Martin Kivlighan III, Arwa Aburizik

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Background and Purpose: Presently, there is a paucity of naturalistic studies that directly compare the effectiveness of psychotherapy versus concurrent psychotherapy and psychiatric care for the treatment of depression and anxiety in cancer patients. Informed by previous clinical trials examining the efficacy of concurrent approaches, this study sought to test the hypothesis that a combined approach would result in the greatest reduction of depression and anxiety symptoms. Methods: Data for this study consisted of 433 adult cancer patients, with 252 receiving only psychotherapy and 181 receiving concurrent psychotherapy and psychiatric care at the University of Iowa Hospitals and Clinics. Longitudinal PHQ9 and GAD7 data were analyzed between both groups using latent growth curve analyses. Results: After controlling for treatment length and provider effects, results indicated that concurrent care was more effective than psychotherapy alone for depressive symptoms (γ₁₂ = -0.12, p = .037). Specifically, the simple slope for concurrent care was -0.25 (p = .022), and the simple slope for psychotherapy alone was -0.13 (p = .006), suggesting that patients receiving concurrent care experienced a greater reduction in depressive symptoms compared to patients receiving psychotherapy alone. In contrast, there were no significant differences between psychotherapy alone and concurrent psychotherapy and psychiatric care in the reduction of anxious symptoms. Conclusions: Overall, as both psychotherapy and psychiatric care may address unique aspects of mental health conditions, in addition to potentially providing synergetic support to each other, a combinatorial approach to mental healthcare for cancer patients may improve outcomes.

Keywords: psychiatry, psychology, psycho-oncology, combined care, psychotherapy, behavioral psychology

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Authors: Claus Bier, Dennis Binder, Alexander Gruenberger, Dagmar Drobietz, Dietrich Kohlheyer, Anita Loeschcke, Karl Erich Jaeger, Thomas Drepper, Joerg Pietruszka

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Light absorbing chromophoric systems are important optogenetic tools for biotechnical and biophysical investigations. Processes such as fluorescence or photolysis can be triggered by light-absorption of chromophores. These play a central role in life science. Photocaged compounds belong to such chromophoric systems. The photo-labile protecting groups enable them to release biologically active substances with high temporal and spatial resolution. The properties of photocaged compounds are specified by the characteristics of the caging group as well as the characteristics of the linked effector molecule. In our research, we work with different types of photo-labile protecting groups and various effector molecules giving us possible access to a large library of caged compounds. As a function of the caged effector molecule, a nearly limitless number of biological systems can be directed. Our main interest focusses on photocaging carbohydrates (e.g. arabinose) and their derivatives as effector molecules. Based on these resulting photocaged compounds a precisely controlled photoinduced gene expression will give us access to studies of numerous biotechnological and synthetic biological applications. It could be shown, that the regulation of gene expression via light is possible with photocaged carbohydrates achieving a higher-order control over this processes. With the one-step cleavable photocaged carbohydrate, a homogeneous expression was achieved in comparison to free carbohydrates.

Keywords: bacterial gene expression, biotechnology, caged compounds, carbohydrates, optogenetics, photo-removable protecting group

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Authors: Riaz A. Agha, Ishani Barai, Shivanchan Rajmohan, Seon Lee, Mohammed O. Anwar, Alex J. Fowler, Dennis P. Orgill, Douglas G. Altman

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Introduction: Medical knowledge is growing fast. Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. Methods: A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results were compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. Results: 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047 to 8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the journals (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). Conclusion: The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. This will allow peer-reviewers to focus on what is present, not what is missing, raising the level of scholarly discourse between authors and the scientific community and reducing frustration amongst readers.

Keywords: CONSORT, guide for authors, PRISMA, reporting guidelines, journal impact factor, citation analysis

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Authors: Riaz A. Agha, Alexander J. Fowler, Seon-Young Lee, Buket Gundogan, Katharine Whitehurst, Harkiran K. Sagoo, Kyung Jin Lee Jeong, Douglas G. Altman, Dennis P. Orgill

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Introduction: Case Series are an important and common study type. Currently, no guideline exists for reporting case series and there is evidence of key data being missed from such reports. We propose to develop a reporting guideline for case series using a methodologically robust technique. The first step in this process is a systematic review of literature relevant to the reporting deficiencies of case series. Methods: A systematic review of methodological and reporting quality in surgical case series was performed. The electronic search strategy was developed by an information specialist and included MEDLINE, EMBASE, Cochrane Methods Register, Science Citation index and Conference Proceedings Citation index, from the start of indexing until 5th November 2014. Independent screening, eligibility assessments and data extraction was performed. Included articles were analyzed for five areas of deficiency: failure to use standardized definitions missing or selective data transparency or incomplete reporting whether alternate study designs were considered. Results: The database searching identified 2,205 records. Through the process of screening and eligibility assessments, 92 articles met inclusion criteria. Frequency of methodological and reporting issues identified was a failure to use standardized definitions (57%), missing or selective data (66%), transparency, or incomplete reporting (70%), whether alternate study designs were considered (11%) and other issues (52%). Conclusion: The methodological and reporting quality of surgical case series needs improvement. Our data shows that clear evidence-based guidelines for the conduct and reporting of a case series may be useful to those planning or conducting them.

Keywords: case series, reporting quality, surgery, systematic review

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Authors: Dennis Schmickle

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Introductory statement: Augmented reality (AR) can be used to breathe life into traditional graphic design media, such as posters, book covers, and album art. AR superimposes a unique image/video on a user’s view of the real world, which makes it more immersive and realistic than traditional 2D media. This study developed a series of projects that utilize both traditional and AR media to teach the fundamental principles of graphic design. The results of this study suggest that AR can be an effective tool for teaching graphic design. Abstract: Traditional graphic design media, such as posters, book covers, and album art, could be considered to be “old media.” However, augmented reality (AR) can breathe life into these formats by making them more interactive and engaging for students and audiences alike. AR is a technology that superimposes a computer-generated image on a user’s view of the real world. This allows users to interact with digital content in a way that is more immersive and interactive than traditional 2D media. AR is becoming increasingly popular, as more and more people have access to smartphones and other devices that can support AR experiences. This study is comprised of a series of projects that utilize both traditional and AR media to teach the fundamental principles of graphic design. In these projects, students learn to create traditional design objects, such as posters, book covers, and album art. However, they are also required to create an animated version of their design and to use AR software to create an AR experience with which viewers can interact. The results of this study suggest that AR can be an effective and exciting tool for teaching graphic design. The students who participated in the study were able to learn the fundamental principles of graphic design, and they also developed the skills they need to create effective AR content. This study has implications for the future of graphic design education. As AR becomes more popular, it is likely that it will become an increasingly important tool for teaching graphic design.

Keywords: graphic design, augmented reality, print media, new media, AR, old media

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Authors: F. Infante, W. Kaal, S. Perfetto, S. Herold

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In the last decade the demand of wireless sensors and low-power electric devices for condition monitoring in mechanical structures has been strongly increased. Networks of wireless sensors can potentially be applied in a huge variety of applications. Due to the reduction of both size and power consumption of the electric components and the increasing complexity of mechanical systems, the interest of creating dense nodes sensor networks has become very salient. Nevertheless, with the development of large sensor networks with numerous nodes, the critical problem of powering them is drawing more and more attention. Batteries are not a valid alternative for consideration regarding lifetime, size and effort in replacing them. Between possible alternative solutions for durable power sources useable in mechanical components, vibrations represent a suitable source for the amount of power required to feed a wireless sensor network. For this purpose, energy harvesting from structural vibrations has received much attention in the past few years. Suitable vibrations can be found in numerous mechanical environments including automotive moving structures, household applications, but also civil engineering structures like buildings and bridges. Similarly, a dynamic vibration absorber (DVA) is one of the most used devices to mitigate unwanted vibration of structures. This device is used to transfer the primary structural vibration to the auxiliary system. Thus, the related energy is effectively localized in the secondary less sensitive structure. Then, the additional benefit of harvesting part of the energy can be obtained by implementing dedicated components. This paper describes the design process of an energy harvesting tuned vibration absorber (EHTVA) for rotating systems using piezoelectric elements. The energy of the vibration is converted into electricity rather than dissipated. The device proposed is indeed designed to mitigate torsional vibrations as with a conventional rotational TVA, while harvesting energy as a power source for immediate use or storage. The resultant rotational multi degree of freedom (MDOF) system is initially reduced in an equivalent single degree of freedom (SDOF) system. The Den Hartog’s theory is used for evaluating the optimal mechanical parameters of the initial DVA for the SDOF systems defined. The performance of the TVA is operationally assessed and the vibration reduction at the original resonance frequency is measured. Then, the design is modified for the integration of active piezoelectric patches without detuning the TVA. In order to estimate the real power generated, a complex storage circuit is implemented. A DC-DC step-down converter is connected to the device through a rectifier to return a fixed output voltage. Introducing a big capacitor, the energy stored is measured at different frequencies. Finally, the electromechanical prototype is tested and validated achieving simultaneously reduction and harvesting functions.

Keywords: energy harvesting, piezoelectricity, torsional vibration, vibration absorber

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Authors: Daniel Osieko Okach, Joseph Otieno Ondier, Gerhard Rambold, John Tenhunen, Bernd Huwe, Dennis Otieno

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Increased human activities such as grazing, logging, and agriculture alongside unpredictable rainfall patterns have been detrimental to the ecosystem service delivery, therefore compromising its productivity potential. This study aimed at simulating the impact of drought (50%) and enhanced rainfall (150%) on the future herbaceous CO2 uptake, biomass production and soil C:N dynamics in a humid savanna ecosystem influenced by livestock grazing. Rainfall pattern was predicted using manipulation experiments set up to reduce (50%) and increase (150%) ambient (100%) rainfall amounts in grazed and non-grazed plots. The impact of manipulated rainfall regime on herbaceous CO2 fluxes, biomass production and soil C:N dynamics was measured against volumetric soil water content (VWC) logged every 30 minutes using the 5TE (Decagon Devices Inc., Washington, USA) soil moisture sensors installed (at 20 cm soil depth) in every plots. Herbaceous biomass was estimated using destructive method augmented by standardized photographic imaging. CO2 fluxes were measured using the ecosystem chamber method and the gas analysed using LI-820 gas analyzer (USA). C:N ratio was calculated from the soil carbon and Nitrogen contents (analyzed using EA2400CHNS/O and EA2410 N elemental analyzers respectively) of different plots under study. The patterning of VWC was directly influenced by the rainfall amount with lower VWC observed in the grazed compared to the non-grazed plots. Rainfall variability, grazing and their interaction significantly affected changes in VWC (p < 0.05) and subsequently total biomass and CO2 fluxes. VWC had a strong influence on CO2 fluxes under 50% rainfall reduction in the grazed (r2 = 0.91; p < 0.05) and ambient rainfall in the ungrazed (r2 = 0.77; p < 0.05). The dependence of biomass on VWC across plots was enhanced under grazed (r2 = 0.78 - 0.87; p < 0.05) condition as compared to ungrazed (r2 = 0.44 - 0.85; p < 0.05). The C:N ratio was however not correlated to VWC across plots. This study provides insight on how the predicted trends in humid savanna will respond to changes influenced by rainfall variability and livestock grazing and consequently the sustainable management of such ecosystems.

Keywords: CO2 fluxes, rainfall manipulation, soil properties, sustainability

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Authors: Turki J. Alharbi, Jencia Wong, Dennis Yue, Tania P. Markovic, Julie Hetherington, Ted Wu, Belinda Brooks, Radhika Seimon, Alice Gibson, Stephanie L. Silviera, Amanda Sainsbury, Tanya J. Little

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Fasting has been practiced for centuries and is incorporated into the practices of different religions including Islam, whose followers intermittently fast throughout the month of Ramadan. Thus, Ramadan presents a unique model of prolonged intermittent fasting (IF). Despite a growing body of evidence for a cardio-metabolic and endocrine benefit of IF, detailed studies of the effects of IF on these indices in type 2 diabetes are scarce. We studied 5 subjects with type 2 diabetes (T2DM) and 7 healthy controls (C) at baseline (pre), and in the last week of Ramadan (post). Fasting circulating levels of glucose, HbA1c and lipids, as well as body composition (with DXA) and resting energy expenditure (REE) were measured. Plasma gut hormone levels and appetite responses to a mixed meal were also studied. Data are means±SEM. Ramadan decreased total fat mass (-907±92 g, p=0.001) and trunk fat (-778±190 g, p=0.014) in T2DM but not in controls, without any reductions in lean mass or REE. There was a trend towards a decline in plasma FFA in both groups. Ramadan had no effect on body weight, glycemia, blood pressure, or plasma lipids in either group. In T2DM only, the area under the curve for post-meal plasma ghrelin concentrations increased after Ramadan (pre:6632±1737 vs. post:9025±2518 pg/ml.min-1, p=0.045). Despite this increase in orexigenic ghrelin, subjective appetite scores were not altered by Ramadan. Meal-induced plasma concentrations of the satiety hormone pancreatic polypeptide did not change during Ramadan, but were higher in T2DM compared to controls (post: C: 23486±6677 vs. T2DM: 62193±6880 pg/ml.min-1, p=0.003. In conclusion, Ramadan, as a model for IF appears to have more favourable effects on body composition in T2DM, without adverse effects on metabolic control or subjective appetite. These data suggest that IF may be particularly beneficial in T2DM as a nutritional intervention. Larger studies are warranted.

Keywords: type 2 diabetes, obesity, intermittent fasting, appetite regulating hormones

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Authors: Kyere Francis, Sun Dongying, Asante Dennis, Nkrumah Nana Kwame Edmund, Naana Yaa Gyamea Kumah

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With a focus on renewable energy to achieve low-carbon transition objectives, there is a greater demand for effective collaborative strategies for planning, strategic decision mechanisms, and long-term policy designs to steer the transitions. Government agencies, NGOs, the private sector, and individual citizens play an important role in sustainable energy production. In Ghana, however, such collaboration is fragile in the fight against climate change. This current study seeks to re-examine the position or potential of network governance in Ghana's renewable energy transition. The study adopted a qualitative approach and employed semi-structured interviews for data gathering. To explore network governance and low carbon transitions in Ghana, we examine key themes such as political environment and impact, actor cooperation and stakeholder interactions, financing and the transition, market design and renewable energy integration, existing regulation and policy gaps for renewable energy transition, clean cooking accessibility, and affordability. The findings reveal the following; Lack of comprehensive consultations with relevant stakeholders leads to lower acceptance of the policy model and sometimes lack of policy awareness. Again, the unavailability and affordability of renewable energy technologies and access to credit facilities is a significant hurdle to long-term renewable transition. Ghana's renewable energy transitions require strong networking and interaction among the public, private, and non-governmental organizations. The study participants believe that the involvement of relevant energy experts and stakeholders devoid of any political biases is instrumental in accelerating renewable energy transitions, as emphasized in the proposed framework. The study recommends that the national renewable energy transition plan be evident to all stakeholders and political administrators. Such policy may encourage renewable energy investment through stable and fixed lending rates by the financial institutions and build a network with international organizations and corporations. These findings could serve as valuable information for the transition-based energy process, primarily aiming to govern sustainability changes through network governance.

Keywords: actors, development, sustainable energy, network governance, renewable energy transition

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Authors: Dennis Otieno, Lilian Kirimi Nicholas Odhiambo, Hillary Bii

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Kenya is considered to be a middle level income country and usuaaly does not meet household food security needs especially in North and South eastern parts. Approximately half of the population is living under the poverty line (www, CIA 1, 2012). Agriculture is the largest sector in the country, employing 80% of the population. These are thereby directly dependent on the sufficiency of outputs received. This makes efficient, easy-accessible and cheap agricultural practices an important matter in order to improve food security. Maize is the prime staple food commodity in Kenya and represents a substantial share of people’s nutritional intake. This study is the result of questionnaire based interviews, Key informant and focus group discussion involving 220 small scale maize farmers Kenyan. The study was located to two separated areas; Lower Kuja, Bunyala, Nandi, Lower Nzoia, Perkerra, Mwea Bura, Hola and Galana Kulalu in Kenya. The questionnaire captured the farmers’ use and perceived importance of the use irrigation services and irrigated maize production. Viability was evaluated using the four indices which were all positive with NPV giving positive cash flows in less than 21 years at most for one season output. The mean willingness to pay was found to be KES 3082 and willingness to pay increased with increase in irrigation premiums. The economic value of water was found to be greater than the willingness to pay implying that irrigated maize production is sustainable. Farmers stated that viability was influenced by high output levels, good produce quality, crop of choice, availability of sufficient water and enforcement the last two factors had a positive influence while the other had negative effect on the viability of irrigated maize. A regression was made over the correlation between the willingness to pay for irrigated maize production using scheme and plot level factors. Farmers that already use other inputs such as animal manure, hired labor and chemical fertilizer should also have a demand for improved seeds according to Liebig's law of minimum and expansion path theory. The regression showed that premiums, and high yields have a positive effect on willingness to pay while produce quality, efficient fertilizer use, and crop season have a negative effect.

Keywords: maize, food security, profits, sustainability, willingness to pay

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Authors: Dennis Kreutzer, Sarah Müller-Abdelrazeq, Ingrid Isenhardt

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Resource scarcity, energy transition and the planned climate neutrality pose enormous challenges for manufacturing companies. In order to achieve these goals and a holistic sustainable development, the European Union has listed the circular economy as part of the Circular Economy Action Plan. In addition to a reduction in resource consumption, reduced emissions of greenhouse gases and a reduced volume of waste, the principles of the circular economy also offer enormous economic potential for companies, such as the generation of new circular business models. However, many manufacturing companies, especially small and medium-sized enterprises, do not have the necessary capacity to plan their transformation. They need support and strategies on the path to circular transformation, because this change affects not only production but also the entire company. Maturity models offer an approach, as they enable companies to determine the current status of their transformation processes. In addition, companies can use the models to identify transformation strategies and thus promote the transformation process. While maturity models are established in other areas, e.g. IT or project management, only a few circular economy maturity models can be found in the scientific literature. The aim of this paper is to analyse the identified maturity models of the circular economy through a systematic literature review (SLR) and, besides other aspects, to check their completeness as well as their quality. Since the terms "maturity model" and "readiness model" are often used to assess the transformation process, this paper considers both types of models to provide a more comprehensive result. For this purpose, circular economy maturity models at the company (micro) level were identified from the literature, compared, and analysed with regard to their theoretical and methodological structure. A specific focus was placed, on the one hand, on the analysis of the business units considered in the respective models and, on the other hand, on the underlying metrics and indicators in order to determine the individual maturity level of the entire company. The results of the literature review show, for instance, a significant difference in the holism of their assessment framework. Only a few models include the entire company with supporting areas outside the value-creating core process, e.g. strategy and vision. Additionally, there are large differences in the number and type of indicators as well as their metrics. For example, most models often use subjective indicators and very few objective indicators in their surveys. It was also found that there are rarely well-founded thresholds between the levels. Based on the generated results, concrete ideas and proposals for a research agenda in the field of circular economy maturity models are made.

Keywords: maturity model, circular economy, transformation, metric, assessment

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

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Authors: Xianghe Dai, Dennis Lam, Therese Sheehan, Naveed Rehman, Jie Yang

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Concrete is one of the most used construction materials that may be made onsite as fresh concrete and then placed in formwork to produce the desired shapes of structures. It has been recognized that the raw materials and mix proportion of concrete dominate the mechanical characteristics of hardened concrete, and the curing method and environment applied to the concrete in early stages of hardening will significantly influence the concrete properties, such as compressive strength, durability, permeability etc. In construction practice, there are various curing methods to maintain the presence of mixing water throughout the early stages of concrete hardening. They are also beneficial to concrete in hot weather conditions as they provide cooling and prevent the evaporation of water. Such methods include ponding or immersion, spraying or fogging, saturated wet covering etc. Also there are various curing methods that may be implemented to decrease the level of water lost which belongs to the concrete surface, such as putting a layer of impervious paper, plastic sheeting or membrane on the concrete to cover it. In the concrete material laboratory, accelerated strength gain methods supply the concrete with heat and additional moisture by applying live steam, coils that are subject to heating or pads that have been warmed electrically. Currently when determining the mechanical parameters of a concrete, the concrete is usually sampled from fresh concrete on site and then cured and tested in laboratories where standardized curing procedures are adopted. However, in engineering practice, curing procedures in the construction sites after the placing of concrete might be very different from the laboratory criteria, and this includes some standard curing procedures adopted in the laboratory that can’t be applied on site. Sometimes the contractor compromises the curing methods in order to reduce construction costs etc. Obviously the difference between curing procedures adopted in the laboratory and those used on construction sites might over- or under-estimate the real concrete quality. This paper presents the effect of three typical curing methods (air curing, water immersion curing, plastic film curing) and of maintaining concrete in steel moulds on the compressive strength development of normal concrete. In this study, Portland cement with 30% fly ash was used and different curing periods, 7 days, 28 days and 60 days were applied. It was found that the highest compressive strength was observed from concrete samples to which 7-day water immersion curing was applied and from samples maintained in steel moulds up to the testing date. The research results implied that concrete used as infill in steel tubular members might develop a higher strength than predicted by design assumptions based on air curing methods. Wrapping concrete with plastic film as a curing method might delay the concrete strength development in the early stages. Water immersion curing for 7 days might significantly increase the concrete compressive strength.

Keywords: compressive strength, air curing, water immersion curing, plastic film curing, maintaining in steel mould, comparison

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Authors: Matt Fullmer, Carol Wilkinson, Keven Prusak, Dennis Eggett, Todd Pennington

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Obesity and chronic health issues are linked to physical inactivity. Physical education (PE) programs in school can play a major role in combating these health-related issues. This study focused on supporting competence through keeping a leisure-time physical activity (LTPA) record as part of PE. Keeping a daily LTPA record may be an effective intervention helping students feel more competent toward exercise, and thus, self-determined (within the context of self-determination theory) to exercise. Little is known about the relationship between daily LTPA records and perceived competence, motivational profiles, and LTPA levels of students enrolled in PE. This study examined the relationship between keeping a daily, online LTPA record and adolescent (a) motivational profiles toward LTPA, (b) perceived competence toward LTPA, and (c) LTPA behaviors. Secondary students (N = 124) in physical education classes completed a baseline questionnaire which consisted of the Behavioural Regulation in Exercise Questionnaire–2, the Perceived Competence Scale, and the Godin Leisure-Time Exercise Questionnaire. For three weeks, the students were assigned to keep the Presidential Active Lifestyle Award Challenge (PALAC) as their online LTPA record. They completed the questionnaire after each week. A 2 (gender) x 4 (trials) repeated measures ANCOVA examined the relationships between recording compliance and motivation, perceived competence, and physical activity. Results showed that recording compliance was not a significant predictor of perceived competence to participate in LTPA. Examining motivational factors, a significant interaction between recording compliance and introjected regulation was found. The more students recorded the less motivated they were by guilt or obligation to exercise in their leisure-time. Also, a significant interaction was found between recording compliance and intrinsic regulation, indicating that the more students recorded the more intrinsically motivated they were to exercise in their leisure-time. Lastly, there was a significant interaction between recording compliance and LTPA. As students kept the LTPA record, girls’ LTPA levels significantly decreased and boys’ LTPA levels significantly increased. The key findings are that, as implemented in this study: a) the lack of PALAC compliance suggests that daily LTPA records may NOT be the most effective intervention for this population, b) keeping a daily LTPA record did NOT help students feel more competent to exercise in their leisure-time, c) a daily LTPA record may help students move towards being more self-determined in their feelings towards LTPA, and d) the outcome of keeping a LTPA record on LTPA behavior is statistically significant, although actual differences may not be practically important.

Keywords: behavioural regulation in exercise questionnaire–2, Godin leisure–time exercise questionnaire, online physical activity log, perceived competence scale, self-determination theory

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Authors: Jemely M. Punzalan, Christine B. Bernal, Beatrice B. Canonigo, Maria Rosario F. Cabansag, Dennis S. Flores, Paul Joseph T. Galutira, Remedios D. Chan

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Background: Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders predominates in women of childbearing age. Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) is the only health specific quality of life tool for pediatric SLE, which has been translated to different languages except in Filipino. Objective: The primary objective of this study was to develop a Filipino translation of the SMILEY and to examine the validity and reliability of this translation. Methodology: The SMILEY was translated into Filipino by a bilingual individual and back-translated by another bilingual individual blinded from the original English version. The translation was evaluated for content validity by a panel of experts and subjected to pilot testing. The pilot-tested translation was used in the validity and reliability testing proper. The SMILEY, together with the previously validated PEDSQL 4.0 Generic Core Scale was administered to lupus pediatric patients and their parent at two separate occasions: a baseline and a re-test seven to fourteen days apart. Tests for convergent validity, internal consistency, and test-retest reliability were performed. Results: A total of fifty children and their parent were recruited. The mean age was 15.38±2.62 years (range 8-18 years), mean education at high school level. The mean duration of SLE was 28 months (range 1-81 months). Subjects found the questionnaires to be relevant, easy to understand and answer. The validity of the SMILEY was demonstrated in terms of content validity, convergent validity, internal consistency, and test-retest reliability. Age, socioeconomic status and educational attainment did not show a significant effect on the scores. The difference between scores of child and parent report was showed to be significant with SMILEY total (p=0.0214), effect on social life (p=0.0000), and PEDSQL physical function (p=0.0460). Child reports showed higher scores for the following domains compared to their parent. Conclusion: SMILEY is a brief, easy to understand, valid and reliable tool for assessing pediatric SLE specific HRQOL. It will be useful in providing better care, understanding and may offer critical information regarding the effect of SLE in the quality of life of our pediatric lupus patients. It will help physician understands the needs of their patient not only on treatment of the specific disease but as well as the impact of the treatment on their daily lives.

Keywords: systemic lupus erythematosus, pediatrics, quality of life, Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY)

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Authors: Robert Kwame Kpaliba, Dennis Kpakpor Adotey, Yaw Serfor-Armah

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Increase in the oceanic carbon dioxide absorbance from the atmosphere due to climate change has led to appreciable change in the chemistry of the oceans. The change in oceanic pH referred to as ocean acidification poses multiple threats and stresses on marine species, biodiversity, goods and services, and livelihoods. Marine ecosystems are continuously threatened by plethora of natural and anthropogenic stressors including carbon dioxide (CO₂) emissions causing a lot of changes which has not been experienced for approximately 60 years. Little has been done in Africa as a whole and Ghana in particular to improve the understanding of the variations of the carbonate chemistry of seawater and the biophysical impacts of ocean acidification on security of seafood, nutrition, climate and environmental change. There is, therefore, the need for regular monitoring of carbonate chemistry of seawater along Ghana’s coastline to generate reliable data to aid marine policy formulation. Samples of seawater were collected thrice every month for a one-year period from five study sites for the various parameters to be analyzed. Analysis of the measured physico-chemical and the carbonate chemistry parameters was done using simple statistics. Correlation test and ANOVA were run on both of the physico-chemical and carbonate chemistry parameters. The carbonate chemistry parameters were measured using computer software programme (CO₂cal v4.0.9) except total alkalinity and pH. The study assessed the variability of seawater carbonate chemistry in selected portions of the Central Atlantic Coastline of Ghana (Tsokomey/Bortianor, Kokrobitey, Gomoa Nyanyanor, Gomoa Fetteh, and Senya Breku landing beaches) over a 1-year period (June 2016–May 2017). For physico-chemical parameters, there was insignificant variation in nitrate (NO₃⁻) (1.62 - 2.3 mg/L), ammonia (NH₃) (1.52 - 2.05 mg/L), and salinity (sal) (34.50 - 34.74 ppt). Carbonate chemistry parameters for all the five study sites showed significant variation: partial pressure of carbon dioxide (pCO₂) (414.08-715.5 µmol/kg), carbonate ion (CO₃²⁻) (115-157.92 µmol/kg), pH (7.9-8.12), total alkalinity (TA) (1711.8-1986 µmol/kg), total carbon dioxide (TCO₂) (1512.1 - 1792 µmol/kg), dissolved carbon dioxide (CO₂aq) (10.97-18.92 µmol/kg), Revelle Factor (RF) (9.62-11.84), aragonite (ΩAr) (0.75-1.48) and calcite (ΩCa) (1.08-2.14). The study revealed that the partial pressure of carbon dioxide and temperature did not have a significant effect on each other (r² = 0.31) (p-value = 0.0717). There was an appreciable effect of pH on dissolved carbon dioxide (r² = 0.921) (p-value = 0.0000). The variation between total alkalinity and dissolved carbon dioxide was appreciable (r² = 0.731) (p-value = 0.0008). There was a significant correlation between total carbon dioxide and dissolved carbon dioxide (r² = 0.852) (p-value = 0.0000). Revelle factor correlated strongly with dissolved carbon dioxide (r² = 0.982) (p-value = 0.0000). Partial pressure of carbon dioxide corresponds strongly with atmospheric carbon dioxide (r² = 0.9999) (p-value = 0.00000).

Keywords: carbonate chemistry, seawater, central atlantic coastline, Ghana, ocean acidification

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Authors: Binbin Chen, Dennis Y. C. Leung

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Aluminium (Al) -air cell holds a high volumetric capacity density of 8.05 Ah cm-3, benefit from the trivalence of Al ions. Additional benefits of Al-air cell are low price and environmental friendliness. Furthermore, the Al energy conversion process is characterized of 100% recyclability in theory. Along with a large base of raw material reserve, Al attracts considerable attentions as a promising material to be integrated within the global energy system. However, despite the early successful applications in military services, several problems exist that prevent the Al-air cells from widely civilian use. The most serious issue is the parasitic corrosion of Al when contacts with electrolyte. To overcome this problem, super-pure Al alloyed with various traces of metal elements are used to increase the corrosion resistance. Nevertheless, high-purity Al alloys are costly and require high energy consumption during production process. An alternative approach is to add inexpensive inhibitors directly into the electrolyte. However, such additives would increase the internal ohmic resistance and hamper the cell performance. So far these methods have not provided satisfactory solutions for the problem within Al-air cells. For the operation of alkaline Al-air cell, there are still other minor problems. One of them is the formation of aluminium hydroxide in the electrolyte. This process decreases ionic conductivity of electrolyte. Another one is the carbonation process within the gas diffusion layer of cathode, blocking the porosity of gas diffusion. Both these would hinder the performance of cells. The present work optimizes the above problems by building an Al-air cell operation system, consisting of four components. A top electrolyte tank containing fresh electrolyte is located at a high level, so that it can drive the electrolyte flow by gravity force. A mechanical rechargeable Al-air cell is fabricated with low-cost materials including low grade Al, carbon paper, and PMMA plates. An electrolyte waste tank with elaborate channel is designed to separate the hydrogen generated from the corrosion, which would be collected by gas collection device. In the first section of the research work, we investigated the performance of the mechanical rechargeable Al-air cell with a constant flow rate of electrolyte, to ensure the repeatability experiments. Then the whole system was assembled together and the feasibility of operating was demonstrated. During experiment, pure hydrogen is collected by collection device, which holds potential for various applications. By collecting this by-product, high utilization efficiency of aluminum is achieved. Considering both electricity and hydrogen generated, an overall utilization efficiency of around 90 % or even higher under different working voltages are achieved. Fluidic electrolyte could remove aluminum hydroxide precipitate and solve the electrolyte deterioration problem. This operation system provides a low-cost strategy for harvesting energy from the abundant secondary Al. The system could also be applied into other metal-air cells and is suitable for emergency power supply, power plant and other applications. The low cost feature implies great potential for commercialization. Further optimization, such as scaling up and optimization of fabrication, will help to refine the technology into practical market offerings.

Keywords: aluminium-air cell, high efficiency, hydrogen, mechanical recharge

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Authors: Lynn Sheridan, Dennis Alonzo, Hoa Nguyen, Andy Gao, Tracy Durksen

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Disruptions to teaching (e.g., COVID-related) have increased work demands for teachers. There is an opportunity for research to explore evidence-informed steps to support teachers. Collective evidence informs data on teachers’ personal attributes (e.g., self-efficacy beliefs) in the workplace are seen to promote success in teaching and support teacher engagement. Teacher engagement plays a role in students’ learning and teachers’ effectiveness. Engaged teachers are better at overcoming work-related stress, burnout and are more likely to take on active roles. Teachers’ commitment is influenced by a host of personal (e.g., teacher well-being) and environmental factors (e.g., job stresses). The job demands-resources model provided a conceptual basis for examining how teachers’ well-being, and is influenced by job demands and job resources. Job demands potentially evoke strain and exceed the employee’s capability to adapt. Job resources entail what the job offers to individual teachers (e.g., organisational support), helping to reduce job demands. The application of the job demands-resources model involves gathering an evidence-base of and connection to personal attributes (job resources). The study explored the association between constructs (resilience, adaptability, commitment, self/collective efficacy) and a teacher’s engagement with the job. The paper sought to elaborate on the model and determine the associations between key constructs of well-being (resilience, adaptability), commitment, and motivation (self and collective-efficacy beliefs) to teachers’ engagement in teaching. Data collection involved online a multi-dimensional instrument using validated items distributed from 2020-2022. The instrument was designed to identify construct relationships. The participant number was 170. Data Analysis: The reliability coefficients, means, standard deviations, skewness, and kurtosis statistics for the six variables were completed. All scales have good reliability coefficients (.72-.96). A confirmatory factor analysis (CFA) and structural equation model (SEM) were performed to provide measurement support and to obtain latent correlations among factors. The final analysis was performed using structural equation modelling. Several fit indices were used to evaluate the model fit, including chi-square statistics and root mean square error of approximation. The CFA and SEM analysis was performed. The correlations of constructs indicated positive correlations exist, with the highest found between teacher engagement and resilience (r=.80) and the lowest between teacher adaptability and collective teacher efficacy (r=.22). Given the associations; we proceeded with CFA. The CFA yielded adequate fit: CFA fit: X (270, 1019) = 1836.79, p < .001, RMSEA = .04, and CFI = .94, TLI = .93 and SRMR = .04. All values were within the threshold values, indicating a good model fit. Results indicate that increasing teacher self-efficacy beliefs will increase a teacher’s level of engagement; that teacher ‘adaptability and resilience are positively associated with self-efficacy beliefs, as are collective teacher efficacy beliefs. Implications for school leaders and school systems: 1. investing in increasing teachers’ sense of efficacy beliefs to manage work demands; 2. leadership approaches can enhance teachers' adaptability and resilience; and 3. a culture of collective efficacy support. Preparing teachers for now and in the future offers an important reminder to policymakers and school leaders on the importance of supporting teachers’ personal attributes when faced with the challenging demands of the job.

Keywords: collective teacher efficacy, teacher self-efficacy, job demands, teacher engagement

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Authors: Danyi Wang, Andrew Schriefer, Dennis O'Rourke, Brajendra Kumar, Yang Liu, Fei Zhong, Juergen Scheuenpflug, Zheng Feng

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Purpose: It has been recognized that the microbiome plays critical roles in disease pathogenesis, including cancer, autoimmune disease, and multiple sclerosis. To develop a clinical-grade assay for exploring microbiome-derived clinical biomarkers across disease areas, a two-phase approach is implemented. 1) Identification of the optimal sample preparation reagents using pre-mixed bacteria and healthy donor stool samples coupled with proprietary Sigma-Aldrich® bioinformatics solution. 2) Exploratory analysis of patient samples for enabling precision medicine. Study Procedure: In phase 1 study, we first compared the 16S sequencing results of two ATCC® microbiome standards (MSA 2002 and MSA 2003) across five different extraction kits (Kit A, B, C, D & E). Both microbiome standards samples were extracted in triplicate across all extraction kits. Following isolation, DNA quantity was determined by Qubit assay. DNA quality was assessed to determine purity and to confirm extracted DNA is of high molecular weight. Bacterial 16S ribosomal ribonucleic acid (rRNA) amplicons were generated via amplification of the V3/V4 hypervariable region of the 16S rRNA. Sequencing was performed using a 2x300 bp paired-end configuration on the Illumina MiSeq. Fastq files were analyzed using the Sigma-Aldrich® Microbiome Platform. The Microbiome Platform is a cloud-based service that offers best-in-class 16S-seq and WGS analysis pipelines and databases. The Platform and its methods have been extensively benchmarked using microbiome standards generated internally by MilliporeSigma and other external providers. Data Summary: The DNA yield using the extraction kit D and E is below the limit of detection (100 pg/µl) of Qubit assay as both extraction kits are intended for samples with low bacterial counts. The pre-mixed bacterial pellets at high concentrations with an input of 2 x106 cells for MSA-2002 and 1 x106 cells from MSA-2003 were not compatible with the kits. Among the remaining 3 extraction kits, kit A produced the greatest yield whereas kit B provided the least yield (Kit-A/MSA-2002: 174.25 ± 34.98; Kit-A/MSA-2003: 179.89 ± 30.18; Kit-B/MSA-2002: 27.86 ± 9.35; Kit-B/MSA-2003: 23.14 ± 6.39; Kit-C/MSA-2002: 55.19 ± 10.18; Kit-C/MSA-2003: 35.80 ± 11.41 (Mean ± SD)). Also, kit A produced the greatest yield, whereas kit B provided the least yield. The PCoA 3D visualization of the Weighted Unifrac beta diversity shows that kits A and C cluster closely together while kit B appears as an outlier. The kit A sequencing samples cluster more closely together than both the other kits. The taxonomic profiles of kit B have lower recall when compared to the known mixture profiles indicating that kit B was inefficient at detecting some of the bacteria. Conclusion: Our data demonstrated that the DNA extraction method impacts DNA concentration, purity, and microbial communities detected by next-generation sequencing analysis. Further microbiome analysis performance comparison of using healthy stool samples is underway; also, colorectal cancer patients' samples will be acquired for further explore the clinical utilities. Collectively, our comprehensive qualification approach, including the evaluation of optimal DNA extraction conditions, the inclusion of positive controls, and the implementation of a robust qualified bioinformatics pipeline, assures accurate characterization of the microbiota in a complex matrix for deciphering the deep biology and enabling precision medicine.

Keywords: 16S rRNA sequencing, analytical validation, bioinformatics pipeline, metagenomics

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Authors: Roven Tumaneng, Angelica Kristina Monzon, Ralph Sedricke Lapuz, Jose Don De Alban, Jennica Paula Masigan, Joanne Rae Pales, Laila Monera Pornel, Dennis Tablazon, Rizza Karen Veridiano, Jackie Lou Wenceslao, Edmund Leo Rico, Neil Aldrin Mallari

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Most protected area management plans in the Philippines, particularly the smaller and more remote islands suffer from insufficient baseline data, which should provide the bases for formulating measureable conservation targets and appropriate management interventions for these protected areas. Attempts to synthesize available data particularly on cultural and socio-economic characteristic of local peoples within and outside protected areas also suffer from the lack of comprehensive and detailed inventories, which should be considered in designing adaptive management interventions to be used for those protected areas. Mt Guiting-guiting Natural Park (MGGNP) located in Sibuyan Island is one of the poorly studied protected areas in the Philippines. In this study, we determined the highly biologically important areas of the protected area using Maximum Entropy approach (MaxEnt) from environmental predictors (i.e., topographic, bioclimatic,land cover, and soil image layers) derived from global remotely sensed data and point occurrence data of species of birds and trees recorded during field surveys on the island. A total of 23 trigger species of birds and trees was modeled and stacked to generate species richness maps for biological high conservation value areas (HCVAs). Forest habitat change was delineated using dual-polarised L-band ALOS-PALSAR mosaic data at 25 meter spatial resolution, taken at two acquisition years 2007 and 2009 to provide information on forest cover ad habitat change in the island between year 2007 and 2009. Determining the livelihood guilds were also conducted using the data gathered from171 household interviews, from which demographic and livelihood variables were extracted (i.e., age, gender, number of household members, educational attainment, years of residency, distance from forest edge, main occupation, alternative sources of food and resources during scarcity months, and sources of these alternative resources).Using Principal Component Analysis (PCA) and Kruskal-Wallis test, the diversity and patterns of forest resource use by people in the island were determined with particular focus on the economic activities that directly and indirectly affect the population of key species as well as to identify levels of forest resource use by people in different areas of the park.Results showed that there are gaps in the area occupied by the natural park, as evidenced by the mismatch of the proposed HCVAs and the existing perimeters of the park. We found out that subsistence forest gathering was the possible main driver for forest degradation out of the eight livelihood guilds that were identified in the park. Determining the high conservation areas and identifyingthe anthropogenic factors that influence the species richness and abundance of key species in the different management zone of MGGNP would provide guidance for the design of a protected area management plan and future monitoring programs. However, through intensive communication and consultation with government stakeholders and local communities our results led to setting conservation targets in local development plans and serve as a basis for the reposition of the boundaries and reconfiguration of the management zones of MGGNP.

Keywords: conservation gaps, livelihood guilds, MaxEnt, protected area

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