Search results for: clinical communication
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7410

Search results for: clinical communication

600 Development of Optimized Eye Mascara Packages with Bioinspired Spiral Methodology

Authors: Daniela Brioschi, Rovilson Mafalda, Silvia Titotto

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In the present days, packages are considered a fundamental element in the commercialization of products and services. A good package is capable of helping to attract new customers and also increasing a product’s purchase intent. In this scenario, packaging design emerges as an important tool, since products and design of their packaging are so interconnected that they are no longer seen as separate elements. Packaging design is, in fact, capable of generating desire for a product. The packaging market for cosmetics, especially makeup market, has also been experiencing an increasing level of sophistication and requirements. Considering packaging represents an important link of communication with the final user and plays a significant role on the sales process, it is of great importance that packages accomplish not only with functional requirements but also with the visual appeal. One of the possibilities for the design of packages and, in this context, packages for make-up, is the bioinspired design – or biomimicry. The bio-inspired design presents a promising paradigm for innovation in both design and sustainable design, by using biological system analogies to develop solutions. It has gained importance as a widely diffused movement in design for environmentally conscious development and is also responsible for several useful and innovative designs. As eye mascara packages are also part of the constant evolution on the design for cosmetics area and the traditional packages present the disadvantage of product drying along time, this project aims to develop a new and innovative package for this product, by using a selected bioinspired design methodology during the development process and also suitable computational tools. In order to guide the development process of the package, it was chosen the spiral methodology, conceived by The Biomimicry Institut, which consists of a reliable tool, since it was based on traditional design methodologies. The spiral design comprises identification, translation, discovery, abstraction, emulation and evaluation steps, that can work iteratively as the process develops as a spiral. As support tool for packaging, 3D modelling is being used by the software Inventor Autodesk Inventor 2018. Although this is an ongoing research, first results showed that spiral methodology design, together with Autodesk Inventor, consist of suitable instruments for the bio-inspired design process, and also nature proved itself to be an amazing and inexhaustible source of inspiration.

Keywords: bio-inspired design, design methodology, packaging, cosmetics

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599 TNF Modulation of Cancer Stem Cells in Renal Clear Cell Carcinoma

Authors: Rafia S. Al-lamki, Jun Wang, Simon Pacey, Jordan Pober, John R. Bradley

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Tumor necrosis factor alpha (TNF), signaling through TNFR2, may act an autocrine growth factor for renal tubular epithelial cells. Clear cell renal carcinomas (ccRCC) contain cancer stem cells (CSCs) that give rise to progeny which form the bulk of the tumor. CSCs are rarely in cell cycle and, as non-proliferating cells, resist most chemotherapeutic agents. Thus, recurrence after chemotherapy may result from the survival of CSCs. Therapeutic targeting of both CSCs and the more differentiated bulk tumor populations may provide a more effective strategy for treatment of RCC. In this study, we hypothesized that TNFR2 signaling will induce CSCs in ccRCC to enter cell cycle so that treatment with ligands that engage TNFR2 will render CSCs susceptible to chemotherapy. To test this hypothesis, we have utilized wild-type TNF (wtTNF) or specific muteins selective for TNFR1 (R1TNF) or TNFR2 (R2TNF) to treat either short-term organ cultures of ccRCC and adjacent normal kidney (NK) tissue or cultures of CD133+ cells isolated from ccRCC and adjacent NK, hereafter referred to as stem cell-like cells (SCLCs). The effect of cyclophosphamide (CP), currently an effective anticancer agent, was tested on CD133+SCLCs from ccRCC and NK before and after R2TNF treatment. Responses to TNF were assessed by flow cytometry (FACS), immunofluorescence, and quantitative real-time PCR, TUNEL, and cell viability assays. Cytotoxic effect of CP was analyzed by Annexin V and propidium iodide staining with FACS. In addition, we assessed the effect of TNF on isolated SCLCs differentiation using a three-dimensional (3D) culture system. Clinical samples of ccRCC contain a greater number SCLCs compared to NK and the number of SCSC increases with higher tumor grade. Isolated SCLCs show expression of stemness markers (oct4, Nanog, Sox2, Lin28) but not differentiation markers (cytokeratin, CD31, CD45, and EpCAM). In ccRCC organ cultures, wtTNF and R2TNF increase CD133 and TNFR2 expression and promote cell cycle entry whereas wtTNF and R1TNF increase TNFR1 expression and promote cell death of SCLCs. Similar findings are observed in SCLCs isolated from NK but the effect was greater in SCLCs isolated from ccRCC. Application of CP distinctly triggered apoptotic and necrotic cell death in SLCSs pre-treatment with R2TNF as compared to CP treatment alone, with SCLCs from ccRCC more sensitive to CP compared to SLCS from NK. Furthermore, TNF promotes differentiation of SCLCs to an epithelial phenotype in 3D cultures, confirmed by cytokeratin expression and loss of stemness markers Nanog and Sox2. The differentiated cells show positive expression of TNF and TNFR2. These findings provide evidence that selective engagement of TNFR2 drive CSCs to cell proliferation/differentiation, and targeting of cycling cells with TNFR2 agonist in combination with anti-cancer agents may be a potential therapy for RCC.

Keywords: cancer stem cells, ccRCC, cell cycle, cell death, TNF, TNFR1, TNFR2, CD133

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598 Improvement of Autism Diagnostic Observation Schedule Scores after Comprehensive Intensive Early Interventions in a Clinical Setting

Authors: Nils Haglund, Svenolof Dahlgren, Maria Rastam, Peik Gustafsson, Karin Kalien

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In Sweden, like in most developed countries, there is a substantial increase of children diagnosed with autism and other conditions within the autism spectrum (ASD). The rapid increase of ASD rates stresses the importance of developing care programs to provide support and comprehensive interventions for affected families. The current observational study was conducted in order to evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with autism in southern Sweden. The change in autism symptoms among children participating in CIEI (intervention group, n=67) was compared with children who received traditional habilitation services only (comparison group, n=27). Children of parents who accepted the offered CIEI-program, constituted the intervention group, whereas children, whose parents (for some reason) were not interested in the offered CIEI-program, constituted the comparison group. The CIEI-program was individualized to each child by experienced applied behavior analysis (ABA) specialists with different backgrounds as psychologists, speech pathologists or special education teachers, in cooperation with parents and preschool staff. Due to the individualization, the intervention could vary in intensity and techniques. The intensity was calculated to 15-25 hours each week at home and the preschool altogether. Each child was assigned one 'trainer', who was often employed as a preschool teacher but could have another educational background. An agreement between supervisor- parents and preschool staff was reached to confirm the intensity and content of the CIEI- program over an approximately two-year intervention period. Symptom changes were measured as evaluation-ADOS-2-scores, total- and severity-scores, minus the corresponding baseline-scores, divided by the time between baseline and evaluation. The difference between the study-groups regarding change of ADOS-2-scores was estimated using ANCOVA. In the current study, children in the CIEI-group improved their ADOS-2-total scores between baseline and evaluation (-0.8 scores per year; 95%CI: -1.2 to -0.4), whereas no such improvement was detected in the comparison group (+0.1 scores per year; 95%CI: -0.7 to +0.9). The change difference (change in the CIEI-group vs. change in the comparison group) was statistically significant, both crude and after adjusting for possible confounders (-1.1; 95%CI -1.9 to -0.4). Children in the CIEI-group also significantly improved their ADOS-calibrated severity scores, but not significantly differently so from the comparison group. The results from the current study indicate that the CIEI program significantly improves social and communicative skills among children with autism and that children with developmental delay could benefit to a similar degree as other children. The results support earlier studies reporting on the improvement of autism symptoms after early intensive interventions. The results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. Such results may be of immediate importance to healthcare organizations when allocating the already strained resources to different patient groups. Albeit the obvious limitation of the current naturalistic study, the results support previous positive studies and indicate that children with autism benefit from participating in early comprehensive, intensive programs and that investments in these programs may be highly justifiable.

Keywords: autism symptoms, ADOS-scores, evaluation, intervention program

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597 An Empirical Study of Gender, Expectations and Actual Experiences from Industrial Work Experience of Undergraduate Accounting Students in Selected Nigerian Universities

Authors: Obiamaka Nwobu, Samuel Faboyede, O. Oluseyi

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This study investigated the influence of gender on expectations and actual experiences from Industrial Work Experience, which is an aspect of the curriculum of undergraduate accounting students in selected Nigerian Universities. A survey research design was employed. Copies of a research questionnaire were made and administered to eighty (80) accounting students in selected Nigerian Universities who embarked on Students’ Industrial Work Experience Scheme (SIWES). Their expectations were juxtaposed with their actual experiences gleaned from the Industrial Work Experience. The data for the purpose of this study was analyzed using independent sample t-test. A total of fifteen (15) male and forty four (44) female students responded to the survey. This resulted in a response rate of 73.8 per cent. The results of this study indicated that there was no significant difference in the expectation of male and female undergraduate accounting students that the internship experience will be able to prepare them for an accounting career in the future, impart relevant knowledge, relate theories to work environment, enhance knowledge in financial accounting, cost accounting, accounting software, and general practice of accounting; prepare financial statements, interpret financial statements, develop problem solving skills, communication skills, and interpersonal skills; improve personal confidence and self-esteem, increase exposure to latest technology in the workplace, build rapport and networks, provide earnings, job experience, provide information and experience to choose career path. Furthermore, findings from the survey showed that there were differences in the expectations of students and their actual experiences with respect to their ability to relate theories to work environment, enhance knowledge in financial accounting, cost accounting, accounting software and exposure to latest technology in the workplace. The study only examined the perceptions of students from two Universities in South-West Nigeria. The research instrument used in this study can be administered to undergraduate accounting students in other universities in Nigeria. The Industrial Work Experience Scheme for undergraduate accounting students should be highly encouraged by tertiary institutions in Nigeria. This will ultimately make the students well prepared for a career in accounting.

Keywords: gender, expectations, actual experiences, industrial work experience

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596 Classification of Emotions in Emergency Call Center Conversations

Authors: Magdalena Igras, Joanna Grzybowska, Mariusz Ziółko

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The study of emotions expressed in emergency phone call is presented, covering both statistical analysis of emotions configurations and an attempt to automatically classify emotions. An emergency call is a situation usually accompanied by intense, authentic emotions. They influence (and may inhibit) the communication between caller and responder. In order to support responders in their responsible and psychically exhaustive work, we studied when and in which combinations emotions appeared in calls. A corpus of 45 hours of conversations (about 3300 calls) from emergency call center was collected. Each recording was manually tagged with labels of emotions valence (positive, negative or neutral), type (sadness, tiredness, anxiety, surprise, stress, anger, fury, calm, relief, compassion, satisfaction, amusement, joy) and arousal (weak, typical, varying, high) on the basis of perceptual judgment of two annotators. As we concluded, basic emotions tend to appear in specific configurations depending on the overall situational context and attitude of speaker. After performing statistical analysis we distinguished four main types of emotional behavior of callers: worry/helplessness (sadness, tiredness, compassion), alarm (anxiety, intense stress), mistake or neutral request for information (calm, surprise, sometimes with amusement) and pretension/insisting (anger, fury). The frequency of profiles was respectively: 51%, 21%, 18% and 8% of recordings. A model of presenting the complex emotional profiles on the two-dimensional (tension-insecurity) plane was introduced. In the stage of acoustic analysis, a set of prosodic parameters, as well as Mel-Frequency Cepstral Coefficients (MFCC) were used. Using these parameters, complex emotional states were modeled with machine learning techniques including Gaussian mixture models, decision trees and discriminant analysis. Results of classification with several methods will be presented and compared with the state of the art results obtained for classification of basic emotions. Future work will include optimization of the algorithm to perform in real time in order to track changes of emotions during a conversation.

Keywords: acoustic analysis, complex emotions, emotion recognition, machine learning

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595 Serum Concentration of the CCL7 Chemokine in Diabetic Pregnant Women during Pregnancy until the Postpartum Period

Authors: Fernanda Piculo, Giovana Vesentini, Gabriela Marini, Debora Cristina Damasceno, Angelica Mercia Pascon Barbosa, Marilza Vieira Cunha Rudge

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Introduction: Women with previous gestational diabetes mellitus (GDM) were significantly more likely to have urinary incontinence (UI) and pelvic floor muscle dysfunction compared to non-diabetic women two years after a cesarean section. Additional results demonstrated that induced diabetes causes detrimental effects on pregnant rat urethral muscle. These results indicate the need for exploration of the mechanistic role of a recovery factor in female UI. Chemokine ligand 7 (CCL7) was significantly over expressed in rat serum, urethral and vaginal tissues immediately following induction of stress UI in a rat model simulating birth trauma. CCL7 over expression has shown potency for stimulating targeted stem cell migration and provide a translational link (clinical measurement) which further provide opportunities for treatment. The aim of this study was to investigate the CCL7 levels profile in diabetic pregnant women with urinary incontinence during pregnancy over the first year postpartum. Methods: This study was conducted in the Perinatal Diabetes Research Center of the Botucatu Medical School/UNESP, and was approved by the Research Ethics Committee of the Institution (CAAE: 20639813.0.0000.5411). The diagnosis of GDM was established between 24th and 28th gestational weeks, by the 75 g-OGTT test according to ADA’s criteria. Urinary incontinence was defined according to the International Continence Society and the CCL7 levels was measured by ELISA (R&D Systems, Catalog Number DCC700). Two hundred twelve women were classified into four study groups: normoglycemic continent (NC), normoglycemic incontinent (NI), diabetic continent (DC) and diabetic incontinent (DI). They were evaluated at six-time-points: 12-18, 24-28 and 34-38 gestational weeks, 24-48 hours, 6 weeks and 6-12 months postpartum. Results: At 12-18 weeks, it was possible to consider only two groups, continent and incontinent, because at this early gestational period has not yet been the diagnosis of GDM. The group with GDM and UI (DI group) showed lower levels of CCL7 in all time points during pregnancy and postpartum, compared to normoglycemic groups (NC and NI), indicating that these women have not recovered from child birth induced UI during the 6-12 months postpartum compared to their controls, and that the progression of UI and/or lack of recovery throughout the first postpartum year can be related with lower levels of CCL7. Instead, serum CCL7 was significantly increased in the NC group. Taken together, these findings of overexpression of CCL7 in the NC group and decreased levels in the DI group, could confirm that diabetes delays the recovery from child birth induced UI, and that CCL7 could potentially be used as a serum marker of injury. Conclusion: This study demonstrates lower levels of CCL7 in the DI group during pregnancy and postpartum and suggests that the progression of UI in diabetic women and/or lack of recovery throughout the first postpartum year can be related with low levels of CCL7. This provides a translational potential where CCL7 measurement could be used as a surrogate for injury after delivery. Successful controlled CCL7 mediated stem cell homing to the lower urinary tract could one day introduce the potential for non-operative treatment or prevention of stress urinary incontinence.

Keywords: CCL7, gestational diabetes, pregnancy, urinary incontinence

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594 Scoring System for the Prognosis of Sepsis Patients in Intensive Care Units

Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz

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Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.

Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting

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593 An Analysis of Emmanuel Macron's Campaign Discourse

Authors: Robin Turner

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In the context of the strengthening conservative movements such as “Brexit” and the election of US President Donald Trump, the global political stage was shaken up by the election of Emmanuel Macron to the French presidency, defeating the far-right candidate Marine Le Pen. The election itself was a first for the Fifth Republic in which neither final candidate was from the traditional two major political parties: the left Parti Socialiste (PS) and the right Les Républicains (LR). Macron, who served as the Minister of Finance under his predecessor, founded the centrist liberal political party En Marche! in April 2016 before resigning from his post in August to launch his bid for the presidency. Between the time of the party’s creation to the first round of elections a year later, Emmanuel Macron and En Marche! had garnered enough support to make it to the run-off election, finishing far ahead of many seasoned national political figures. Now months into his presidency, the youngest President of the Republic shows no sign of losing fuel anytime soon. His unprecedented success raises a lot of questions with respect to international relations, economics, and the evolving relationship between the French government and its citizens. The effectiveness of Macron’s campaign, of course, relies on many factors, one of which is his manner of communicating his platform to French voters. Using data from oral discourse and primary material from Macron and En Marche! in sources such as party publications and Twitter, the study categorizes linguistic instruments – address, lexicon, tone, register, and syntax – to identify prevailing patterns of speech and communication. The linguistic analysis in this project is two-fold. In addition to these findings’ stand-alone value, these discourse patterns are contextualized by comparable discourse of other 2017 presidential candidates with high emphasis on that of Marine Le Pen. Secondly, to provide an alternative approach, the study contextualizes Macron’s discourse using those of two immediate predecessors representing the traditional stronghold political parties, François Hollande (PS) and Nicolas Sarkozy (LR). These comparative methods produce an analysis that gives insight to not only a contributing factor to Macron’s successful 2017 campaign but also provides insight into how Macron’s platform presents itself differently to previous presidential platforms. Furthermore, this study extends analysis to supply data that contributes to a wider analysis of the defeat of “traditional” French political parties by the “start-up” movement En Marche!.

Keywords: Emmanuel Macron, French, discourse analysis, political discourse

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592 The Impact of Artificial Intelligence on Medicine Production

Authors: Yasser Ahmed Mahmoud Ali Helal

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The use of CAD (Computer Aided Design) technology is ubiquitous in the architecture, engineering and construction (AEC) industry. This has led to its inclusion in the curriculum of architecture schools in Nigeria as an important part of the training module. This article examines the ethical issues involved in implementing CAD (Computer Aided Design) content into the architectural education curriculum. Using existing literature, this study begins with the benefits of integrating CAD into architectural education and the responsibilities of different stakeholders in the implementation process. It also examines issues related to the negative use of information technology and the perceived negative impact of CAD use on design creativity. Using a survey method, data from the architecture department of University was collected to serve as a case study on how the issues raised were being addressed. The article draws conclusions on what ensures successful ethical implementation. Millions of people around the world suffer from hepatitis C, one of the world's deadliest diseases. Interferon (IFN) is treatment options for patients with hepatitis C, but these treatments have their side effects. Our research focused on developing an oral small molecule drug that targets hepatitis C virus (HCV) proteins and has fewer side effects. Our current study aims to develop a drug based on a small molecule antiviral drug specific for the hepatitis C virus (HCV). Drug development using laboratory experiments is not only expensive, but also time-consuming to conduct these experiments. Instead, in this in silicon study, we used computational techniques to propose a specific antiviral drug for the protein domains of found in the hepatitis C virus. This study used homology modeling and abs initio modeling to generate the 3D structure of the proteins, then identifying pockets in the proteins. Acceptable lagans for pocket drugs have been developed using the de novo drug design method. Pocket geometry is taken into account when designing ligands. Among the various lagans generated, a new specific for each of the HCV protein domains has been proposed.

Keywords: drug design, anti-viral drug, in-silicon drug design, hepatitis C virus (HCV) CAD (Computer Aided Design), CAD education, education improvement, small-size contractor automatic pharmacy, PLC, control system, management system, communication

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591 Comprehensive Analysis of RNA m5C Regulator ALYREF as a Suppressive Factor of Anti-tumor Immune and a Potential Tumor Prognostic Marker in Pan-Cancer

Authors: Yujie Yuan, Yiyang Fan, Hong Fan

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Objective: The RNA methylation recognition protein Aly/REF export factor (ALYREF) is considered one type of “reader” protein acting as a recognition protein of m5C, has been reported involved in several biological progresses including cancer initiation and progression. 5-methylcytosine (m5C) is a conserved and prevalent RNA modification in all species, as accumulating evidence suggests its role in the promotion of tumorigenesis. It has been claimed that ALYREF mediates nuclear export of mRNA with m5C modification and regulates biological effects of cancer cells. However, the systematical regulatory pathways of ALYREF in cancer tissues have not been clarified, yet. Methods: The expression level of ALYREF in pan-cancer and their normal tissues was compared through the data acquired from The Cancer Genome Atlas (TCGA). The University of Alabama at Birmingham Cancer data analysis Portal UALCAN was used to analyze the relationship between ALYREF and clinical pathological features. The relationship between the expression level of ALYREF and prognosis of pan-cancer, and the correlation genes of ALYREF were figured out by using Gene Expression Correlation Analysis database GEPIA. Immune related genes were obtained from TISIDB (an integrated repository portal for tumor-immune system interactions). Immune-related research was conducted by using Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) and TIMER. Results: Based on the data acquired from TCGA, ALYREF has an obviously higher-level expression in various types of cancers compared with relevant normal tissues excluding thyroid carcinoma and kidney chromophobe. The immunohistochemical images on The Human Protein Atlas showed that ALYREF can be detected in cytoplasm, membrane, but mainly located in nuclear. In addition, a higher expression level of ALYREF in tumor tissue generates a poor prognosis in majority of cancers. According to the above results, cancers with a higher expression level of ALYREF compared with normal tissues and a significant correlation between ALYREF and prognosis were selected for further analysis. By using TISIDB, we found that portion of ALYREF co-expression genes (such as BIRC5, H2AFZ, CCDC137, TK1, and PPM1G) with high Pearson correlation coefficient (PCC) were involved in anti-tumor immunity or affect resistance or sensitivity to T cell-mediated killing. Furthermore, based on the results acquired from GEPIA, there was significant correlation between ALYREF and PD-L1. It was exposed that there is a negative correlation between the expression level of ALYREF and ESTIMATE score. Conclusion: The present study indicated that ALYREF plays a vital and universal role in cancer initiation and progression of pan-cancer through regulating mitotic progression, DNA synthesis and metabolic process, and RNA processing. The correlation between ALYREF and PD-L1 implied ALYREF may affect the therapeutic effect of immunotherapy of tumor. More evidence revealed that ALYREF may play an important role in tumor immunomodulation. The correlation between ALYREF and immune cell infiltration level indicated that ALYREF can be a potential therapeutic target. Exploring the regulatory mechanism of ALYREF in tumor tissues may expose the reason for poor efficacy of immunotherapy and offer more directions of tumor treatment.

Keywords: ALYREF, pan-cancer, immunotherapy, PD-L1

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590 TikTok as a Search Engine for Selecting Traveling Destinations and Its Relation to Nation’s Destinations Branding: Comparative Study Between Gen-Y and Gen-Z in the Egyptian Community

Authors: Ghadeer Aly, Yasmeen Hanafy

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The way we research travel options and decide where to go has substantially changed in the digital age. Atypical search engines like social networking sites like TikTok have evolved, influencing the preferences of various generations. The influence of TikTok use as a search engine for choosing travel locations and its effect on a country's destination branding are both examined in this study. The study specifically focuses on the comparative preferences and actions of Generations Y and Z within the Egyptian community, shedding light on how these generations interact with travel related TikTok content and how it influences their perceptions of various destinations. It also investigates how TikTok Accounts use tourism branding techniques to promote a country's tourist destination. The investigation of how social media platforms are changing as unconventional search engines has theoretical relevance. This study can advance our knowledge of how digital platforms alter information-seeking behaviors and affect the way people make decisions. Furthermore, investigating the relationship between TikTok video and destination branding might shed light on the intricate interplay between social media, perceptions of locations, and travel preferences, enhancing theories about consumer behavior and communication in the digital age. Regarding the methodology of the research, the study is conducted in two stages: first, both generations are polled, and from the results, the top three destinations are chosen to be subjected to content analysis. As for the research's theoretical framework, it incorporates the tourism destination branding model as well as the conceptual model of nation branding. Through the use of the survey as a quantitative approach and the qualitative content analysis, the research will rely on both quantitative and qualitative methods. When it comes to the theoretical framework, both the Nation Branding Model and the Tourism Branding Model can offer useful frameworks for analyzing and comprehending the dynamics of using TikTok as a search engine to choose travel destinations, especially in the context of Generation Y and Generation Z in the Egyptian community. Additionally, the sample will be drawn specifically from both Gen-Y and Gen-Z. 100 members of Gen Z and 100 members of Gen Y will be chosen from TikTok users and followers of travel-related accounts, and the sample for the content analysis will be chosen based on the survey's results.

Keywords: tiktok, nation image, egyptian community, tourism branding

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589 Barriers and Challenges to a Healthy Lifestyle for Postpartum Women and the Possibilities in an Information Technology-Based Intervention: A Qualitative Study

Authors: Pernille K. Christiansen, Mette Maria Skjøth, Line Lorenzen, Eva Draborg, Christina Anne Vinter, Trine Kjær, Mette Juel Rothmann

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Background and aims: Overweight and obesity are an increasing challenge on a global level. In Denmark, more than one-third of all pregnant women are overweight or obese, and many women exceed the gestational weight gain recommendations from the Institute of Medicine. Being overweight or obese, is associated with a higher risk of adverse maternal and fetal outcomes, including gestational diabetes and childhood obesity. Thus, it is important to focus on the women’s lifestyles between their pregnancies to lower the risk of gestational weight retention in the long run. The objective of this study was to explorer what barriers and challenges postpartum women experience with respect to healthy lifestyles during the postpartum period and to access whether an Information Technology based intervention might be a supportive tool to assist and motivate postpartum women to a healthy lifestyle. Materials and methods: The method is inspired by participatory design. A systematic text condensation was applied to semi-structured focus groups. Five focus group interviews were carried out with a total of 17 postpartum women and two interviews with a total of six health professionals. Participants were recruited through the municipality in Svendborg, Denmark, and at Odense University Hospital in Odense, Denmark, during a four-month period in early 2018. Results: From the women’s perspective, better assistance is needed from the health professionals to obtain or maintain a healthy lifestyle. The women need tools that inform and help them understand and prioritise their own health-related risks, and to motivate them to plan and take care of their own health. As the women use Information Technology on a daily basis, the solution could be delivered through Information Technology. Finally, there is room for engaging the partner more in the communication related to the baby and family’s lifestyle. Conclusion: Postpartum women need tools that inform and motivate a healthy lifestyle postpartum. The tools should allow access to high-quality information from health care professionals, when the information is needed, and also allow engagement from the partner. Finally, Information Technology is a potential tool for delivering tools.

Keywords: information technology, lifestyle, overweight, postpartum

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588 An Inexhaustible Will of Infinite, or the Creative Will in the Psychophysiological Artistic Practice: An Analysis through Nietzsche's Will to Power

Authors: Filipa Cruz, Grecia P. Matos

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An Inexhaustible Will of Infinite is ongoing practice-based research focused on a psychophysiological conception of body and on the creative will that seeks to examine the possibility of art being simultaneously a pacifier and an intensifier in a physiological artistic production. This is a study where philosophy and art converge in a commentary on the affection of the concept of will to power in the art world through Nietzsche’s commentaries, through the analysis of case studies and a reflection arising from artistic practice. Through Nietzsche, it is sought to compare concepts that communicate with the artistic practice since creation is an intensification and engenders perspectives. It is also a practice highly embedded in the body, in the non-verbal, in the physiology of art and in the coexistence between the sensorial and the thought. It is questioned if the physiology of art could be thought of as a thinking-feeling with no primacy of the thought over the sensorial. Art as a manifestation of the will to power participates in a comprehension of the world. In this article, art is taken as a privileged way of communication – implicating corporeal-sensorial-conceptual – and of connection between humans. Problematized is the dream and the drunkenness as intensifications and expressions of life’s comprehension. Therefore, art is perceived as suggestion and invention, where the artistic intoxication breaks limits in the experience of life, and the artist, dominated by creative forces, claims, orders, obeys, proclaims love for life. The intention is also to consider how one can start from pain to create and how one can generate new and endless artistic forms through nightmares, daydreams, impulses, intoxication, enhancement, intensification in a plurality of subjects and matters. It is taken into consideration the fact that artistic creation is something that is intensified corporeally, expanded, continuously generated and acting on bodies. It is inextinguishable and a constant movement intertwining Apollonian and Dionysian instincts of destruction and creation of new forms. The concept of love also appears associated with conquering, that, in a process of intensification and drunkenness, impels the artist to generate and to transform matter. Just like a love relationship, love in Nietzsche requires time, patience, effort, courage, conquest, seduction, obedience, and command, potentiating the amplification of knowledge of the other / the world. Interlacing Nietzsche's philosophy, not with Modern Art, but with Contemporary Art, it is argued that intoxication, will to power (strongly connected with the creative will) and love still have a place in the artistic production as creative agents.

Keywords: artistic creation, body, intensification, psychophysiology, will to power

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587 Left Cornual Ectopic Pregnancy with Uterine Rupture - a Case Report

Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

Procedia PDF Downloads 116
586 Cooperation of Unmanned Vehicles for Accomplishing Missions

Authors: Ahmet Ozcan, Onder Alparslan, Anil Sezgin, Omer Cetin

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The use of unmanned systems for different purposes has become very popular over the past decade. Expectations from these systems have also shown an incredible increase in this parallel. But meeting the demands of the tasks are often not possible with the usage of a single unmanned vehicle in a mission, so it is necessary to use multiple autonomous vehicles with different abilities together in coordination. Therefore the usage of the same type of vehicles together as a swarm is helped especially to satisfy the time constraints of the missions effectively. In other words, it allows sharing the workload by the various numbers of homogenous platforms together. Besides, it is possible to say there are many kinds of problems that require the usage of the different capabilities of the heterogeneous platforms together cooperatively to achieve successful results. In this case, cooperative working brings additional problems beyond the homogeneous clusters. In the scenario presented as an example problem, it is expected that an autonomous ground vehicle, which is lack of its position information, manage to perform point-to-point navigation without losing its way in a previously unknown labyrinth. Furthermore, the ground vehicle is equipped with very limited sensors such as ultrasonic sensors that can detect obstacles. It is very hard to plan or complete the mission for the ground vehicle by self without lost its way in the unknown labyrinth. Thus, in order to assist the ground vehicle, the autonomous air drone is also used to solve the problem cooperatively. The autonomous drone also has limited sensors like downward looking camera and IMU, and it also lacks computing its global position. In this context, it is aimed to solve the problem effectively without taking additional support or input from the outside, just benefiting capabilities of two autonomous vehicles. To manage the point-to-point navigation in a previously unknown labyrinth, the platforms have to work together coordinated. In this paper, cooperative work of heterogeneous unmanned systems is handled in an applied sample scenario, and it is mentioned that how to work together with an autonomous ground vehicle and the autonomous flying platform together in a harmony to take advantage of different platform-specific capabilities. The difficulties of using heterogeneous multiple autonomous platforms in a mission are put forward, and the successful solutions are defined and implemented against the problems like spatially distributed tasks planning, simultaneous coordinated motion, effective communication, and sensor fusion.

Keywords: unmanned systems, heterogeneous autonomous vehicles, coordination, task planning

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585 Using a Mobile App to Foster Children Active Travel to School in Spain

Authors: P. Pérez-Martín, G. Pedrós, P. Martínez-Jiménez, M. Varo-Martínez

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In recent decades, family habits related to children’s displacements to school have changed, increasing motorized travels against active modes. This entails a major negative impact on the urban environment, road safety in cities and the physical and psychological development of children. One of the more common actions used to reverse this trend is Walking School Bus (WSB), which consists of a predefined adult-scorted pedestrian route to school with several stops along the path where schoolchildren are collected. At Tirso de Molina School in Cordoba (Spain), a new ICT-based methodology to deploy WSB has been tested. A mobile app that allows the geoposition of the group, the notification of the arrival and real-time communication between the WSB participants have been presented to the families in order to organize and register the daily participation. After an initial survey to know the travel mode and the spatial distribution of the interested families, three WSB routes have been established and the families have been trained in the app usage. During nine weeks, 33 children have joined the WSB and their parents have accompanied the groups in turns. A high recurrence in the attendance has been registered. Through a final survey, participants have valued highly the tool and the methodology designed, emphasizing as most useful features of the mobile app: notifications system, chat and real-time monitoring. It has also been found that the tool has had a major impact on the degree of confidence of parents regarding the autonomous on foot displacement of their children to school. Moreover, 37,9% of the participant families have reported a total or partial modal shift from car to walking, and the benefits more reported are an increment of the parents available time and less problems in the travel to school daily organization. As a consequence, It has been proved the effectiveness of this user-centric innovative ICT-based methodology to reduce the levels of private car drop offs, minimize barriers of time constraints, volunteer recruitment, and parents’ safety concerns, while, at the same time, increase convenience and time savings for families. This pilot study can offer guidance for community coordinated actions and local authority interventions to support sustainable school travel outcomes.

Keywords: active travel, mobile app, sustainable mobility, urban transportation planning, walking school bus

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584 Thermodynamic Analyses of Information Dissipation along the Passive Dendritic Trees and Active Action Potential

Authors: Bahar Hazal Yalçınkaya, Bayram Yılmaz, Mustafa Özilgen

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Brain information transmission in the neuronal network occurs in the form of electrical signals. Neural work transmits information between the neurons or neurons and target cells by moving charged particles in a voltage field; a fraction of the energy utilized in this process is dissipated via entropy generation. Exergy loss and entropy generation models demonstrate the inefficiencies of the communication along the dendritic trees. In this study, neurons of 4 different animals were analyzed with one dimensional cable model with N=6 identical dendritic trees and M=3 order of symmetrical branching. Each branch symmetrically bifurcates in accordance with the 3/2 power law in an infinitely long cylinder with the usual core conductor assumptions, where membrane potential is conserved in the core conductor at all branching points. In the model, exergy loss and entropy generation rates are calculated for each branch of equivalent cylinders of electrotonic length (L) ranging from 0.1 to 1.5 for four different dendritic branches, input branch (BI), and sister branch (BS) and two cousin branches (BC-1 & BC-2). Thermodynamic analysis with the data coming from two different cat motoneuron studies show that in both experiments nearly the same amount of exergy is lost while generating nearly the same amount of entropy. Guinea pig vagal motoneuron loses twofold more exergy compared to the cat models and the squid exergy loss and entropy generation were nearly tenfold compared to the guinea pig vagal motoneuron model. Thermodynamic analysis show that the dissipated energy in the dendritic tress is directly proportional with the electrotonic length, exergy loss and entropy generation. Entropy generation and exergy loss show variability not only between the vertebrate and invertebrates but also within the same class. Concurrently, single action potential Na+ ion load, metabolic energy utilization and its thermodynamic aspect contributed for squid giant axon and mammalian motoneuron model. Energy demand is supplied to the neurons in the form of Adenosine triphosphate (ATP). Exergy destruction and entropy generation upon ATP hydrolysis are calculated. ATP utilization, exergy destruction and entropy generation showed differences in each model depending on the variations in the ion transport along the channels.

Keywords: ATP utilization, entropy generation, exergy loss, neuronal information transmittance

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583 Mesenchymal Stem Cells (MSC)-Derived Exosomes Could Alleviate Neuronal Damage and Neuroinflammation in Alzheimer’s Disease (AD) as Potential Therapy-Carrier Dual Roles

Authors: Huan Peng, Chenye Zeng, Zhao Wang

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Alzheimer’s disease (AD) is an age-related neurodegenerative disease that is a leading cause of dementia syndromes and has become a huge burden on society and families. The main pathological features of AD involve excessive deposition of β-amyloid (Aβ) and Tau proteins in the brain, resulting in loss of neurons, expansion of neuroinflammation, and cognitive dysfunction in patients. Researchers have found effective drugs to clear the brain of error-accumulating proteins or to slow the loss of neurons, but their direct administration has key bottlenecks such as single-drug limitation, rapid blood clearance rate, impenetrable blood-brain barrier (BBB), and poor ability to target tissues and cells. Therefore, we are committed to seeking a suitable and efficient delivery system. Inspired by the possibility that exosomes may be involved in the secretion and transport mechanism of many signaling molecules or proteins in the brain, exosomes have attracted extensive attention as natural nanoscale drug carriers. We selected exosomes derived from bone marrow mesenchymal stem cells (MSC-EXO) with low immunogenicity and exosomes derived from hippocampal neurons (HT22-EXO) that may have excellent homing ability to overcome the deficiencies of oral or injectable pathways and bypass the BBB through nasal administration and evaluated their delivery ability and effect on AD. First, MSC-EXO and HT22 cells were isolated and cultured, and MSCs were identified by microimaging and flow cytometry. Then MSC-EXO and HT22-EXO were obtained by gradient centrifugation and qEV SEC separation column, and a series of physicochemical characterization were performed by transmission electron microscope, western blot, nanoparticle tracking analysis and dynamic light scattering. Next, exosomes labeled with lipophilic fluorescent dye were administered to WT mice and APP/PS1 mice to obtain fluorescence images of various organs at different times. Finally, APP/PS1 mice were administered intranasally with two exosomes 20 times over 40 days and 20 μL each time. Behavioral analysis and pathological section analysis of the hippocampus were performed after the experiment. The results showed that MSC-EXO and HT22-EXO were successfully isolated and characterized, and they had good biocompatibility. MSC-EXO showed excellent brain enrichment in APP/PS1 mice after intranasal administration, could improve the neuronal damage and reduce inflammation levels in the hippocampus of APP/PS1 mice, and the improvement effect was significantly better than HT22-EXO. However, intranasal administration of the two exosomes did not cause depression and anxious-like phenotypes in APP/PS1 mice, nor significantly improved the short-term or spatial learning and memory ability of APP/PS1 mice, and had no significant effect on the content of Aβ plaques in the hippocampus, which also meant that MSC-EXO could use their own advantages in combination with other drugs to clear Aβ plaques. The possibility of realizing highly effective non-invasive synergistic treatment for AD provides new strategies and ideas for clinical research.

Keywords: Alzheimer’s disease, exosomes derived from mesenchymal stem cell, intranasal administration, therapy-carrier dual roles

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582 Analyzing Social and Political Constraints in Development Aid Projects in Post Conflict Region of SWAT, Pakistan

Authors: Faizan Sultan

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Non-government organizations (NGOs) in Pakistan have the potential to deliver services such as health, education, and rural development through targeting the most vulnerable communities of society. Having this significant importance, NGOs are facing numerous challenges in service delivery. So, there is a need to identify the challenges NGOs face in community development, particularly post-conflict development. The current study has analyzed the social and political constraints in development projects in the post-conflict region of the Swat district of Khyber Pakhtunkhwa. The objectives of this study are “What are the social and political constraints faced by the nongovernmental organizations in the implementation of development aid Projects in post-conflict development of Swat and to examine the challenges in coordination mechanism between government departments, NGOs, and community in reconstruction activities”. This research is based upon both the quantitative and qualitative data that is being gathered from the NGO representatives, government officials, and community members who were involved in post-conflict development interventions in the Swat region. A purposive sampling technique was used to select respondents from the community members/activists (25 in number) and government and NGO officials (10 in number). Based on analysis against our objectives, NGOs have faced numerous constraints such as Insecurity, Negative Perceptions about NGOs, restrictions on women's mobility, government policies and regulations, lack of coordination and networking, trust deficit, and political interference while implementing their project interventions. These findings concluded that constraints have affected project implementation to a greater extent, including women's participation, involvement of marginalized populations, and equal distribution of resources. In the Swat region, NGOs cannot openly discuss sensitive projects such as human rights, gender-based projects, or women empowerment as these issues are very sensitive to the local community due to their cultural values. The community may not allow their females to go outside their homes as this region is a male-dominated society. Similarly, lack of communication and poor networking for the arrangements of the project meetings were also the major constraints.

Keywords: national disaster management authority, millennium development goals, provincial disaster management authority, provincial reconstruction, rehabilitation and settlement authority

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581 The Relationship between Caregiver Burden and Life Satisfaction of Caregivers of Elderly Individuals

Authors: Guler Duru Asiret, Cemile Kutmec Yilmaz, Gulcan Bagcivan, Tugce Turten Kaymaz

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This descriptive study was conducted to determine the relationship between caregiver burden and life satisfaction who give home care to elderly individuals. The sample was recruited from the internal medicine unit and palliative unit of a state hospital located in Turkey on June 2016-2017. The study sample consisted of 231 primary caregiver family member, who met the eligibility criteria and agreed to participate in the study. The inclusion criteria were as follows: inpatient’s caregiver, primary caregiver for at least 3 months, at least 18 years of age, no communication problem or mental disorder. Data were gathered using an Information Form prepared by the researchers based on previous literature, the Zarit Burden Interview (ZBI), and the Satisfaction with Life Scale (SWLS). The data were analyzed using IBM SPSS Statistics software version 20.0 (SPSS, Chicago, IL). The descriptive characteristics of the participant were analyzed using number, percentage, mean and standard deviation. The suitability of normal distribution of scale scores was analyzed using Kolmogorov-Smirnov and Shapiro-Wilk test. Relationships between scales were analyzed using Spearman’s rank-correlation coefficient. P values less than 0.05 were considered to be significant. The average age of the caregivers was 50.11±13.46 (mean±SD) years. Of the caregivers, 76.2% were women, 45% were primary school graduates, 89.2% were married, 38.1% were the daughters of their patients. Among these, 52.4% evaluated their income level to be good. Of them, 53.6% had been giving care less than 2 years. The patients’ average age was 77.1±8.0 years. Of the patients, 55.8% were women, 56.3% were illeterate, 70.6% were married, and 97.4% had at least one chronic disease. The mean Zarit Burden Interview score was 35.4±1.5 and the Satisfaction with Life Scale score was 20.6±6.8. A negative relationship was found between the patients’ score average on the ZBI, and on the SWLS (r= -0.438, p=0.000). The present study determined that the caregivers have a moderate caregiver burden and the life satisfaction. And the life satisfaction of caregivers decreased as their caregiver burden increase. In line with the results obtained from the research, it is recommended that to increase the effectiveness of discharge training, to arrange training and counseling programs for caregivers to cope with the problems they experienced, to monitor the caregivers at regular intervals and to provide necessary institutional support.

Keywords: caregiver burden, family caregivers, nurses, satisfaction

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580 Utilising Indigenous Knowledge to Design Dykes in Malawi

Authors: Martin Kleynhans, Margot Soler, Gavin Quibell

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Malawi is one of the world’s poorest nations and consequently, the design of flood risk management infrastructure comes with a different set of challenges. There is a lack of good quality hydromet data, both in spatial terms and in the quality thereof and the challenge in the design of flood risk management infrastructure is compounded by the fact that maintenance is almost completely non-existent and that solutions have to be simple to be effective. Solutions should not require any further resources to remain functional after completion, and they should be resilient. They also have to be cost effective. The Lower Shire Valley of Malawi suffers from frequent flood events. Various flood risk management interventions have been designed across the valley during the course of the Shire River Basin Management Project – Phase I, and due to the data poor environment, indigenous knowledge was relied upon to a great extent for hydrological and hydraulic model calibration and verification. However, indigenous knowledge comes with the caveat that it is ‘fuzzy’ and that it can be manipulated for political reasons. The experience in the Lower Shire valley suggests that indigenous knowledge is unlikely to invent a problem where none exists, but that flood depths and extents may be exaggerated to secure prioritization of the intervention. Indigenous knowledge relies on the memory of a community and cannot foresee events that exceed past experience, that could occur differently to those that have occurred in the past, or where flood management interventions change the flow regime. This complicates communication of planned interventions to local inhabitants. Indigenous knowledge is, for the most part, intuitive, but flooding can sometimes be counter intuitive, and the rural poor may have a lower trust of technology. Due to a near complete lack of maintenance of infrastructure, infrastructure has to be designed with no moving parts and no requirement for energy inputs. This precludes pumps, valves, flap gates and sophisticated warning systems. Designs of dykes during this project included ‘flood warning spillways’, that double up as pedestrian and animal crossing points, which provide warning of impending dangerous water levels behind dykes to residents before water levels that could cause a possible dyke failure are reached. Locally available materials and erosion protection using vegetation were used wherever possible to keep costs down.

Keywords: design of dykes in low-income countries, flood warning spillways, indigenous knowledge, Malawi

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579 Exploring Stakeholders’ Perceptions of the Implementation of the Door-to-Door Vaccination Campaign for the Oral Polio Vaccine (NOPV2) In Uganda: A Qualitative Study

Authors: Elizabeth B. Katana, Brenda N. Simbwa, Josephine Namayanja, Bob O. Amodan, Edirisa J. Nsubuga, Eva A. O. Laker

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Background: Understanding stakeholders’ perceptions towards the implementation of a mass vaccination campaign is important to ensure the design of better strategies to address challenges. We explored stakeholders’ perceptions of the implementation of a nationwide door-to-door mass vaccination campaign for the oral polio vaccine (nOPV2) in Uganda for the two rounds that occurred in January and November 2022. Methods: A qualitative study was conducted among stakeholders who participated in the campaign implementation from 8 districts in Uganda using random sampling. We conducted 46 In-depth interviews lasting 30 – 40 minutes with 6 national/central supervisors, 12 district, 14 sub-county, and 14 parish-level supervisors. Stakeholders were asked about their experiences in the campaign implementation, including challenges faced and their opinions of the campaign impact and use of the door-to-door strategy. Data were analyzed thematically in line with the major campaign activities. Results: Most of the stakeholders were primarily concerned about poor planning, inadequate training of vaccination teams, community resistance including schools, challenges with recruitment and teaming of vaccinators, poor and delayed payments, lack of logistics and motivation for vaccination teams, the timing of the activities and implementing amidst COVID-19 and Ebola. The stakeholders believed that the first round was not well planned and implemented, while the second round was leveraged in their previous experiences. On the other hand, some positive experiences were noted with regard to communication, advocacy and mobilization, vaccine delivery and distribution, district readiness assessments, and cold chain management. Conclusion: This study identified many challenges that were faced in the implementation of the door-to-door mass campaign for nOPV2 in Uganda. This study identified that more needs to be done to improve door-to-door mass campaigns with a focus on motivating the implementers. These findings highlight the need for conducting performance reviews, improved planning, especially routine updates and verification of target populations and training in microplanning, and adequate mapping of community resistance to inform the implementation of future mass campaigns.

Keywords: mass polio vaccination campaigns, door-to-door strategy, stakeholders' perceptions, implementation challenges

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578 Comprehensive Machine Learning-Based Glucose Sensing from Near-Infrared Spectra

Authors: Bitewulign Mekonnen

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Context: This scientific paper focuses on the use of near-infrared (NIR) spectroscopy to determine glucose concentration in aqueous solutions accurately and rapidly. The study compares six different machine learning methods for predicting glucose concentration and also explores the development of a deep learning model for classifying NIR spectra. The objective is to optimize the detection model and improve the accuracy of glucose prediction. This research is important because it provides a comprehensive analysis of various machine-learning techniques for estimating aqueous glucose concentrations. Research Aim: The aim of this study is to compare and evaluate different machine-learning methods for predicting glucose concentration from NIR spectra. Additionally, the study aims to develop and assess a deep-learning model for classifying NIR spectra. Methodology: The research methodology involves the use of machine learning and deep learning techniques. Six machine learning regression models, including support vector machine regression, partial least squares regression, extra tree regression, random forest regression, extreme gradient boosting, and principal component analysis-neural network, are employed to predict glucose concentration. The NIR spectra data is randomly divided into train and test sets, and the process is repeated ten times to increase generalization ability. In addition, a convolutional neural network is developed for classifying NIR spectra. Findings: The study reveals that the SVMR, ETR, and PCA-NN models exhibit excellent performance in predicting glucose concentration, with correlation coefficients (R) > 0.99 and determination coefficients (R²)> 0.985. The deep learning model achieves high macro-averaging scores for precision, recall, and F1-measure. These findings demonstrate the effectiveness of machine learning and deep learning methods in optimizing the detection model and improving glucose prediction accuracy. Theoretical Importance: This research contributes to the field by providing a comprehensive analysis of various machine-learning techniques for estimating glucose concentrations from NIR spectra. It also explores the use of deep learning for the classification of indistinguishable NIR spectra. The findings highlight the potential of machine learning and deep learning in enhancing the prediction accuracy of glucose-relevant features. Data Collection and Analysis Procedures: The NIR spectra and corresponding references for glucose concentration are measured in increments of 20 mg/dl. The data is randomly divided into train and test sets, and the models are evaluated using regression analysis and classification metrics. The performance of each model is assessed based on correlation coefficients, determination coefficients, precision, recall, and F1-measure. Question Addressed: The study addresses the question of whether machine learning and deep learning methods can optimize the detection model and improve the accuracy of glucose prediction from NIR spectra. Conclusion: The research demonstrates that machine learning and deep learning methods can effectively predict glucose concentration from NIR spectra. The SVMR, ETR, and PCA-NN models exhibit superior performance, while the deep learning model achieves high classification scores. These findings suggest that machine learning and deep learning techniques can be used to improve the prediction accuracy of glucose-relevant features. Further research is needed to explore their clinical utility in analyzing complex matrices, such as blood glucose levels.

Keywords: machine learning, signal processing, near-infrared spectroscopy, support vector machine, neural network

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577 Decision Making Regarding Spouse Selection and Women's Autonomy in India: Exploring the Linkage

Authors: Nivedita Paul

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The changing character of marriage be it arranged marriage, love marriage, polygamy, informal unions, all signify different gender relations in everyday lives. Marriages in India are part and parcel of the kinship and cultural practices. Arranged marriage is still the dominant form of marriage where spouse selection is the initiative and decision of the parents; but its form is changing, as women are now actively participating in spouse selection but with parental consent. Spouse selection related decision making is important because marriage as an institution brings social change and gender inequality; especially in a women’s life as marriages in India are mostly patrilocal. Moreover, the amount of say in spouse selection can affect a woman’s reproductive rights, domestic violence issues, household resource allocation, communication possibilities with the spouse/husband, marital life, etc. The present study uses data from Indian Human Development Survey II (2011-12) which is a nationally representative multitopic survey that covers 41,554 households. Currently, married women of age group 15-49 in their first marriage; whose year of marriage is from 1970s to 2000s have been taken for the study. Based on spouse selection experiences, the sample of women has been divided into three marriage categories-self, semi and family arranged. Women in self arranged or love marriage is the sole decision maker in choosing the partner, in semi arranged marriage or arranged marriage with consent both parents and women together take the decision, whereas in family arranged or arranged marriage without consent only parents take the decision. The main aim of the study is to find the relationship between spouse selection experiences and women’s autonomy in India. Decision making in economic matters, child and health related decision making, mobility and access to resources are taken to be proxies of autonomy. Method of ordinal regression has been used to find the relationship between spouse selection experiences and autonomy after marriage keeping other independent variables as control factors. Results show that women in semi arranged marriage have more decision making power regarding financial matters of the household, health related matters, mobility and accessibility to resources, when compared to women in family, arranged marriages. For freedom of movement and access to resources women in self arranged marriage have the highest say or exercise greatest power. Therefore, greater participation of women (even though not absolute control) in spouse selection may lead to greater autonomy after marriage.

Keywords: arranged marriage, autonomy, consent, spouse selection

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576 A Systematic Review Regarding Caregiving Relationships of Adolescents Orphaned by Aids and Primary Caregivers

Authors: M. Petunia Tsweleng

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Statement of the Problem: Research and aid organisations report that children and adolescents orphaned due to HIV and AIDS are particularly vulnerable as they are often exposed to negative effects of both HIV and AIDS and orphanhood. Without much-needed parental love, care, and support, these children and adolescents are at risk of poor developmental outcomes. A cursory look at the available literature on AIDS-orphaned adolescents, and the quality of caregiving relationships with caregivers, shows that this is a relatively under-researched terrain. This article is a review of the literature on caregiving relationships of adolescents orphaned due to AIDS and their current primary caregivers. It aims to inform community programmes and policymakers by providing insight into the qualities of these relationships. Methodology: A comprehensive search of both peer-reviewed and non-peer-reviewed literature was conducted through EBSCOhost, SpringLINK, PsycINFO, SAGE, PubMed, Elsevier ScienceDirect, JSTOR, Wiley Online Library databases, and Google Scholar. The combination of keywords used for the search were: (caregiving relationships); (orphans OR AIDS orphaned children OR AIDS orphaned adolescents); (primary caregivers); and (quality caregiving); (orphans); (HIV and AIDS). The search took place between 24 January and 28 February 2022. Both qualitative and quantitative research studies published between 2010 and 2020 were reviewed. However, only qualitative studies were selected in the end -as they presented more profound findings concerning orphan-caregiver relationships. The following three stages of meta-synthesis analysis were used to analyse data: refutational syntheses, reciprocal syntheses, and line of argument. Results: The search resulted in a total of 2090 titles, of which 750 were duplicates and therefore subtracted. The researcher reviewed all the titles and abstracts of the remaining 1340 articles. 329 articles were identified as relevant, and full texts were reviewed. Following the review of the full texts, 313 studies were excluded for relevance and 4 for methodology. Twelve articles representing 11 studies fulfilled the inclusion criteria and were selected. These studies, representing different countries across the globe, reported similar forms of hardships experienced by caregivers economically, psychosocially, and healthwise. However, the studies also show that the majority of caregivers found contentment in caring for orphans, particularly grandmother carers, and were thus enabled to provide love, care, and support despite hardships. This resulted in positive caregiving relationships -as orphans fared well emotionally and psychosocially. Some relationships, however, were found negative due to unhealed emotional wounds suffered by both caregivers and orphans and others due to the caregiver’s lack of interest in providing care. These findings were based on self-report data from both orphans and caregivers. Conclusion: Findings suggest that intervention efforts need to be intensified to: alleviate poverty in households that are affected by HIV and AIDS pandemic, strengthen the community psychosocial support programmes for orphans and their caregivers; and integrate clinical services with community programmes for the healing of emotional and psychological wounds. Contributions: Findings inform community programmes and policymakers by providing insight into the qualities of the mentioned relationships as well as identifying factors commonly associated with high-quality caregiving and poor-quality caregiving.

Keywords: systematic review, caregiving relationships, orphans and primary caregivers, AIDS

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575 Quantified Metabolomics for the Determination of Phenotypes and Biomarkers across Species in Health and Disease

Authors: Miroslava Cuperlovic-Culf, Lipu Wang, Ketty Boyle, Nadine Makley, Ian Burton, Anissa Belkaid, Mohamed Touaibia, Marc E. Surrette

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Metabolic changes are one of the major factors in the development of a variety of diseases in various species. Metabolism of agricultural plants is altered the following infection with pathogens sometimes contributing to resistance. At the same time, pathogens use metabolites for infection and progression. In humans, metabolism is a hallmark of cancer development for example. Quantified metabolomics data combined with other omics or clinical data and analyzed using various unsupervised and supervised methods can lead to better diagnosis and prognosis. It can also provide information about resistance as well as contribute knowledge of compounds significant for disease progression or prevention. In this work, different methods for metabolomics quantification and analysis from Nuclear Magnetic Resonance (NMR) measurements that are used for investigation of disease development in wheat and human cells will be presented. One-dimensional 1H NMR spectra are used extensively for metabolic profiling due to their high reliability, wide range of applicability, speed, trivial sample preparation and low cost. This presentation will describe a new method for metabolite quantification from NMR data that combines alignment of spectra of standards to sample spectra followed by multivariate linear regression optimization of spectra of assigned metabolites to samples’ spectra. Several different alignment methods were tested and multivariate linear regression result has been compared with other quantification methods. Quantified metabolomics data can be analyzed in the variety of ways and we will present different clustering methods used for phenotype determination, network analysis providing knowledge about the relationships between metabolites through metabolic network as well as biomarker selection providing novel markers. These analysis methods have been utilized for the investigation of fusarium head blight resistance in wheat cultivars as well as analysis of the effect of estrogen receptor and carbonic anhydrase activation and inhibition on breast cancer cell metabolism. Metabolic changes in spikelet’s of wheat cultivars FL62R1, Stettler, MuchMore and Sumai3 following fusarium graminearum infection were explored. Extensive 1D 1H and 2D NMR measurements provided information for detailed metabolite assignment and quantification leading to possible metabolic markers discriminating resistance level in wheat subtypes. Quantification data is compared to results obtained using other published methods. Fusarium infection induced metabolic changes in different wheat varieties are discussed in the context of metabolic network and resistance. Quantitative metabolomics has been used for the investigation of the effect of targeted enzyme inhibition in cancer. In this work, the effect of 17 β -estradiol and ferulic acid on metabolism of ER+ breast cancer cells has been compared to their effect on ER- control cells. The effect of the inhibitors of carbonic anhydrase on the observed metabolic changes resulting from ER activation has also been determined. Metabolic profiles were studied using 1D and 2D metabolomic NMR experiments, combined with the identification and quantification of metabolites, and the annotation of the results is provided in the context of biochemical pathways.

Keywords: metabolic biomarkers, metabolic network, metabolomics, multivariate linear regression, NMR quantification, quantified metabolomics, spectral alignment

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574 The Structure of Financial Regulation: The Regulators Perspective

Authors: Mohamed Aljarallah, Mohamed Nurullah, George Saridakis

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This paper aims and objectives are to investigate how the structural change of the financial regulatory bodies affect the financial supervision and how the regulators can design such a structure with taking into account; the Central Bank, the conduct of business and the prudential regulators, it will also consider looking at the structure of the international regulatory bodies and what barriers are found. There will be five questions to be answered; should conduct of business and prudential regulation be separated? Should the financial supervision and financial stability be separated? Should the financial supervision be under the Central Bank? To what extent the politician should intervene in changing the regulatory and supervisory structure? What should be the regulatory and supervisory structure when there is financial conglomerate? Semi structure interview design will be applied. This research sample selection contains a collective of financial regulators and supervisors from the emerged and emerging countries. Moreover, financial regulators and supervisors must be at a senior level at their organisations. Additionally, senior financial regulators and supervisors would come from different authorities and from around the world. For instance, one of the participants comes from the International Bank Settlements, others come from European Central Bank, and an additional one will come from Hong Kong Monetary Authority and others. Such a variety aims to fulfil the aims and objectives of the research and cover the research questions. The analysis process starts with transcription of the interview, using Nvivo software for coding, applying thematic interview to generate the main themes. The major findings of the study are as follow. First, organisational structure changes quite frequently if the mandates are not clear. Second, measuring structural change is difficult, which makes the whole process unclear. Third, effective coordination and communication are what regulators looking for when they change the structure and that requires; openness, trust, and incentive. In addition to that, issues appear during the event of crisis tend to be the reason why the structure change. Also, the development of the market sometime causes a change in the regulatory structure. And, some structural change occurs simply because of the international trend, fashion, or other countries' experiences. Furthermore, when the top management change the structure tends to change. Moreover, the structure change due to the political change, or politicians try to show they are doing something. Finally, fear of being blamed can be a driver of structural change. In conclusion, this research aims to provide an insight from the senior regulators and supervisors from fifty different countries to have a clear understanding of why the regulatory structure keeps changing from time to time through a qualitative approach, namely, semi-structure interview.

Keywords: financial regulation bodies, financial regulatory structure, global financial regulation, financial crisis

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573 Partnering With Key Stakeholders for Successful Implementation of Inhaled Analgesia for Specific Emergency Department Presentations

Authors: Sarah Hazelwood, Janice Hay

Abstract:

Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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572 A Qualitative Study on Overcoming Problems and Limitations of Telepsychological Support (Online Counseling): Through Interviews with Practitioners

Authors: Toshiki Ito, Takahiro Yamane, Yuki Adachi, Yoshiko Kato, Eiji Tsuda, Kousaku Nagasaka, Keigo Yoshida, Yoshiko Kawasaki, Naoki Aizawa, Kyouhei Nishi, Tetsuko Kato

Abstract:

The epidemic of the coronavirus (COVID-19), first reported in Wuhan at the end of 2019, has drastically changed our daily lives. Under these circumstances, counseling, which provides psychological support to people, was also greatly affected. The structure of counseling, which had generally been implicitly common practice to be conducted in person, was greatly shaken. The author wondered how counseling can be conducted in situations where it is impossible to meet face-to-face. This is where telepsychological support (online counseling) came into use. The authors found that there were the following problems in telepsychological support: (1) anxiety about whether the communication is appropriate, (2) difficulty in understanding the client's situation and condition, (3) inability to perceive what was normally perceived in person, (4) difficulty in adjusting to severely ill clients, (5) difficulty in dealing with emergency situations, etc. In this study, we interviewed psychologists who had been accustomed to telepsychological support for more than two years after the Corona disaster began to clarify how they had or had not overcome the problems of telepsychological support identified in the above studies. We also aim to consider the unique possibilities of how telepsychological support, a new technique of psychological support, can be implemented to provide more effective and meaningful support in society after the end of the Corona disaster (post-Corona society). Thirteen psychologists who are currently providing telepsychological support in the Corona Disaster will be interviewed, and semi-structured interviews will be conducted for one hour per person. In order to empirically examine how the problems in telepsychological support had been overcome or not through the interview survey, the authors asked (1) how they overcame their anxiety about whether they were able to communicate appropriately, (2) how they devised ways to overcome it, (3) how they overcame the difficulty in adapting to heavy clients in terms of the level of the disease, (4) how they overcame the difficulty in dealing with emergency situations. The interviews were analyzed using Thematic Analysis, a qualitative analysis method commonly used in qualitative research overseas. The authors found that some devices and perspectives were newly discovered as a result of two years of practice of telepsychological support and that psychologists in this study considered face-to-face interviews and telepsychological support to be separate and were flexible enough to use them when available and to move to face-to-face interviews when not appropriate.

Keywords: telepsychology, COVID-19, Corona, psychologist

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571 Inclusion and Equity in Higher Education: Case of a Higher Education Institution in Portugal

Authors: Mariana Fernandes

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Instituto Politécnico de Viana do Castelo (IPVC) has adopted a policy of inclusion and equity and the promotion of health and academic well-being, reinforcing measures already implemented in previous years, but also with the inclusion of new inclusion and equity policies that allow access, throughout all students, to Higher Education (ES). The Inclusive School project, the Plan for Equality, the IPVC's own Regulations for students with Special Educational Needs (SEN), and the support guaranteed by the Health and Wellbeing Office, Academic Services, and teaching staff are some of the examples of the varied strategies that IPVC undertakes to guarantee effective conditions so that students with disabilities can enter ES and experience a positive academic experience. This study's main objective is to reflect and disseminate the inclusion practices that IPVC practices with regard to Students with SEN. To this, a consultation and documentary analysis of internal documentation was carried out, consultation of the IPVC Quality Management System (QMS) process and, also, using the report referring to the ENEE questionnaire implemented in the year 2023, this report which presents the opinion of IPVC students with SEN, whether with support throughout the ENEE application submission process, with response deadlines, with the Individual Support Plan, as well as with physical and technological accessibility and communication. The results obtained show IPVC's effective commitment to this topic, in addition to the entire circuit created to guarantee equitable access for these students from the moment they join IPVC, a circuit that involves various human resources and( s) its sensitivity to this topic, it also promoted, through the Health and Wellbeing Office, the restructuring of the IPVC ENEE Regulation itself based on the needs and challenges felt in monitoring these students, the innovation of the services themselves of health and consequent awareness of all surrounding resources and services (from the Management, to the teaching staff and academic services). Currently, there is already an Individual Pedagogical Support Plan (PIAP), frequent meetings with the Reception Group, Psychology consultations – both clinically and educationally – and a growing concern in listening to the student community to improve the process. Based on these results, it is concluded that IPVC is an institution sensitive to promoting a positive, equitable, and, above all, inclusive higher education path.

Keywords: special educational needs, inclusion, equity, equality

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