Search results for: early intensive behavioral intervention
Commenced in January 2007
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Edition: International
Paper Count: 7772

Search results for: early intensive behavioral intervention

362 Evaluation of Cyclic Steam Injection in Multi-Layered Heterogeneous Reservoir

Authors: Worawanna Panyakotkaew, Falan Srisuriyachai

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Cyclic steam injection (CSI) is a thermal recovery technique performed by injecting periodically heated steam into heavy oil reservoir. Oil viscosity is substantially reduced by means of heat transferred from steam. Together with gas pressurization, oil recovery is greatly improved. Nevertheless, prediction of effectiveness of the process is difficult when reservoir contains degree of heterogeneity. Therefore, study of heterogeneity together with interest reservoir properties must be evaluated prior to field implementation. In this study, thermal reservoir simulation program is utilized. Reservoir model is firstly constructed as multi-layered with coarsening upward sequence. The highest permeability is located on top layer with descending of permeability values in lower layers. Steam is injected from two wells located diagonally in quarter five-spot pattern. Heavy oil is produced by adjusting operating parameters including soaking period and steam quality. After selecting the best conditions for both parameters yielding the highest oil recovery, effects of degree of heterogeneity (represented by Lorenz coefficient), vertical permeability and permeability sequence are evaluated. Surprisingly, simulation results show that reservoir heterogeneity yields benefits on CSI technique. Increasing of reservoir heterogeneity impoverishes permeability distribution. High permeability contrast results in steam intruding in upper layers. Once temperature is cool down during back flow period, condense water percolates downward, resulting in high oil saturation on top layers. Gas saturation appears on top after while, causing better propagation of steam in the following cycle due to high compressibility of gas. Large steam chamber therefore covers most of the area in upper zone. Oil recovery reaches approximately 60% which is of about 20% higher than case of heterogeneous reservoir. Vertical permeability exhibits benefits on CSI. Expansion of steam chamber occurs within shorter time from upper to lower zone. For fining upward permeability sequence where permeability values are reversed from the previous case, steam does not override to top layers due to low permeability. Propagation of steam chamber occurs in middle of reservoir where permeability is high enough. Rate of oil recovery is slower compared to coarsening upward case due to lower permeability at the location where propagation of steam chamber occurs. Even CSI technique produces oil quite slowly in early cycles, once steam chamber is formed deep in the reservoir, heat is delivered to formation quickly in latter cycles. Since reservoir heterogeneity is unavoidable, a thorough understanding of its effect must be considered. This study shows that CSI technique might be one of the compatible solutions for highly heterogeneous reservoir. This competitive technique also shows benefit in terms of heat consumption as steam is injected periodically.

Keywords: cyclic steam injection, heterogeneity, reservoir simulation, thermal recovery

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361 Combination of Unmanned Aerial Vehicle and Terrestrial Laser Scanner Data for Citrus Yield Estimation

Authors: Mohammed Hmimou, Khalid Amediaz, Imane Sebari, Nabil Bounajma

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Annual crop production is one of the most important macroeconomic indicators for the majority of countries around the world. This information is valuable, especially for exporting countries which need a yield estimation before harvest in order to correctly plan the supply chain. When it comes to estimating agricultural yield, especially for arboriculture, conventional methods are mostly applied. In the case of the citrus industry, the sale before harvest is largely practiced, which requires an estimation of the production when the fruit is on the tree. However, conventional method based on the sampling surveys of some trees within the field is always used to perform yield estimation, and the success of this process mainly depends on the expertise of the ‘estimator agent’. The present study aims to propose a methodology based on the combination of unmanned aerial vehicle (UAV) images and terrestrial laser scanner (TLS) point cloud to estimate citrus production. During data acquisition, a fixed wing and rotatory drones, as well as a terrestrial laser scanner, were tested. After that, a pre-processing step was performed in order to generate point cloud and digital surface model. At the processing stage, a machine vision workflow was implemented to extract points corresponding to fruits from the whole tree point cloud, cluster them into fruits, and model them geometrically in a 3D space. By linking the resulting geometric properties to the fruit weight, the yield can be estimated, and the statistical distribution of fruits size can be generated. This later property, which is information required by importing countries of citrus, cannot be estimated before harvest using the conventional method. Since terrestrial laser scanner is static, data gathering using this technology can be performed over only some trees. So, integration of drone data was thought in order to estimate the yield over a whole orchard. To achieve that, features derived from drone digital surface model were linked to yield estimation by laser scanner of some trees to build a regression model that predicts the yield of a tree given its features. Several missions were carried out to collect drone and laser scanner data within citrus orchards of different varieties by testing several data acquisition parameters (fly height, images overlap, fly mission plan). The accuracy of the obtained results by the proposed methodology in comparison to the yield estimation results by the conventional method varies from 65% to 94% depending mainly on the phenological stage of the studied citrus variety during the data acquisition mission. The proposed approach demonstrates its strong potential for early estimation of citrus production and the possibility of its extension to other fruit trees.

Keywords: citrus, digital surface model, point cloud, terrestrial laser scanner, UAV, yield estimation, 3D modeling

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360 A Comprehensive Key Performance Indicators Dashboard for Emergency Medical Services

Authors: Giada Feletti, Daniela Tedesco, Paolo Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning the indicators currently used for the performance measurement of EMS systems. From this literature analysis, it emerged that current studies focus on two distinct perspectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). The perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal focuses on the entire healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid to the dependency of decisions that in current EMS management models tend to be neglected or underestimated. In particular, the integration of the two processes enables the evaluation of the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in the extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating the ones firstly not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draws us to exclude additional indicators due to the unavailability of data required for their computation. The final dashboard, which was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness of EDs accessibility in real-time. By associating each KPI to the EMS phase it refers to, it was also possible to design a well-balanced dashboard covering both efficiency and effective performance of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient’s care are covered by traditional KPIs compared to the subsequent phases taking place in the hospital ED. This could be taken into consideration for the potential future development of the dashboard. Moreover, the research could proceed by building a multi-layer dashboard composed of the first level with a minimal set of KPIs to measure the basic performance of the EMS system at an aggregate level and further levels with KPIs that can bring additional and more detailed information.

Keywords: dashboard, decision support, emergency medical services, key performance indicators

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359 Human Immuno-Deficiency Virus Co-Infection with Hepatitis B Virus and Baseline Cd4+ T Cell Count among Patients Attending a Tertiary Care Hospital, Nepal

Authors: Soma Kanta Baral

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Background: Since 1981, when the first AIDS case was reported, worldwide, more than 34 million people have been infected with HIV. Almost 95 percent of the people infected with HIV live in developing countries. As HBV & HIV share similar routes of transmission by sexual intercourse or drug use by parenteral injection, co-infection is common. Because of the limited access to healthcare & HIV treatment in developing countries, HIV-infected individuals are present late for care. Enumeration of CD4+ T cell count at the time of diagnosis has been useful to initiate the therapy in HIV infected individuals. The baseline CD4+ T cell count shows high immunological variability among patients. Methods: This prospective study was done in the serology section of the Department of Microbiology over a period of one year from august 2012 to July 2013. A total of 13037 individuals subjected for HIV test were included in the study comprising of 4982 males & 8055 females. Blood sample was collected by vein puncture aseptically with standard operational procedure in clean & dry test-tube. All blood samples were screened for HIV as described by WHO algorithm by Immuno-chromatography rapid kits. Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. After informed consent, HIV positive individuals were screened for HBsAg by Immuno-chromatography rapid kits (Hepacard). Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. EDTA blood samples were collected from the HIV sero-positive individuals for baseline CD4+ T count. Then, CD4+ T cells count was determined by using FACS Calibur Flow Cytometer (BD). Results: Among 13037 individuals screened for HIV, 104 (0.8%) were found to be infected comprising of 69(66.34%) males & 35 (33.65%) females. The study showed that the high infection was noted in housewives (28.7%), active age group (30.76%), rural area (56.7%) & in heterosexual route (80.9%) of transmission. Out of total HIV infected individuals, distribution of HBV co-infection was found to be 6(5.7%). All co- infected individuals were married, male, above the age of 25 years & heterosexual route of transmission. Baseline CD4+ T cell count of HIV infected patient was found higher (mean CD4+ T cell count; 283cells/cu.mm) than HBV co-infected patients (mean CD4+ T cell count; 91 cells/cu.mm). Majority (77.2%) of HIV infected & all co-infected individuals were presented in our center late (CD4+ T cell count;< 350/cu. mm) for diagnosis and care. Majority of co- infected 4 (80%) were late presented with advanced AIDS stage (CD4+ count; <200/cu.mm). Conclusions: The study showed a high percentage of HIV sero-positive & co- infected individuals. Baseline CD4+ T cell count of majority of HIV infected individuals was found to be low. Hence, more sustained and vigorous awareness campaigns & counseling still need to be done in order to promote early diagnosis and management.

Keywords: HIV/AIDS, HBsAg, co-infection, CD4+

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358 Impact of Interdisciplinary Therapy Allied to Online Health Education on Cardiometabolic Parameters and Inflammation Factor Rating in Obese Adolescents

Authors: Yasmin A. M. Ferreira, Ana C. K. Pelissari, Sofia De C. F. Vicente, Raquel M. Da S. Campos, Deborah C. L. Masquio, Lian Tock, Lila M. Oyama, Flavia C. Corgosinho, Valter T. Boldarine, Ana R. Dâmaso

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The prevalence of overweight and obesity is growing around the world and currently considered a global epidemic. Food and nutrition are essential requirements for promoting health and protecting non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate the inflammation and oxidative stress in obese individuals. Few studies have investigated the dietary Inflammation Factor Rating (IFR) in obese adolescents. The IFR was developed to characterize an individual´s diet on anti- to pro-inflammatory score. This evaluation contributes to investigate the effects of inflammatory diet in metabolic profile in several individual conditions. Objectives: The present study aims to investigate the effects of a multidisciplinary weight loss therapy on inflammation factor rating and cardiometabolic risk in obese adolescents. Methods: A total of 26 volunteers (14-19 y.o) were recruited and submitted to 20 weeks interdisciplinary therapy allied to health education website- Ciclo do Emagrecimento®, including clinical, nutritional, psychological counseling and exercise training. The body weight was monitored weekly by self-report and photo. The adolescents answered a test to evaluate the knowledge of the topics covered in the videos. A 24h dietary record was applied at the baseline and after 20 weeks to assess the food intake and to calculate IFR. A negative IFR suggests that diet may have inflammatory effects and a positive IFR indicates an anti-inflammatory effect. Statistical analysis was performed using the program STATISTICA version 12.5 for Windows. The adopted significant value was α ≤ 5 %. Data normality was verified with the Kolmogorov Smirnov test. Data were expressed as mean±SD values. To analyze the effects of intervention it was applied test t. Pearson´s correlations test was performed. Results: After 20 weeks of treatment, body mass index (BMI), body weight, body fat (kg and %), abdominal and waist circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. Moreover, it was found an improvement of inflammation factor rating from -427,27±322,47 to -297,15±240,01, suggesting beneficial effects of nutritional counselling. Considering the correlations analysis, it was found that pro-inflammatory diet is associated with increase in the BMI, very low-density lipoprotein cholesterol (VLDL), triglycerides, insulin and insulin resistance index (HOMA-IR); while an anti-inflammatory diet is associated with improvement of HDL-c and insulin sensitivity Check index (QUICKI). Conclusion: The 20-week blended multidisciplinary therapy was effective to reduce body weight, anthropometric circumferences and improve inflammatory markers in obese adolescents. In addition, our results showed that an increase in inflammatory profile diet is associated with cardiometabolic parameters, suggesting the relevance to stimulate anti-inflammatory diet habits as an effective strategy to treat and control of obesity and related comorbidities. Financial Support: FAPESP (2017/07372-1) and CNPq (409943/2016-9)

Keywords: cardiometabolic risk, inflammatory diet, multidisciplinary therapy, obesity

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357 Teachers of the Pandemic: Retention, Resilience, and Training

Authors: Theoni Soublis

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The COVID-19 pandemic created a severe interruption in teaching and learning in K-12 schools. It is essential that educational researchers, teachers, and administrators understand the long term effects that COVID-19 had on a variety of stakeholders in education. This investigation aims to analyze the research since the beginning of the pandemic that focuses specifically on teacher retention, resilience, and training. The results of this investigation will help to inform future research in order to better understand how the institution of education can continue to be prepared and to better prepare for future significant shifts in the modalities of instruction. The results of this analysis will directly impact the field of education as it will broaden the scope of understanding regarding how COVID- 19 impacted teaching and learning. The themes that will emerge from the data analysis will directly inform policy makers, administrators, and researchers about how to best implement training and curriculum design in order to support teacher effectiveness this in the classroom. Educational researchers have written about how teacher morale plummeted and how many teachers reported early burnout and higher stress levels. Teachers’ stress and anxiety soared during the COVID-19 pandemic, but so has their resilience and dedication to the field of education. This research aims to understand how public-school teachers overcame teaching obstacles presented to them during COVID-19. Research has been conducted to identify a variety of information regarding the impact the pandemic has had on K-12 teachers, students, and families. This research aims to understand how teachers continued to pursue their teaching objectives without significant training of effective online instruction methods. Not many educators even heard of the video conferencing platform Zoom before the spring of 2020. Researchers are interested in understanding how teachers used their expertise, prior knowledge, and training to institute immediate and effective online learning environments, what types of relationships did teachers build with students while teaching 100% remotely, and how did relationships change with students while teaching remotely? Furthermore, did the teacher-student relationship propel teacher resolve to be successful while teaching during a pandemic. Recent world events have significantly impacted the field of public-school teaching. The pandemic forced teachers to shift their paradigm about how to maintain high academic expectations, meet state curriculum standards, and assess students learning gains to make data-informed decisions while simultaneously adapting modes of instruction through multiple outlets with little to no training on remote, synchronous, asynchronous, virtual, and hybrid teaching. While it would be very interesting to study how teaching positively impacted students learning during the pandemic, I am more interested in understanding how teaches stayed the course and maintained their mental health while dealing with the stress and pressure of teaching during COVID-19.

Keywords: teacher retention, COVID-19, teacher education, teacher moral

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356 Integration of a Protective Film to Enhance the Longevity and Performance of Miniaturized Ion Sensors

Authors: Antonio Ruiz Gonzalez, Kwang-Leong Choy

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The measurement of electrolytes has a high value in the clinical routine. Ions are present in all body fluids with variable concentrations and are involved in multiple pathologies such as heart failures and chronic kidney disease. In the case of dissolved potassium, although a high concentration in the blood (hyperkalemia) is relatively uncommon in the general population, it is one of the most frequent acute electrolyte abnormalities. In recent years, the integration of thin films technologies in this field has allowed the development of highly sensitive biosensors with ultra-low limits of detection for the assessment of metals in liquid samples. However, despite the current efforts in the miniaturization of sensitive devices and their integration into portable systems, only a limited number of successful examples used commercially can be found. This fact can be attributed to a high cost involved in their production and the sustained degradation of the electrodes over time, which causes a signal drift in the measurements. Thus, there is an unmet necessity for the development of low-cost and robust sensors for the real-time monitoring of analyte concentrations in patients to allow the early detection and diagnosis of diseases. This paper reports a thin film ion-selective sensor for the evaluation of potassium ions in aqueous samples. As an alternative for this fabrication method, aerosol assisted chemical vapor deposition (AACVD), was applied due to cost-effectivity and fine control over the film deposition. Such a technique does not require vacuum and is suitable for the coating of large surface areas and structures with complex geometries. This approach allowed the fabrication of highly homogeneous surfaces with well-defined microstructures onto 50 nm thin gold layers. The degradative processes of the ubiquitously employed poly (vinyl chloride) membranes in contact with an electrolyte solution were studied, including the polymer leaching process, mechanical desorption of nanoparticles and chemical degradation over time. Rational design of a protective coating based on an organosilicon material in combination with cellulose to improve the long-term stability of the sensors was then carried out, showing an improvement in the performance after 5 weeks. The antifouling properties of such coating were assessed using a cutting-edge quartz microbalance sensor, allowing the quantification of the adsorbed proteins in the nanogram range. A correlation between the microstructural properties of the films with the surface energy and biomolecules adhesion was then found and used to optimize the protective film.

Keywords: hyperkalemia, drift, AACVD, organosilicon

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355 Effects of Heart Rate Variability Biofeedback to Improve Autonomic Nerve Function, Inflammatory Response and Symptom Distress in Patients with Chronic Kidney Disease: A Randomized Control Trial

Authors: Chia-Pei Chen, Yu-Ju Chen, Yu-Juei Hsu

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The prevalence and incidence of end-stage renal disease in Taiwan ranks the highest in the world. According to the statistical survey of the Ministry of Health and Welfare in 2019, kidney disease is the ninth leading cause of death in Taiwan. It leads to autonomic dysfunction, inflammatory response and symptom distress, and further increases the damage to the structure and function of the kidneys, leading to increased demand for renal replacement therapy and risks of cardiovascular disease, which also has medical costs for the society. If we can intervene in a feasible manual to effectively regulate the autonomic nerve function of CKD patients, reduce the inflammatory response and symptom distress. To prolong the progression of the disease, it will be the main goal of caring for CKD patients. This study aims to test the effect of heart rate variability biofeedback (HRVBF) on improving autonomic nerve function (Heart Rate Variability, HRV), inflammatory response (Interleukin-6 [IL-6], C reaction protein [CRP] ), symptom distress (Piper fatigue scale, Pittsburgh Sleep Quality Index [PSQI], and Beck Depression Inventory-II [BDI-II] ) in patients with chronic kidney disease. This study was experimental research, with a convenience sampling. Participants were recruited from the nephrology clinic at a medical center in northern Taiwan. With signed informed consent, participants were randomly assigned to the HRVBF or control group by using the Excel BINOMDIST function. The HRVBF group received four weekly hospital-based HRVBF training, and 8 weeks of home-based self-practice was done with StressEraser. The control group received usual care. We followed all participants for 3 months, in which we repeatedly measured their autonomic nerve function (HRV), inflammatory response (IL-6, CRP), and symptom distress (Piper fatigue scale, PSQI, and BDI-II) on their first day of study participation (baselines), 1 month, and 3 months after the intervention to test the effects of HRVBF. The results were analyzed by SPSS version 23.0 statistical software. The data of demographics, HRV, IL-6, CRP, Piper fatigue scale, PSQI, and BDI-II were analyzed by descriptive statistics. To test for differences between and within groups in all outcome variables, it was used by paired sample t-test, independent sample t-test, Wilcoxon Signed-Rank test and Mann-Whitney U test. Results: Thirty-four patients with chronic kidney disease were enrolled, but three of them were lost to follow-up. The remaining 31 patients completed the study, including 15 in the HRVBF group and 16 in the control group. The characteristics of the two groups were not significantly different. The four-week hospital-based HRVBF training combined with eight-week home-based self-practice can effectively enhance the parasympathetic nerve performance for patients with chronic kidney disease, which may against the disease-related parasympathetic nerve inhibition. In the inflammatory response, IL-6 and CRP in the HRVBF group could not achieve significant improvement when compared with the control group. Self-reported fatigue and depression significantly decreased in the HRVBF group, but they still failed to achieve a significant difference between the two groups. HRVBF has no significant effect on improving the sleep quality for CKD patients.

Keywords: heart rate variability biofeedback, autonomic nerve function, inflammatory response, symptom distress, chronic kidney disease

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354 Experience of Two Major Research Centers in the Diagnosis of Cardiac Amyloidosis from Transthyretin

Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou

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Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.

Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin

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353 Challenges of Carbon Trading Schemes in Africa

Authors: Bengan Simbarashe Manwere

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The entire African continent, comprising 55 countries, holds a 2% share of the global carbon market. The World Bank attributes the continent’s insignificant share and participation in the carbon market to the limited access to electricity. Approximately 800 million people spread across 47 African countries generate as much power as Spain, with a population of 45million. Only South Africa and North Africa have carbon-reduction investment opportunities on the continent and dominate the 2% market share of the global carbon market. On the back of the 2015 Paris Agreement, South Africa signed into law the Carbon Tax Act 15 of 2019 and the Customs and Excise Amendment Act 13 of 2019 (Gazette No. 4280) on 1 June 2019. By these laws, South Africa was ushered into the league of active global carbon market players. By increasing the cost of production by the rate of R120/tCO2e, the tax intentionally compels the internalization of pollution as a cost of production and, relatedly, stimulate investment in clean technologies. The first phase covered the 1 June 2019 – 31 December 2022 period during which the tax was meant to escalate at CPI + 2% for Scope 1 emitters. However, in the second phase, which stretches from 2023 to 2030, the tax will escalate at the inflation rate only as measured by the consumer price index (CPI). The Carbon Tax Act provides for carbon allowances as mitigation strategies to limit agents’ carbon tax liability by up to 95% for fugitive and process emissions. Although the June 2019 Carbon Tax Act explicitly makes provision for a carbon trading scheme (CTS), the carbon trading regulations thereof were only finalised in December 2020. This points to a delay in the establishment of a carbon trading scheme (CTS). Relatedly, emitters in South Africa are not able to benefit from the 95% reduction in effective carbon tax rate from R120/tCO2e to R6/tCO2e as the Johannesburg Stock Exchange (JSE) has not yet finalized the establishment of the market for trading carbon credits. Whereas most carbon trading schemes have been designed and constructed from the beginning as new tailor-made systems in countries the likes of France, Australia, Romania which treat carbon as a financial product, South Africa intends, on the contrary, to leverage existing trading infrastructure of the Johannesburg Stock Exchange (JSE) and the Clearing and Settlement platforms of Strate, among others, in the interest of the Paris Agreement timelines. Therefore the carbon trading scheme will not be constructed from scratch. At the same time, carbon will be treated as a commodity in order to align with the existing institutional and infrastructural capacity. This explains why the Carbon Tax Act is silent about the involvement of the Financial Sector Conduct Authority (FSCA).For South Africa, there is need to establish they equilibrium stability of the CTS. This is important as South Africa is an innovator in carbon trading and the successful trading of carbon credits on the JSE will lead to imitation by early adopters first, followed by the middle majority thereafter.

Keywords: carbon trading scheme (CTS), Johannesburg stock exchange (JSE), carbon tax act 15 of 2019, South Africa

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352 Changing the Landscape of Fungal Genomics: New Trends

Authors: Igor V. Grigoriev

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Understanding of biological processes encoded in fungi is instrumental in addressing future food, feed, and energy demands of the growing human population. Genomics is a powerful and quickly evolving tool to understand these processes. The Fungal Genomics Program of the US Department of Energy Joint Genome Institute (JGI) partners with researchers around the world to explore fungi in several large scale genomics projects, changing the fungal genomics landscape. The key trends of these changes include: (i) rapidly increasing scale of sequencing and analysis, (ii) developing approaches to go beyond culturable fungi and explore fungal ‘dark matter,’ or unculturables, and (iii) functional genomics and multi-omics data integration. Power of comparative genomics has been recently demonstrated in several JGI projects targeting mycorrhizae, plant pathogens, wood decay fungi, and sugar fermenting yeasts. The largest JGI project ‘1000 Fungal Genomes’ aims at exploring the diversity across the Fungal Tree of Life in order to better understand fungal evolution and to build a catalogue of genes, enzymes, and pathways for biotechnological applications. At this point, at least 65% of over 700 known families have one or more reference genomes sequenced, enabling metagenomics studies of microbial communities and their interactions with plants. For many of the remaining families no representative species are available from culture collections. To sequence genomes of unculturable fungi two approaches have been developed: (a) sequencing DNA from fruiting bodies of ‘macro’ and (b) single cell genomics using fungal spores. The latter has been tested using zoospores from the early diverging fungi and resulted in several near-complete genomes from underexplored branches of the Fungal Tree, including the first genomes of Zoopagomycotina. Genome sequence serves as a reference for transcriptomics studies, the first step towards functional genomics. In the JGI fungal mini-ENCODE project transcriptomes of the model fungus Neurospora crassa grown on a spectrum of carbon sources have been collected to build regulatory gene networks. Epigenomics is another tool to understand gene regulation and recently introduced single molecule sequencing platforms not only provide better genome assemblies but can also detect DNA modifications. For example, 6mC methylome was surveyed across many diverse fungi and the highest among Eukaryota levels of 6mC methylation has been reported. Finally, data production at such scale requires data integration to enable efficient data analysis. Over 700 fungal genomes and other -omes have been integrated in JGI MycoCosm portal and equipped with comparative genomics tools to enable researchers addressing a broad spectrum of biological questions and applications for bioenergy and biotechnology.

Keywords: fungal genomics, single cell genomics, DNA methylation, comparative genomics

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351 Relationship Demise After Having Children: An Analysis of Abandonment and Nuclear Family Structure vs. Supportive Community Cultures

Authors: John W. Travis

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There is an epidemic of couples separating after a child is born into a family, generally with the father leaving emotionally or physically in the first few years after birth. This separation creates high levels of stress for both parents, especially the primary parent, leaving her (or him) less available to the infant for healthy attachment and nurturing. The deterioration of the couple’s bond leaves parents increasingly under-resourced, and the dependent child in a compromised environment, with an increased likelihood of developing an attachment disorder. Objectives: To understand the dynamics of a couple, once the additional and extensive demands of a newborn are added to a nuclear family structure, and to identify effective ways to support all members of the family to thrive. Qualitative studies interviewed men, women, and couples after pregnancy and the early years as a family, regarding key destructive factors, as well as effective tools for the couple to retain a strong bond. In-depth analysis of a few cases, including the author’s own experience, reveal deeper insights about subtle factors, replicated in wider studies. Using a self-assessment survey, many fathers report feeling abandoned, due to the close bond of the mother-baby unit, and in turn, withdrawing themselves, leaving the mother without support and closeness to resource her for the baby. Fathers report various types of abandonment, from his partner to his mother, with whom he did not experience adequate connection as a child. The study identified a key destructive factor to be unrecognized wounding from childhood that was carried into the relationship. The study culminated in the naming of Male Postpartum Abandonment Syndrome (MPAS), describing the epidemic in industrialized cultures with the nuclear family as the primary configuration. A growing family system often collapses without a minimum number of adult caregivers per infant, approximately four per infant (3.87), which allows for proper healing and caretaking. In cases with no additional family or community beyond one or two parents, the layers of abandonment and trauma result in the deterioration of a couple’s relationship and ultimately the family structure. The solution includes engaging community in support of new families. The study identified (and recommends) specific resources to assist couples in recognizing and healing trauma and disconnection at multiple levels. Recommendations include wider awareness and availability of resources for healing childhood wounds and greater community-building efforts to support couples for the whole family to thrive.

Keywords: abandonment, attachment, community building, family and marital functioning, healing childhood wounds, infant wellness, intimacy, marital satisfaction, relationship quality, relationship satisfaction

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350 Gender Differences in the Impact and Subjective Interpretation of Childhood Sexual Abuse Survivors

Authors: T. Borja-Alvarez, V. Jiménez-Borja, M. Jiménez Borja, C. J. Jiménez-Mosquera

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Research on child sexual abuse has predominantly focused on female survivors. This has resulted in less research looking at the particular context in which this abuse takes place for boys and the impact this abuse may have on male survivors. The aim of this study is to examine the sex and age of the perpetrators of child sexual abuse and explore gender differences in the impact along with the subjective interpretation that survivors attribute to these experiences. The data for this study was obtained from Ecuadorian university students (M = 230, F = 293) who reported sexual abuse using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). Participants completed Horowitz's Impact of Event Scale (IES) and were also requested to choose among neutral, positive, and negative adjectives to describe these experiences. The results indicate that in the case of males, perpetrators were both males (adults =27%, peers =20%, relatives =10.3%, cousins =7.4%) and young females (girlfriends or ex-girlfriends =25.6%, neighborhood =20.7%, school =16.7%, cousins =15.3%, strangers =12.8%). In contrast, almost all females reported that adult males were the perpetrators (relatives =29.6%, neighborhood =11.9%, strangers =19.9%, family friends =9.7%). Regarding the impact of these events, significant gender differences emerged. More females (50%) than males (20%) presented symptoms of post-traumatic stress disorder (PTSD). Gender differences also surfaced in the way survivors interpret their experiences. Almost half of the male participants selected the word “consensual” followed by the words “normal”, “helped me to mature”, “shameful”, “confusing”, and “traumatic”. In contrast, almost all females chose the word “non-consensual” followed by the words “shameful”, “traumatic”, “scary”, and “confusing”. In conclusion, the findings of this study suggest that young females and adult males were the most common perpetrators of sexually abused boys whereas adult males were the most common perpetrators of sexually abused girls. The impact and the subjective interpretation of these experiences were more negative for girls than for boys. The factors that account for the gender differences in the impact and the interpretation of these experiences need further exploration. It is likely that the cultural expectations of sexual behaviors for boys and girls in Latin American societies may partially explain the differential impact in the way these childhood sexual abuse experiences are interpreted in adulthood. In Ecuador, as is the case in other Latin American countries, the machismo culture not only accepts but encourages early sexual behaviors in boys and negatively judges premature sexual behavior in females. The result of these different sexual expectations may be that sexually abused boys may re-define these experiences as “consensual” and “normal” in adulthood, even though these were not consensual at the time of occurrence. Future studies are needed to more deeply understand the different contexts of sexual abuse for boys and girls in order to analyze the long-term impact of these experiences.

Keywords: abuse, child, gender differences, sexual

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349 The Use of Artificial Intelligence in the Context of a Space Traffic Management System: Legal Aspects

Authors: George Kyriakopoulos, Photini Pazartzis, Anthi Koskina, Crystalie Bourcha

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The need for securing safe access to and return from outer space, as well as ensuring the viability of outer space operations, maintains vivid the debate over the promotion of organization of space traffic through a Space Traffic Management System (STM). The proliferation of outer space activities in recent years as well as the dynamic emergence of the private sector has gradually resulted in a diverse universe of actors operating in outer space. The said developments created an increased adverse impact on outer space sustainability as the case of the growing number of space debris clearly demonstrates. The above landscape sustains considerable threats to outer space environment and its operators that need to be addressed by a combination of scientific-technological measures and regulatory interventions. In this context, recourse to recent technological advancements and, in particular, to Artificial Intelligence (AI) and machine learning systems, could achieve exponential results in promoting space traffic management with respect to collision avoidance as well as launch and re-entry procedures/phases. New technologies can support the prospects of a successful space traffic management system at an international scale by enabling, inter alia, timely, accurate and analytical processing of large data sets and rapid decision-making, more precise space debris identification and tracking and overall minimization of collision risks and reduction of operational costs. What is more, a significant part of space activities (i.e. launch and/or re-entry phase) takes place in airspace rather than in outer space, hence the overall discussion also involves the highly developed, both technically and legally, international (and national) Air Traffic Management System (ATM). Nonetheless, from a regulatory perspective, the use of AI for the purposes of space traffic management puts forward implications that merit particular attention. Key issues in this regard include the delimitation of AI-based activities as space activities, the designation of the applicable legal regime (international space or air law, national law), the assessment of the nature and extent of international legal obligations regarding space traffic coordination, as well as the appropriate liability regime applicable to AI-based technologies when operating for space traffic coordination, taking into particular consideration the dense regulatory developments at EU level. In addition, the prospects of institutionalizing international cooperation and promoting an international governance system, together with the challenges of establishment of a comprehensive international STM regime are revisited in the light of intervention of AI technologies. This paper aims at examining regulatory implications advanced by the use of AI technology in the context of space traffic management operations and its key correlating concepts (SSA, space debris mitigation) drawing in particular on international and regional considerations in the field of STM (e.g. UNCOPUOS, International Academy of Astronautics, European Space Agency, among other actors), the promising advancements of the EU approach to AI regulation and, last but not least, national approaches regarding the use of AI in the context of space traffic management, in toto. Acknowledgment: The present work was co-funded by the European Union and Greek national funds through the Operational Program "Human Resources Development, Education and Lifelong Learning " (NSRF 2014-2020), under the call "Supporting Researchers with an Emphasis on Young Researchers – Cycle B" (MIS: 5048145).

Keywords: artificial intelligence, space traffic management, space situational awareness, space debris

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348 Relationship Between Brain Entropy Patterns Estimated by Resting State fMRI and Child Behaviour

Authors: Sonia Boscenco, Zihan Wang, Euclides José de Mendoça Filho, João Paulo Hoppe, Irina Pokhvisneva, Geoffrey B.C. Hall, Michael J. Meaney, Patricia Pelufo Silveira

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Entropy can be described as a measure of the number of states of a system, and when used in the context of physiological time-based signals, it serves as a measure of complexity. In functional connectivity data, entropy can account for the moment-to-moment variability that is neglected in traditional functional magnetic resonance imaging (fMRI) analyses. While brain fMRI resting state entropy has been associated with some pathological conditions like schizophrenia, no investigations have explored the association between brain entropy measures and individual differences in child behavior in healthy children. We describe a novel exploratory approach to evaluate brain fMRI resting state data in two child cohorts, and MAVAN (N=54, 4.5 years, 48% males) and GUSTO (N = 206, 4.5 years, 48% males) and its associations to child behavior, that can be used in future research in the context of child exposures and long-term health. Following rs-fMRI data pre-processing and Shannon entropy calculation across 32 network regions of interest to acquire 496 unique functional connections, partial correlation coefficient analysis adjusted for sex was performed to identify associations between entropy data and Strengths and Difficulties questionnaire in MAVAN and Child Behavior Checklist domains in GUSTO. Significance was set at p < 0.01, and we found eight significant associations in GUSTO. Negative associations were found between two frontoparietal regions and cerebellar posterior and oppositional defiant problems, (r = -0.212, p = 0.006) and (r = -0.200, p = 0.009). Positive associations were identified between somatic complaints and four default mode connections: salience insula (r = 0.202, p < 0.01), dorsal attention intraparietal sulcus (r = 0.231, p = 0.003), language inferior frontal gyrus (r = 0.207, p = 0.008) and language posterior superior temporal gyrus (r = 0.210, p = 0.008). Positive associations were also found between insula and frontoparietal connection and attention deficit / hyperactivity problems (r = 0.200, p < 0.01), and insula – default mode connection and pervasive developmental problems (r = 0.210, p = 0.007). In MAVAN, ten significant associations were identified. Two positive associations were found = with prosocial scores: the salience prefrontal cortex and dorsal attention connection (r = 0.474, p = 0.005) and the salience supramarginal gyrus and dorsal attention intraparietal sulcus (r = 0.447, p = 0.008). The insula and prefrontal connection were negatively associated with peer problems (r = -0.437, p < 0.01). Conduct problems were negatively associated with six separate connections, the left salience insula and right salience insula (r = -0.449, p = 0.008), left salience insula and right salience supramarginal gyrus (r = -0.512, p = 0.002), the default mode and visual network (r = -0.444, p = 0.009), dorsal attention and language network (r = -0.490, p = 0.003), and default mode and posterior parietal cortex (r = -0.546, p = 0.001). Entropy measures of resting state functional connectivity can be used to identify individual differences in brain function that are correlated with variation in behavioral problems in healthy children. Further studies applying this marker into the context of environmental exposures are warranted.

Keywords: child behaviour, functional connectivity, imaging, Shannon entropy

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347 Unity in Diversity: Exploring the Psychological Processes and Mechanisms of the Sense of Community for the Chinese Nation in Ethnic Inter-embedded Communities

Authors: Jiamin Chen, Liping Yang

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In 2007, sociologist Putnam proposed a pessimistic forecast in the United States' "Social Capital Community Benchmark Survey," suggesting that "ethnic diversity would challenge social unity and undermine social cohesion." If this pessimistic assumption were proven true, it would indicate a risk of division in diverse societies. China, with 56 ethnic groups, is a multi-ethnic country. On May 26, 2014, General Secretary Xi Jinping proposed "building ethnically inter-embedded communities to promote deeper development in interactions, exchanges, and integration among ethnic groups." Researchers unanimously agree that ethnic inter-embedded communities can serve as practical arenas and pathways for solidifying the sense of the Chinese national community However, there is no research providing evidence that ethnic inter-embedded communities can foster the sense of the Chinese national community, and the influencing factors remain unclear. This study adopts a constructivist grounded theory research approach. Convenience sampling and snowball sampling were used in the study. Data were collected in three communities in Kunming City. Twelve individuals were eventually interviewed, and the transcribed interviews totaled 187,000 words. The research has obtained ethical approval from the Ethics Committee of Nanjing Normal University (NNU202310030). The research analyzed the data and constructed theories, employing strategies such as coding, constant comparison, and theoretical sampling. The study found that: firstly, ethnic inter-embedded communities exhibit characteristics of diversity, including ethnic diversity, cultural diversity, and linguistic diversity. Diversity has positive functions, including increased opportunities for contact, promoting self-expansion, and increasing happiness; negative functions of diversity include highlighting ethnic differences, causing ethnic conflicts, and reminding of ethnic boundaries. Secondly, individuals typically engage in interactions within the community using active embedding and passive embedding strategies. Active embedding strategies include maintaining openness, focusing on similarities, and pro-diversity beliefs, which can increase external group identification, intergroup relational identity, and promote ethnic integration. Individuals using passive embedding strategies tend to focus on ethnic stereotypes, perceive stigmatization of their own ethnic group, and adopt an authoritarian-oriented approach to interactions, leading to a perception of more identity threats and ultimately rejecting ethnic integration. Thirdly, the commonality of the Chinese nation is reflected in the 56 ethnic groups as an "identity community" and "interest community," and both active and passive embedding paths affect individual understanding of the commonality of the Chinese nation. Finally, community work and environment can influence the embedding process. The research constructed a social psychological process and mechanism model for solidifying sense of the Chinese national community in ethnic inter-embedded communities. Based on this theoretical model, future research can conduct more micro-level psychological mechanism tests and intervention studies to enhance Chinese national cohesion.

Keywords: diversity, sense of the chinese national community, ethnic inter-embedded communities, ethnic group

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346 De-Securitizing Identity: Narrative (In)Consistency in Periods of Transition

Authors: Katerina Antoniou

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When examining conflicts around the world, it is evident that the majority of intractable conflicts are steeped in identity. Identity seems to be not only a causal variable for conflict, but also a catalytic parameter for the process of reconciliation that follows ceasefire. This paper focuses on the process of identity securitization that occurs between rival groups of heterogeneous collective identities – ethnic, national or religious – as well as on the relationship between identity securitization and the ability of the groups involved to reconcile. Are securitized identities obstacles to the process of reconciliation, able to hinder any prospects of peace? If the level to which an identity is securitized is catalytic to a conflict’s discourse and settlement, then which factors act as indicators of identity de-securitization? The level of an in-group’s identity securitization can be estimated through a number of indicators, one of which is narrative. The stories, views and stances each in-group adopts in relation to its history of conflict and relation with their rival out-group can clarify whether that specific in-group feels victimized and threatened or safe and ready to reconcile. Accordingly, this study discusses identity securitization through narrative in relation to intractable conflicts. Are there conflicts around the world that, despite having been identified as intractable, stagnated or insoluble, show signs of identity de-securitization through narrative? This inquiry uses the case of the Cyprus conflict and its partitioned societies to present official narratives from the two communities and assess whether these narratives have transformed, indicating a less securitized in-group identity for the Greek and Turkish Cypriots. Specifically, the study compares the official historical overviews presented by each community’s Ministry of Foreign Affairs website and discusses the extent to which the two official narratives present a securitized collective identity. In addition, the study will observe whether official stances by the two communities – as adopted by community leaders – have transformed to depict less securitization over time. Additionally, the leaders’ reflection of popular opinion is evaluated through recent opinion polls from each community. Cyprus is currently experiencing renewed optimism for reunification, with the leaders of its two communities engaging in rigorous negotiations, and with rumors calling for a potential referendum for reunification to be taking place even as early as within 2016. Although leaders’ have shown a shift in their rhetoric and have moved away from narratives of victimization, this is not the case for the official narratives used by their respective ministries of foreign affairs. The study’s findings explore whether this narrative inconsistency proves that Cyprus is transitioning towards reunification, or whether the leaders are risking sending a securitized population to the polls to reject a potential reunification. More broadly, this study suggests that in the event that intractable conflicts might be moving towards viable peace, in-group narratives--official narratives in particular--can act as indicators of the extent to which rival entities have managed to reconcile.

Keywords: conflict, identity, narrative, reconciliation

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345 Re-Presenting the Egyptian Informal Urbanism in Films between 1994 and 2014

Authors: R. Mofeed, N. Elgendy

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Cinema constructs mind-spaces that reflect inherent human thoughts and emotions. As a representational art, Cinema would introduce comprehensive images of life phenomena in different ways. The term “represent” suggests verity of meanings; bring into presence, replace or typify. In that sense, Cinema may present a phenomenon through direct embodiment, or introduce a substitute image that replaces the original phenomena, or typify it by relating the produced image to a more general category through a process of abstraction. This research is interested in questioning the type of images that Egyptian Cinema introduces to informal urbanism and how these images were conditioned and reshaped in the last twenty years. The informalities/slums phenomenon first appeared in Egypt and, particularly, Cairo in the early sixties, however, this phenomenon was completely ignored by the state and society until the eighties, and furthermore, its evident representation in Cinema was by the mid-nineties. The Informal City represents the illegal housing developments, and it is a fast growing form of urbanization in Cairo. Yet, this expanding phenomenon is still depicted as the minority, exceptional and marginal through the Cinematic lenses. This paper aims at tracing the forms of representations of the urban informalities in the Egyptian Cinema between 1994 and 2014, and how did that affect the popular mind and its perception of these areas. The paper runs two main lines of inquiry; the first traces the phenomena through a chronological and geographical mapping of the informal urbanism has been portrayed in films. This analysis is based on an academic research work at Cairo University in Fall 2014. The visual tracing through maps and timelines allowed a reading of the phases of ignorance, presence, typifying and repetition in the representation of this huge sector of the city through more than 50 films that has been investigated. The analysis clearly revealed the “portrayed image” of informality by the Cinema through the examined period. However, the second part of the paper explores the “perceived image”. A designed questionnaire is applied to highlight the main features of that image that is perceived by both inhabitants of informalities and other Cairenes based on watching selected films. The questionnaire covers the different images of informalities proposed in the Cinema whether in a comic or a melodramatic background and highlight the descriptive terms used, to see which of them resonate with the mass perceptions and affected their mental images. The two images; “portrayed” and “perceived” are then to be encountered to reflect on issues of repetitions, stereotyping and reality. The formulated stereotype of informal urbanism is finally outlined and justified in relation to both production consumption mechanisms of films and the State official vision of informalities.

Keywords: cinema, informal urbanism, popular mind, representation

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344 Emphasis on Difference: Ethnic and National Cultural Heritage Identities and Issues in East Asia Focusing on Korea Cases

Authors: Hyuk-Jin Lee

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Even though 23 years have passed in the 21st century, nation-state and nationality-centered cultural identities are still the sentiments and ideologies that dominate the world. Nevertheless, as seen in many cases in Europe, a new perspective is needed to recognize mutual exchanges and influences and to view them as natural cultural exchanges between countries. The situation in East Asia is completely different from Europe. This is presumed to be from the long tradition of having an ethnocentric state concept for at least hundreds of years, quite different from Europe, where the concept of a nation-state was established relatively recently. In other words, unlike Europe, where active exchanges took place, the problem stems from the unique characteristics of East Asia, which has a strong tradition of finding its identity in 'difference'. Thus, it would not be hard to find cultural studies or news of the three East Asian countries emphasizing differences among one another. This applies to all cultural areas, including traditional architecture. For example, in the Korean traditional architecture field, buildings with effects from neighboring countries tend to be ignored, even if they are traditional Korean architecture. In addition to this, in the case of Korea, there seems to be one more cultural harmful aftereffect caused by the 36 years of Japanese colonial rule in the early 20th century; the obsessive filtering concept of 'it must be different from Japan'. In other words, the implicit ideological coercion that the definition of 'Korean cultural heritage' should not be influenced by exchanges with Japan may be found throughout Korean studies. The architectural and cultural aspects of the vast period of time, from the Three Kingdoms era to the beginning of Joseon, which was a period in which cultural influence exchanges with neighboring countries were relatively strong compared to the late Joseon Dynasty, also reflect the 'distorted filtering' caused by finding a repulsive identity against the Japanese colonial period. It is important to look the cultural heritage and traditions as they are inductively, not deductively. If not, we may often ignore or limit our own precious cultural heritage. Conversely, If Baekje, the ancient Korean Kingdom, helped Japan in construction and craftsmen played a big role in building the ancient temple, it would be a healthier perspective to view it as a cultural exchange rather than proudly seeing it as a cultural owner's perspective because this point of view is a proper reconstruction of our ancient and medieval Asian culture (strictly speaking, the color common to East Asia at the time). In particular, this study will examine this topic by giving specific examples from each field of Korean cultural studies. In the search for cultural identity, it would be more helpful for healthy relations between countries and collaborative research in the sensitive part of the interpretation of historical facts as well as cultural circles to minimize excessive meanings on originality and difference.

Keywords: cultural heritage identity, cultural ideology, East Asia, Korea

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343 Socio-Cultural Factors Influencing Adherence to Anti-Retroviral Therapy among HIV Patients in a University Teaching Hospital in South-Western Nigeria

Authors: Okunola Oluseye Ademola

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The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

Procedia PDF Downloads 278
342 Contributory Antioxidant Role of Testosterone and Oxidative Stress Biomarkers in Males Exposed to Mixed Chemicals in an Automobile Repair Community

Authors: Saheed A. Adekola, Mabel A. Charles-Davies, Ridwan A. Adekola

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Background: Testosterone is a known androgenic and anabolic steroid, primarily secreted in the testes. It plays an important role in the development of testes and prostate and has a range of biological actions. There is evidence that exposure to mixed chemicals in the workplace leads to the generation of free radicals and inadequate antioxidants leading to oxidative stress, which may serve as an early indicator of a pathophysiologic state. Based on findings, testosterone shows direct antioxidant effects by increasing the activities of antioxidant enzymes like glutathione peroxidase, thus indirectly contributing to antioxidant capacity. Objective: To evaluate the antioxidant role of testosterone as well as the relationship between testosterone and oxidative stress biomarkers in males exposed to mixed chemicals in the automobile repair community. Methods: The study included 43 participants aged 22- 60years exposed to mixed chemicals (EMC) from the automobile repair community. Forty (40) apparently healthy, unexposed, age-matched controls were recruited after informed consent. Demographic, sexual and anthropometric characteristics were obtained from pre-test structured questionnaires using standard methods. Blood samples (10mls) were collected from each subject into plain bottles and sera obtained were used for biochemical analyses. Serum levels of testosterone and luteinizing hormone (LH) were determined by enzyme immunoassay method, EIA (Immunometrics UK.LTD). Levels of total antioxidant capacity (TAC), total plasma peroxide (TPP), Malondialdehyde (MDA), hydrogen peroxide (H2O2), glutathione peroxide (GPX), superoxide dismutase (SOD), glutathione-S-transferase (GST), and reduced glutathione (GSH) were determined using spectrophotometric methods respectively. Results obtained were analyzed using the Student’s t-test and Chi-square test for quantitative variables and qualitative variables respectively. Multiple regression was used to find associations and relationships between the variables. Results: Significant higher concentrations of TPP, MDA, OSI, H2O2 and GST were observed in EMC compared with controls (p < 0.001). Within EMC, significantly higher levels of testosterone, LH and TAC were observed in eugonadic when compared with hypogonadic participants (p < 0.001). Diastolic blood pressure, waist circumference, waist height ratio and waist hip ratio were significantly higher in participants EMC compared with the controls. Sexual history and dietary intake showed that the controls had normal erection during sex and took more vegetables in their diet which may therefore be beneficial. Conclusion: The significantly increased levels of total antioxidant capacity in males exposed to mixed chemicals despite their exposure may probably reflect the contributory antioxidant role testosterone that prevents oxidative stress.

Keywords: mixed chemicals, oxidative stress, antioxidant, hypogonadism testosterone

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341 Effects of Gym-Based and Audio-Visual Guided Home-Based Exercise Programmes on Some Anthropometric and Cardiovascular Parameters Among Overweight and Obese College Students

Authors: Abiodun Afolabi, Rufus Adesoji Adedoyin

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This study investigated and compared the effects of gym-based exercise programme (GEBP) and audio-visual guided home-based exercise programme (AVGHBEP) on selected Anthropometric variables (Weight (W), Body Mass Index (BMI), Waist Circumference (WC), Hip Circumference (HC), Thigh Circumference (TC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), Waist-Thigh-Ratio (WTR), Biceps Skinfold Thickness (BSFT), Triceps Skinfold Thickness (TSFT), Suprailliac Skinfold Thickness (SISFT), Subscapular Skinfold Thickness (SSSFT) and Percent Body Fat (PBF)); and Cardiovasular variables (Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR)) of overweight and obese students of Federal College of Education (Special), Oyo, Oyo State, Nigeria, with a view to providing information and evidence for GBEP and AVGHBEP in reducing overweight and obesity for promoting cardiovascular fitness. Eighty overweight and obese students (BMI ≥ 25 Kg/m²) were involved in this pretest-posttest quasi experimental study. Participants were randomly assigned into GBEP (n = 40) and AVGBBEP (n = 40) groups. Anthropometric and cardiovascular variables were measured using a weighing scale, height meter, tape measure, skinfold caliper and electronic sphygmomanometer following standard protocols. GBEP and AVGHBEP were implemented following a circuit training (aerobic and resistance training) pattern with a duration of 40-60 minutes, thrice weekly for twelve weeks. GBEP consisted of gymnasium supervised exercise programme while AVGHBEP is a Visual Display guided exercise programme conducted at the home setting. Data were analyzed by Descriptive and Inferential Statistics. The mean ages of the participants were 22.55 ± 2.55 and 23.65 ± 2.89 years for the GBEP group and AVGHBEP group, respectively. Findings showed that in the GBEP group, there were significant reductions in anthropometric variables and adiposity measures of Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR, and PBF at week 12 of the study. Similarly, in the AVGHBEP group, there were significant reductions in Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR and PBF at the 12th week of intervention. Comparison of the effects of GEBP and AVGHBEP on anthropometric variables and measures of adiposity showed that there was no significant difference between the two groups in weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHR, WHtR, WTR and PBF between the two groups at week 12 of the study. Furthermore, findings on the effects of exercise on programmes on cardiovascular variables revealed that significant reductions occurred in SBP in GBEP group and AVGHBEP group respectively. Comparison of the effects of GBEP and AVGHBEP on cardiovascular variables showed that there was no significant difference in SBP, DBP and HR between the two groups at week 12 of the study. It was concluded that the Audio-Visual Guided Home-based Exercise Programme was as effective as the Gym-Based Exercise Programme in causing a significant reduction in anthropometric variables and body fat among college students who are overweight and obese over a period of twelve weeks. Both Gymnasium-Based Exercise Programme and Audio-Visual Guided Home-Based Exercise Programme led to significant reduction in Systolic Blood Pressure over a period of weeks. Audio-Visual Guided Home-Based Exercise Programme can, therefore, be used as an alternative therapy in the non-pharmacological management of people who are overweight and obese.

Keywords: gym-based exercises, audio-visual guided home-based exercises, anthropometric parameters, cardiovascular parameters, overweight students, obese students

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340 Media, Myth and Hero: Sacred Political Narrative in Semiotic and Anthropological Analysis

Authors: Guilherme Oliveira

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The assimilation of images and their potential symbolism into lived experiences is inherent. It is through this exercise of recognition via imagistic records that the questioning of the origins of a constant narrative stimulated by the media arises. The construction of the "Man" archetype and the reflections of active masculine imagery in the 21st century, when conveyed through media channels, could potentially have detrimental effects. Addressing this systematic behavioral chronology of virile cisgender, permeated imagistically through these means, involves exploring potential resolutions. Thus, an investigation process is initiated into the potential representation of the 'hero' in this media emulation through idols contextualized in the political sphere, with the purpose of elucidating the processes of simulation and emulation of narratives based on mythical, historical, and sacred accounts. In this process of sharing, the narratives contained in the imagistic structuring offered by information dissemination channels seek validation through a process of public acceptance. To achieve this consensus, a visual set adorned with mythological and sacred symbolisms adapted to the intended environment is promoted, thus utilizing sociocultural characteristics in favor of political marketing. Visual recognition, therefore, becomes a direct reflection of a cultural heritage acquired through lived human experience, stimulated by continuous representations throughout history. Echoes of imagery and narratives undergo a constant process of resignification of their concepts, sharpened by their premises, and adapted to the environment in which they seek to establish themselves. Political figures analyzed in this article employ the practice of taking possession of symbolisms, mythological stories, and heroisms and adapt their visual construction through a continuous praxis of emulation. Thus, they utilize iconic mythological narratives to gain credibility through belief. Utilizing iconic mythological narratives for credibility through belief, the idol becomes the very act of release of trauma, offering believers liberation from preconceived concepts and allowing for the attribution of new meanings. To dissolve this issue and highlight the subjectivities within the intention of the image, a linguistic, semiotic, and anthropological methodology is created. Linguistics uses expressions like 'Blaming the Image' to create a mechanism of expressive action in questioning why to blame a construction or visual composition and thus seek answers in the first act. Semiotics and anthropology develop an imagistic atlas of graphic analysis, seeking to make connections, comparisons, and relations between modern and sacred/mystical narratives, emphasizing the different subjective layers of embedded symbolism. Thus, it constitutes a performative act of disarming the image. It creates a disenchantment of the superficial gaze under the constant reproduction of visual content stimulated by virtual networks, enabling a discussion about the acceptance of caricatures characterized by past fables.

Keywords: image, heroic narrative, media heroism, virile politics, political, myth, sacred performance, visual mythmaking, characterization dynamics

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339 The Role of Formal and Informal Social Support in Predicting the Involvement of Mothers and Fathers of Young Children with Autism Spectrum Disorder

Authors: Adi Sharabi, Dafna Marom-Golan

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Parents’ involvement in the care of their children with Autism Spectrum Disorder (ASD) and its beneficial effect on the children’s developmental and educational outcomes is well documented. At the same time, parents of children with ASD tend to experience greater psychological distress than parents of children with other developmental disabilities or with typical development. Positive social support is an important resource used by parents to reduce their psychological distress. The goal of the current research was to examine the contribution of formal and informal social support in explaining mothers’ and fathers’ involvement with their young children with ASD. The sample consisted of 107 parents who live in Israel (61 mothers and 46 fathers) of children aged between 2 and 7, all diagnosed with ASD and attending special kindergartens or special day care for children with ASD. Parental involvement and social support perception were assessed. Initial analysis focused on the relations between involvement, support, and demographic variables. In addition, analysis of variance (ANOVA) was conducted to test differences between mothers and fathers. Two hierarchical multiple regression analyses were performed to examine the predicted factors in the involvement model while controlling for group (mothers/fathers). Results indicate that mothers reported significantly higher levels of parenting involvement than fathers. Mothers reported higher levels of general involvement and all sub-types of involvement. For example, mothers reported that they were more interested in and have higher levels of attendance in their child’s educational program. They were also more collaborative in their child’s educational therapeutic program, and socialized with other parents of children from their child’s kindergarten than fathers. Mothers’ involvement was found to be related to their informal support (non-formal relatives). Findings also reveal significant differences between mothers and fathers on the formal support subscale measure of specializes services. Fathers, more than mothers, reported more specializes services support such as social workers or professional therapists. Separate hierarchical multiple regression analyses revealed a unique gender difference in the factors that explained parental involvement. Specifically, informal support only had a unique positive contribution in explaining mothers’, but not fathers’ involvement. This study highlights the central role of mothers in maintaining constant contact with the educational system and the professionals who help care for their child with ASD. At the same time, this research emphasizes the crucial role of both mothers and fathers in their child's development and well-being at every development stage, particularly in early development. Further, different kinds of social support seem to relate to the different kinds of parental involvement. It is in the best interest of educators and family therapists who work with families with children with ASD to support the cohesiveness of the family and the collaboration of the parents by understanding and respecting the way each member addresses the responsibilities of parenting a child with ASD, and her or his need for different types of social support.

Keywords: parental differences, parental involvement, social support, specialized support services

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338 Assessing the Structure of Non-Verbal Semantic Knowledge: The Evaluation and First Results of the Hungarian Semantic Association Test

Authors: Alinka Molnár-Tóth, Tímea Tánczos, Regina Barna, Katalin Jakab, Péter Klivényi

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Supported by neuroscientific findings, the so-called Hub-and-Spoke model of the human semantic system is based on two subcomponents of semantic cognition, namely the semantic control process and semantic representation. Our semantic knowledge is multimodal in nature, as the knowledge system stored in relation to a conception is extensive and broad, while different aspects of the conception may be relevant depending on the purpose. The motivation of our research is to develop a new diagnostic measurement procedure based on the preservation of semantic representation, which is appropriate to the specificities of the Hungarian language and which can be used to compare the non-verbal semantic knowledge of healthy and aphasic persons. The development of the test will broaden the Hungarian clinical diagnostic toolkit, which will allow for more specific therapy planning. The sample of healthy persons (n=480) was determined by the last census data for the representativeness of the sample. Based on the concept of the Pyramids and Palm Tree Test, and according to the characteristics of the Hungarian language, we have elaborated a test based on different types of semantic information, in which the subjects are presented with three pictures: they have to choose the one that best fits the target word above from the two lower options, based on the semantic relation defined. We have measured 5 types of semantic knowledge representations: associative relations, taxonomy, motional representations, concrete as well as abstract verbs. As the first step in our data analysis, we examined the normal distribution of our results, and since it was not normally distributed (p < 0.05), we used nonparametric statistics further into the analysis. Using descriptive statistics, we could determine the frequency of the correct and incorrect responses, and with this knowledge, we could later adjust and remove the items of questionable reliability. The reliability was tested using Cronbach’s α, and it can be safely said that all the results were in an acceptable range of reliability (α = 0.6-0.8). We then tested for the potential gender differences using the Mann Whitney-U test, however, we found no difference between the two (p < 0.05). Likewise, we didn’t see that the age had any effect on the results using one-way ANOVA (p < 0.05), however, the level of education did influence the results (p > 0.05). The relationships between the subtests were observed by the nonparametric Spearman’s rho correlation matrix, showing statistically significant correlation between the subtests (p > 0.05), signifying a linear relationship between the measured semantic functions. A margin of error of 5% was used in all cases. The research will contribute to the expansion of the clinical diagnostic toolkit and will be relevant for the individualised therapeutic design of treatment procedures. The use of a non-verbal test procedure will allow an early assessment of the most severe language conditions, which is a priority in the differential diagnosis. The measurement of reaction time is expected to advance prodrome research, as the tests can be easily conducted in the subclinical phase.

Keywords: communication disorders, diagnostic toolkit, neurorehabilitation, semantic knowlegde

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337 Cut-Off of CMV Cobas® Taqman® (CAP/CTM Roche®) for Introduction of Ganciclovir Pre-Emptive Therapy in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Authors: B. B. S. Pereira, M. O. Souza, L. P. Zanetti, L. C. S. Oliveira, J. R. P. Moreno, M. P. Souza, V. R. Colturato, C. M. Machado

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Background: The introduction of prophylactic or preemptive therapies has effectively decreased the CMV mortality rates after hematopoietic stem cell transplantation (HSCT). CMV antigenemia (pp65) or quantitative PCR are methods currently approved for CMV surveillance in pre-emptive strategies. Commercial assays are preferred as cut-off levels defined by in-house assays may vary among different protocols and in general show low reproducibility. Moreover, comparison of published data among different centers is only possible if international standards of quantification are included in the assays. Recently, the World Health Organization (WHO) established the first international standard for CMV detection. The real time PCR COBAS Ampliprep/ CobasTaqMan (CAP/CTM) (Roche®) was developed using the WHO standard for CMV quantification. However, the cut-off for the introduction of antiviral has not been determined yet. Methods: We conducted a retrospective study to determine: 1) the sensitivity and specificity of the new CMV CAP/CTM test in comparison with pp65 antigenemia to detect episodes of CMV infection/reactivation, and 2) the cut-off of viral load for introduction of ganciclovir (GCV). Pp65 antigenemia was performed and the corresponding plasma samples were stored at -20°C for further CMV detection by CAP/CTM. Comparison of tests was performed by kappa index. The appearance of positive antigenemia was considered the state variable to determine the cut-off of CMV viral load by ROC curve. Statistical analysis was performed using SPSS software version 19 (SPSS, Chicago, IL, USA.). Results: Thirty-eight patients were included and followed from August 2014 through May 2015. The antigenemia test detected 53 episodes of CMV infection in 34 patients (89.5%), while CAP/CTM detected 37 episodes in 33 patients (86.8%). AG and PCR results were compared in 431 samples and Kappa index was 30.9%. The median time for first AG detection was 42 (28-140) days, while CAP/CTM detected at a median of 7 days earlier (34 days, ranging from 7 to 110 days). The optimum cut-off value of CMV DNA was 34.25 IU/mL to detect positive antigenemia with 88.2% of sensibility, 100% of specificity and AUC of 0.91. This cut-off value is below the limit of detection and quantification of the equipment which is 56 IU/mL. According to CMV recurrence definition, 16 episodes of CMV recurrence were detected by antigenemia (47.1%) and 4 (12.1%) by CAP/CTM. The duration of viremia as detected by antigenemia was shorter (60.5% of the episodes lasted ≤ 7 days) in comparison to CAP/CTM (57.9% of the episodes lasting 15 days or more). This data suggests that the use of antigenemia to define the duration of GCV therapy might prompt early interruption of antiviral, which may favor CMV reactivation. The CAP/CTM PCR could possibly provide a safer information concerning the duration of GCV therapy. As prolonged treatment may increase the risk of toxicity, this hypothesis should be confirmed in prospective trials. Conclusions: Even though CAP/CTM by ROCHE showed great qualitative correlation with the antigenemia technique, the fully automated CAP/CTM did not demonstrate increased sensitivity. The cut-off value below the limit of detection and quantification may result in delayed introduction of pre-emptive therapy.

Keywords: antigenemia, CMV COBAS/TAQMAN, cytomegalovirus, antiviral cut-off

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336 Citation Analysis of New Zealand Court Decisions

Authors: Tobias Milz, L. Macpherson, Varvara Vetrova

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The law is a fundamental pillar of human societies as it shapes, controls and governs how humans conduct business, behave and interact with each other. Recent advances in computer-assisted technologies such as NLP, data science and AI are creating opportunities to support the practice, research and study of this pervasive domain. It is therefore not surprising that there has been an increase in investments into supporting technologies for the legal industry (also known as “legal tech” or “law tech”) over the last decade. A sub-discipline of particular appeal is concerned with assisted legal research. Supporting law researchers and practitioners to retrieve information from the vast amount of ever-growing legal documentation is of natural interest to the legal research community. One tool that has been in use for this purpose since the early nineteenth century is legal citation indexing. Among other use cases, they provided an effective means to discover new precedent cases. Nowadays, computer-assisted network analysis tools can allow for new and more efficient ways to reveal the “hidden” information that is conveyed through citation behavior. Unfortunately, access to openly available legal data is still lacking in New Zealand and access to such networks is only commercially available via providers such as LexisNexis. Consequently, there is a need to create, analyze and provide a legal citation network with sufficient data to support legal research tasks. This paper describes the development and analysis of a legal citation Network for New Zealand containing over 300.000 decisions from 125 different courts of all areas of law and jurisdiction. Using python, the authors assembled web crawlers, scrapers and an OCR pipeline to collect and convert court decisions from openly available sources such as NZLII into uniform and machine-readable text. This facilitated the use of regular expressions to identify references to other court decisions from within the decision text. The data was then imported into a graph-based database (Neo4j) with the courts and their respective cases represented as nodes and the extracted citations as links. Furthermore, additional links between courts of connected cases were added to indicate an indirect citation between the courts. Neo4j, as a graph-based database, allows efficient querying and use of network algorithms such as PageRank to reveal the most influential/most cited courts and court decisions over time. This paper shows that the in-degree distribution of the New Zealand legal citation network resembles a power-law distribution, which indicates a possible scale-free behavior of the network. This is in line with findings of the respective citation networks of the U.S. Supreme Court, Austria and Germany. The authors of this paper provide the database as an openly available data source to support further legal research. The decision texts can be exported from the database to be used for NLP-related legal research, while the network can be used for in-depth analysis. For example, users of the database can specify the network algorithms and metrics to only include specific courts to filter the results to the area of law of interest.

Keywords: case citation network, citation analysis, network analysis, Neo4j

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335 Liquid Illumination: Fabricating Images of Fashion and Architecture

Authors: Sue Hershberger Yoder, Jon Yoder

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“The appearance does not hide the essence, it reveals it; it is the essence.”—Jean-Paul Sartre, Being and Nothingness Three decades ago, transarchitect Marcos Novak developed an early form of algorithmic animation he called “liquid architecture.” In that project, digitally floating forms morphed seamlessly in cyberspace without claiming to evolve or improve. Change itself was seen as inevitable. And although some imagistic moments certainly stood out, none was hierarchically privileged over another. That project challenged longstanding assumptions about creativity and artistic genius by posing infinite parametric possibilities as inviting alternatives to traditional notions of stability, originality, and evolution. Through ephemeral processes of printing, milling, and projecting, the exhibition “Liquid Illumination” destabilizes the solid foundations of fashion and architecture. The installation is neither worn nor built in the conventional sense, but—like the sensual art forms of fashion and architecture—it is still radically embodied through the logics and techniques of design. Appearances are everything. Surface pattern and color are no longer understood as minor afterthoughts or vapid carriers of dubious content. Here, they become essential but ever-changing aspects of precisely fabricated images. Fourteen silk “colorways” (a term from the fashion industry) are framed selections from ongoing experiments with intricate pattern and complex color configurations. Whether these images are printed on fabric, milled in foam, or illuminated through projection, they explore and celebrate the untapped potentials of the surficial and superficial. Some components of individual prints appear to float in front of others through stereoscopic superimpositions; some figures appear to melt into others due to subtle changes in hue without corresponding changes in value; and some layers appear to vibrate via moiré effects that emerge from unexpected pattern and color combinations. The liturgical atmosphere of Liquid Illumination is intended to acknowledge that, like the simultaneously sacred and superficial qualities of rose windows and illuminated manuscripts, artistic and religious ideologies are also always malleable. The intellectual provocation of this paper pushes the boundaries of current thinking concerning viable applications for fashion print designs and architectural images—challenging traditional boundaries between fine art and design. The opportunistic installation of digital printing, CNC milling, and video projection mapping in a gallery that is normally reserved for fine art exhibitions raises important questions about cultural/commercial display, mass customization, digital reproduction, and the increasing prominence of surface effects (color, texture, pattern, reflection, saturation, etc.) across a range of artistic practices and design disciplines.

Keywords: fashion, print design, architecture, projection mapping, image, fabrication

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334 Impact of Increased Radiology Staffing on After-Hours Radiology Reporting Efficiency and Quality

Authors: Peregrine James Dalziel, Philip Vu Tran

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Objective / Introduction: Demand for radiology services from Emergency Departments (ED) continues to increase with greater demands placed on radiology staff providing reports for the management of complex cases. Queuing theory indicates that wide variability of process time with the random nature of request arrival increases the probability of significant queues. This can lead to delays in the time-to-availability of radiology reports (TTA-RR) and potentially impaired ED patient flow. In addition, greater “cognitive workload” of greater volume may lead to reduced productivity and increased errors. We sought to quantify the potential ED flow improvements obtainable from increased radiology providers serving 3 public hospitals in Melbourne Australia. We sought to assess the potential productivity gains, quality improvement and the cost-effectiveness of increased labor inputs. Methods & Materials: The Western Health Medical Imaging Department moved from single resident coverage on weekend days 8:30 am-10:30 pm to a limited period of 2 resident coverage 1 pm-6 pm on both weekend days. The TTA-RR for weekend CT scans was calculated from the PACs database for the 8 month period symmetrically around the date of staffing change. A multivariate linear regression model was developed to isolate the improvement in TTA-RR, between the two 4-months periods. Daily and hourly scan volume at the time of each CT scan was calculated to assess the impact of varying department workload. To assess any improvement in report quality/errors a random sample of 200 studies was assessed to compare the average number of clinically significant over-read addendums to reports between the 2 periods. Cost-effectiveness was assessed by comparing the marginal cost of additional staffing against a conservative estimate of the economic benefit of improved ED patient throughput using the Australian national insurance rebate for private ED attendance as a revenue proxy. Results: The primary resident on call and the type of scan accounted for most of the explained variability in time to report availability (R2=0.29). Increasing daily volume and hourly volume was associated with increased TTA-RR (1.5m (p<0.01) and 4.8m (p<0.01) respectively per additional scan ordered within each time frame. Reports were available 25.9 minutes sooner on average in the 4 months post-implementation of double coverage (p<0.01) with additional 23.6 minutes improvement when 2 residents were on-site concomitantly (p<0.01). The aggregate average improvement in TTA-RR was 24.8 hours per weekend day This represents the increased decision-making time available to ED physicians and potential improvement in ED bed utilisation. 5% of reports from the intervention period contained clinically significant addendums vs 7% in the single resident period but this was not statistically significant (p=0.7). The marginal cost was less than the anticipated economic benefit based assuming a 50% capture of improved TTA-RR inpatient disposition and using the lowest available national insurance rebate as a proxy for economic benefit. Conclusion: TTA-RR improved significantly during the period of increased staff availability, both during the specific period of increased staffing and throughout the day. Increased labor utilisation is cost-effective compared with the potential improved productivity for ED cases requiring CT imaging.

Keywords: workflow, quality, administration, CT, staffing

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333 Influence of Counter-Face Roughness on the Friction of Bionic Microstructures

Authors: Haytam Kasem

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The problem of quick and easy reversible attachment has become of great importance in different fields of technology. For the reason, during the last decade, a new emerging field of adhesion science has been developed. Essentially inspired by some animals and insects, which during their natural evolution have developed fantastic biological attachment systems allowing them to adhere and run on walls and ceilings of uneven surfaces. Potential applications of engineering bio-inspired solutions include climbing robots, handling systems for wafers in nanofabrication facilities, and mobile sensor platforms, to name a few. However, despite the efforts provided to apply bio-inspired patterned adhesive-surfaces to the biomedical field, they are still in the early stages compared with their conventional uses in other industries mentioned above. In fact, there are some critical issues that still need to be addressed for the wide usage of the bio-inspired patterned surfaces as advanced biomedical platforms. For example, surface durability and long-term stability of surfaces with high adhesive capacity should be improved, but also the friction and adhesion capacities of these bio-inspired microstructures when contacting rough surfaces. One of the well-known prototypes for bio-inspired attachment systems is biomimetic wall-shaped hierarchical microstructure for gecko-like attachments. Although physical background of these attachment systems is widely understood, the influence of counter-face roughness and its relationship with the friction force generated when sliding against wall-shaped hierarchical microstructure have yet to be fully analyzed and understood. To elucidate the effect of the counter-face roughness on the friction of biomimetic wall-shaped hierarchical microstructure we have replicated the isotropic topography of 12 different surfaces using replicas made of the same epoxy material. The different counter-faces were fully characterized under 3D optical profilometer to measure roughness parameters. The friction forces generated by spatula-shaped microstructure in contact with the tested counter-faces were measured on a home-made tribometer and compared with the friction forces generated by the spatulae in contact with a smooth reference. It was found that classical roughness parameters, such as average roughness Ra and others, could not be utilized to explain topography-related variation in friction force. This has led us to the development of an integrated roughness parameter obtained by combining different parameters which are the mean asperity radius of curvature (R), the asperity density (η), the deviation of asperities high (σ) and the mean asperities angle (SDQ). This new integrated parameter is capable of explaining the variation of results of friction measurements. Based on the experimental results, we developed and validated an analytical model to predict the variation of the friction force as a function of roughness parameters of the counter-face and the applied normal load, as well.

Keywords: friction, bio-mimetic micro-structure, counter-face roughness, analytical model

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