Search results for: network distributed diagnosis

Authors: Maryline Vere, Wilma ten Ham-Baloyi, Lucy Ochola, Opeoluwa Oyedele, Lindsey Beyleveld, Siphokazi Tili, Takafira Mduluza, Paula E. Melariri

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Schistosomiasis, caused by Schistosoma (S.) haematobium and Schistosoma (S.) mansoni parasites poses a significant public health challenge in low-income regions. Diagnosis typically relies on identifying specific urine biomarkers such as haematuria, protein, and leukocytes for S. haematobium, while the Point-of-Care Circulating Cathodic Antigen (POC-CCA) assay is employed for detecting S. mansoni. Urinalysis and the POC-CCA assay are favoured for their rapid, non-invasive nature and cost-effectiveness. However, traditional diagnostic methods such as Kato-Katz and urine filtration lack sensitivity in low-transmission areas, which can lead to underreporting of cases and hinder effective disease control efforts. Therefore, in this study, urinalysis and the POC-CCA assay was utilised to diagnose schistosomiasis effectively among school-going children in Nelson Mandela Bay Municipality. This was a cross-sectional study with a total of 759 children, aged 5 to 14 years, who provided urine samples. Urinalysis was performed using urinary dipstick tests, which measure multiple parameters, including haematuria, protein, leukocytes, bilirubin, urobilinogen, ketones, pH, specific gravity and other biomarkers. Urinalysis was performed by dipping the strip into the urine sample and observing colour changes on specific reagent pads. The POC-CCA test was conducted by applying a drop of urine onto a cassette containing CCA-specific antibodies, and the presence of a visible test line indicated a positive result for S. mansoni infection. Descriptive statistics were used to summarize urine parameters, and Pearson correlation coefficients (r) were calculated to analyze associations among urine parameters using R software (version 4.3.1). Among the 759 children, the prevalence of S. haematobium using haematuria as a diagnostic marker was 33.6%. Additionally, leukocytes were detected in 21.3% of the samples, and protein was present in 15%. The prevalence of positive POC-CCA test results for S. mansoni was 3.7%. Urine parameters exhibited low to moderate associations, suggesting complex interrelationships. For instance, specific gravity and pH showed a negative correlation (r = -0.37), indicating that higher specific gravity was associated with lower pH. Weak correlations were observed between haematuria and pH (r = -0.10), bilirubin and ketones (r = 0.14), protein and bilirubin (r = 0.13), and urobilinogen and pH (r = 0.12). A mild positive correlation was found between leukocytes and blood (r = 0.23), reflecting some association between these inflammation markers. In conclusion, the study identified a significant prevalence of schistosomiasis among school-going children in Nelson Mandela Bay Municipality, with S. haematobium detected through haematuria and S. mansoni identified using the POC-CCA assay. The detection of leukocytes and protein in urine samples serves as critical biomarkers for schistosomiasis infections, reinforcing the presence of schistosomiasis in the study area when considered alongside haematuria. These urine parameters are indicative of inflammatory responses associated with schistosomiasis, underscoring the necessity for effective diagnostic methodologies. Such findings highlight the importance of comprehensive diagnostic assessments to accurately identify and monitor schistosomiasis prevalence and its associated health impacts. The significant burden of schistosomiasis in this population highlights the urgent need to develop targeted control interventions to effectively reduce its prevalence in the study area.

Keywords: schistosomiasis, urinalysis, haematuria, POC-CCA

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Authors: Alison C. Essary, Victor Trastek

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Introduction: The current state of the health care system in the U.S. is characterized by an unprecedented number of people living with multiple chronic conditions, unsustainable rise in health care costs, inadequate access to care, and wide variation in health outcomes throughout the country. An estimated two-thirds of Americans are living with two or more chronic conditions, contributing to 75% of all health care spending. In 2013, the School for the Science of Health Care Delivery (SHCD) was charged with redesigning the health care system through education and research. Faculty in business, law, and public policy, and thought leaders in health care delivery, administration, public health and health IT created undergraduate, graduate, and executive academic programs to address this pressing need. Faculty and students work across disciplines, and with community partners and employers to improve care delivery and increase value for patients. Methods: Curricula apply content in health care administration and operations within the clinical context. Graduate modules are team-taught by faculty across academic units to model team-based practice. Seminars, team-based assignments, faculty mentoring, and applied projects are integral to student success. Cohort-driven models enhance networking and collaboration. This observational study evaluated two years of admissions data, and one year of graduate data to assess program outcomes and inform the current graduate-level curricula. Descriptive statistics includes means, percentages. Results: Fall 2013, the program received 51 applications. The mean GPA of the entering class of 37 students was 3.38. Ninety-seven percent of the fall 2013 cohort successfully completed the program (n=35). Sixty-six percent are currently employed in the health care industry (n=23). Of the remaining 12 graduates, two successfully matriculated to medical school; one works in the original field of study; four await results on the MCAT or DAT, and five were lost to follow up. Attrition of one student was attributed to non-academic reasons. Fall 2014, the program expanded to include both on-ground and online cohorts. Applications were evenly distributed between on-ground (n=70) and online (n=68). Thirty-eight students enrolled in the on-ground program. The mean GPA was 3.95. Ninety-five percent of students successfully completed the program (n=36). Thirty-six students enrolled in the online program. The mean GPA was 3.85. Graduate outcomes are pending. Discussion: Challenges include demographic variability between online and on-ground students; yet, both profiles are similar in that students intend to become change agents in the health care system. In the past two years, on-ground applications increased by 31%, persistence to graduation is > 95%, mean GPA is 3.67, graduates report admission to six U.S. medical schools, the Mayo Medical School integrates SHCD content within their curricula, and there is national interest in collaborating on industry and academic partnerships. This places SHCD at the forefront of developing innovative curricula in order to improve high-value, patient-centered care.

Keywords: delivery science, education, health care delivery, high-value care, innovation in education, patient-centered

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Authors: Caroline Seo, Jennifer Stephens, Kirstin H. Heinrich

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Background: Clostridiodes (formerly Clostridium) difficile infection (CDI) is an anaerobic, spore-forming bacterium with manifestations including diarrhea, pseudomembranous colitis and toxic megacolon. Despite general understanding that CDI may be associated with marked burden on patients’ health, there has been limited information available on the humanistic burden of CDI. The objective of this literature review was to summarize the published data on the humanistic burden of CDI globally, in order to better inform future research efforts and increase awareness of the patient perspective in this disease. Methods: A comprehensive literature review of the past 15 years (2002-2017) was conducted using MEDLINE, Embase and Cumulative Index of Nursing and Allied Health Literature. Additional searches were conducted from conference proceedings (2015-2017). Articles selected were studies specifically designed to examine the humanistic burden of illness associated with adult patients with CDI. Results: Of 3,325 articles or abstracts identified, 33 remained after screening and full text review. Sixty percent (60%) were published in 2016 or 2017. Data from the United States or Western Europe were most common. Data from Brazil, Canada, China and Spain also exist. Thirteen (13) studies used validated patient-reported outcomes instruments, mostly EQ-5D utility and SF-36 generic instruments. Three (3) studies used CDI-specific instruments (CDiff32, CDI-DaySyms). The burden of CDI impacts patients in multiple health-related quality of life (HRQOL) domains. SF-36 domains with the largest decrements compared to other GI diarrheal diseases (IBS-D and Crohn’s) were role physical, physical functioning, vitality, social functioning, and role emotional. Reported EQ-5D utilities for CDI ranged from 0.35-0.42 compared to 0.65 in Crohn’s and 0.72 in IBS-D. The majority of papers addressed physical functioning and mental health domains (67% for both). Across various studies patients reported weakness, lack of appetite, sleep disturbance, functional dependence, and decreased activities of daily lives due to the continuous diarrhea. Due to lack of control over this infection, CDI also impacts the psychological and emotional quality of life of the patients. Patients reported feelings of fear, anxiety, frustration, depression, and embarrassment. Additionally, the type of disease (primary vs. recurrent) may impact mental health. One study indicated that there is a decrement in SF-36 mental scores in patients with recurrent CDI, in comparison to patients with primary CDI. Other domains highlighted by these studies include pain (27%), social isolation (27%), vitality and fatigue (24%), self-care (9%), and caregiver burden (0%). Two studies addressed work productivity, with 1 of these studies reporting that CDI patients had the highest work productivity and activity impairment scores among the gastrointestinal diseases. No study specifically included caregiver self-report. However, 3 studies did provide mention of patients’ worry on how their diagnosis of CDI would impact family, caregivers, and/or friends. Conclusions: Despite being a serious public health issue there has been a paucity of research on the HRQOL among those with CDI. While progress is being made, gaps exist in understanding the burden on patients, caregivers, and families. Future research is warranted to aid understanding of the CDI patient perspective.

Keywords: burden, Clostridiodes, difficile, humanistic, infection

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Authors: Maria Ledinskaya

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This paper examines the Morris Collection Conservation Project at the Sainsbury Centre for Visual Arts in the context of Agile, Lean, and Hybrid project management. It is part case study and part literature review. To date, relatively little has been written about non-traditional project management approaches in heritage conservation. This paper seeks to introduce Agile, Lean, and Hybrid project management concepts from business, software development, and manufacturing fields to museum conservation, by referencing their practical application on a recent museum-based conservation project. The Morris Collection Conservation Project was carried out in 2019-2021 in Norwich, UK, and concerned the remedial conservation of around 150 Abstract Constructivist artworks bequeathed to the Sainsbury Centre for Visual Arts by private collectors Michael and Joyce Morris. The first part introduces the chronological timeline and key elements of the project. It describes a medium-size conservation project of moderate complexity, which was planned and delivered in an environment with multiple known unknowns – unresearched collection, unknown condition and materials, unconfirmed budget. The project was also impacted by the unknown unknowns of the COVID-19 pandemic, such as indeterminate lockdowns, and the need to accommodate social distancing and remote communications. The author, a staff conservator at the Sainsbury Centre who acted as project manager on the Morris Collection Conservation Project, presents an incremental, iterative, and value-based approach to managing a conservation project in an uncertain environment. Subsequent sections examine the project from the point of view of Traditional, Agile, Lean, and Hybrid project management. The author argues that most academic writing on project management in conservation has focussed on a Traditional plan-driven approach – also known as Waterfall project management – which has significant drawbacks in today’s museum environment, due to its over-reliance on prediction-based planning and its low tolerance to change. In the last 20 years, alternative Agile, Lean and Hybrid approaches to project management have been widely adopted in software development, manufacturing, and other industries, although their recognition in the museum sector has been slow. Using examples from the Morris Collection Conservation Project, the author introduces key principles and tools of Agile, Lean, and Hybrid project management and presents a series of arguments on the effectiveness of these alternative methodologies in museum conservation, as well as the ethical and practical challenges to their implementation. These project management approaches are discussed in the context of consequentialist, relativist, and utilitarian developments in contemporary conservation ethics, particularly with respect to change management, bespoke ethics, shared decision-making, and value-based cost-benefit conservation strategy. The author concludes that the Morris Collection Conservation Project had multiple Agile and Lean features which were instrumental to the successful delivery of the project. These key features are identified as distributed decision making, a co-located cross-disciplinary team, servant leadership, focus on value-added work, flexible planning done in shorter sprint cycles, light documentation, and emphasis on reducing procedural, financial, and logistical waste. Overall, the author’s findings point largely in favour of a Hybrid model which combines traditional and alternative project processes and tools to suit the specific needs of the project.

Keywords: project management, conservation, waterfall, agile, lean, hybrid

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Authors: Pedram Saadati, Zahra Nazari

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Today, the role and importance of financial technology businesses in Iran have increased significantly. Although, in Iran, there is no Islamic or non-Islamic personal financial planning field of study in the universities or educational centers, the profession of personal financial planning is not defined, and there is no software introduced in this regard for advisors or consumers. The largest sales network of financial services in Iran belongs to the insurance industry, and there is an untapped market for international companies in Iran that can contribute to 130 thousand representatives in the insurance industry and 28 million families by providing training and personal financial advisory software. To the best of the author's knowledge, despite the lack of previous internal studies in this field, the present study investigates the level of readiness of the salesforce of the insurance industry to accept this career and its technology. The statistical population of the research is made up of managers, insurance sales representatives, assistants and heads of sales departments of insurance companies. An 18-minute video was prepared that introduced and taught the job of Islamic personal financial planning and explained its difference from its non-Islamic model. This video was provided to the respondents. The data collection tool was a research-made questionnaire. To investigate the factors affecting technology acceptance and job change, independent T descriptive statistics and Pearson correlation were used, and Friedman's test was used to rank the effective factors. The results indicate the mental perception and very positive attitude of the insurance industry activists towards the usefulness of this job and its technology, and the studied sample confirmed the intention of training in this knowledge. Based on research results, the change in the customer's attitude towards the insurance advisor and the possibility of increasing income are considered as the reasons for accepting. However, Restrictions on using investment opportunities due to Islamic financial services laws and the uncertainty of the position of the central insurance in this regard are considered as the most important obstacles.

Keywords: fintech, insurance, personal financial planning, wealth management

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Authors: Yang Zhou, Kaijian Li, Guiwen Liu

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Offsite construction is an innovative alternative to conventional site-based construction, with wide-ranging benefits. It requires building components, elements or modules were prefabricated and pre-assembly before installed into their final locations. To improve efficiency and achieve synergies, in recent years, construction companies were clustered into construction industrial parks (CIPs) in China. A CIP is a community of construction manufacturing and service businesses located together on a common property. Companies involved in industrial clusters can obtain environment and economic benefits by sharing resources and information in a given region. Therefore, the concept of industrial symbiosis (IS) can be applied to the traditional CIP to achieve sustainable industrial development or redevelopment through the implementation of eco-industrial parks (EIP). However, before designing a symbiosis network between companies in a CIP, candidate support tenants need to be selected to complement the existing construction companies. In this study, an access indicator system and a linear programming model are established to select candidate tenants in a CIP while satisfying the degree of connectivity among the enterprises in the CIP, minimizing the environmental impact, and maximizing the annualized profit of the CIP. The access indicator system comprises three primary indicators and fifteen secondary indicators, is proposed from the perspective of park-based level. The fifteen indicators are classified as three primary indicators including industrial symbiosis, environment performance and economic benefit, according to the three dimensions of sustainability (environment, economic and social dimensions) and the three R's of the environment (reduce, reuse and recycle). The linear programming model is a method to assess the satisfactoriness of all the indicators and to make an optimal multi-objective selection among candidate tenants. This method provides a practical tool for planners of a CIP in evaluating which among the candidate tenants would best complement existing anchor construction tenants. The reasonability and validity of the indicator system and the method is worth further study in the future.

Keywords: construction industrial park, China, industrial symbiosis, offsite construction, selection of support tenants

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Authors: Godwin Dennison, C. E. Boulind, O. Gould, B. de Lacy Costello, J. Allison, P. White, P. Ewings, A. Wicaksono, N. J. Curtis, A. Pullyblank, D. Jayne, J. A. Covington, N. Ratcliffe, N. K. Francis

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Background: Colorectal symptoms are common but only infrequently represent serious pathology, including colorectal cancer (CRC). A large number of invasive tests are presently performed for reassurance. We investigated the feasibility of urinary volatile organic compound (VOC) testing as a potential triage tool in patients fast-tracked for assessment for possible CRC. Methods: A prospective, multi-centre, observational feasibility study was performed across three sites. Patients referred on NHS fast-track pathways for potential CRC provided a urine sample which underwent Gas Chromatography Mass Spectrometry (GC-MS), Field Asymmetric Ion Mobility Spectrometry (FAIMS) and Selected Ion Flow Tube Mass Spectrometry (SIFT-MS) analysis. Patients underwent colonoscopy and/or CT colonography and were grouped as either CRC, adenomatous polyp(s), or controls to explore the diagnostic accuracy of VOC output data supported by an artificial neural network (ANN) model. Results: 558 patients participated with 23 (4.1%) CRC diagnosed. 59% of colonoscopies and 86% of CT colonographies showed no abnormalities. Urinary VOC testing was feasible, acceptable to patients, and applicable within the clinical fast track pathway. GC-MS showed the highest clinical utility for CRC and polyp detection vs. controls (sensitivity=0.878, specificity=0.882, AUROC=0.884). Conclusion: Urinary VOC testing and analysis are feasible within NHS fast-track CRC pathways. Clinically meaningful differences between patients with cancer, polyps, or no pathology were identified therefore suggesting VOC analysis may have future utility as a triage tool. Acknowledgment: Funding: NIHR Research for Patient Benefit grant (ref: PB-PG-0416-20022).

Keywords: colorectal cancer, volatile organic compound, gas chromatography mass spectrometry, field asymmetric ion mobility spectrometry, selected ion flow tube mass spectrometry

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Authors: Yelda Kağnıcı, Seçil Seymenler, Bahar Baran, Erol Esen, Barışcan Öztürk, Ender Siyez, Diğdem M. Siyez

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Infertility is the inability to reproduce after twelve months or longer unprotected sexual relationship. Although infertility is not a life threatening illness, it is considered as a serious problem for both the individual and the society. At this point, the importance of examining attitudes towards infertility is critical. Negative attitudes towards infertility may postpone individuals’ help seeking behaviors. The aim of this study is to investigate university students’ attitudes towards infertility in terms of socio-demographic variables (gender, age, taking sexual health education, existence of an infertile individual in the social network, plans about having child and behaviors about health). The sample of the study was 9693 university students attending to 21 universities in Turkey. Of the 9693 students, % 51.6 (n = 5002) were female, % 48.4 (n = 4691) were male. The data was collected by Attitudes toward Infertility Scale developed by researchers and Personal Information Form. In data analysis first frequencies were calculated, then in order to test whether there were significant differences in attitudes towards infertility scores of university students in terms of socio-demographic variables, one way ANOVA was conducted. According to the results, it was found that female students, students who had sexual health education, who have sexual relationship experience, who have an infertile individual in their social networks, who have child plans, who have high caffeine usage and who use alcohol regularly have more positive attitudes towards infertility. On the other hand, attitudes towards infidelity did not show significant differences in terms of age and cigarette usage. When the results of the study were evaluated in general, it was seen that university students’ attitudes towards infertility were negative. The attitudes of students who have high caffeine and alcohols usage were high. It can be considered that these students are aware that their social habits are risky. Female students’ positive attitudes might be explained by their gender role. The results point out that in order to decrease university students’ negative attitudes towards infertility, there is a necessity to develop preventive programs in universities.

Keywords: infertility, attitudes, sex, university students

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Authors: Javier Sandoval Bustamante, Pardis Sheikhzadeh, Vijayanarasimha Hindupur Pakka

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In the pursuit of achieving net-zero carbon emissions, the integration of low carbon technologies into electricity distribution networks is paramount. This paper delves into the critical assessment of how the integration of low carbon technologies, such as heat pumps, electric vehicle chargers, and photovoltaic systems, impacts the infrastructure and operation of electricity distribution networks. The study employs rigorous methodologies, including power flow analysis and headroom analysis, to evaluate the feasibility and implications of integrating these technologies into existing distribution systems. Furthermore, the research utilizes Local Area Energy Planning (LAEP) methodologies to guide local authorities and distribution network operators in formulating effective plans to meet regional and national decarbonization objectives. Geospatial analysis techniques, coupled with building physics and electric energy systems modeling, are employed to develop geographic datasets aimed at informing the deployment of low carbon technologies at the local level. Drawing upon insights from the Local Energy Net Zero Accelerator (LENZA) project, a comprehensive case study illustrates the practical application of these methodologies in assessing the rollout potential of LCTs. The findings not only shed light on the technical feasibility of integrating low carbon technologies but also provide valuable insights into the broader transition towards a sustainable and electrified energy future. This paper contributes to the advancement of knowledge in power electrical engineering by providing empirical evidence and methodologies to support the integration of low carbon technologies into electricity distribution networks. The insights gained are instrumental for policymakers, utility companies, and stakeholders involved in navigating the complex challenges of energy transition and achieving long-term sustainability goals.

Keywords: energy planning, energy systems, digital twins, power flow analysis, headroom analysis

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Authors: Tamar Lin, Nufar Buchshtab, Yifat Elharar, Julian Nicenboim, Rotem Edgar, Iddo Weiner, Lior Zelcbuch, Ariel Cohen, Sharon Kredo-Russo, Inbar Gahali-Sass, Naomi Zak, Sailaja Puttagunta, Merav Bassan

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Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder that is characterized by dry skin and flares of eczematous lesions and intense pruritus. Multiple lines of evidence suggest that AD is associated with increased colonization by Staphylococcus aureus, which contributes to disease pathogenesis through the release of virulence factors that affect both keratinocytes and immune cells, leading to disruption of the skin barrier and immune cell dysfunction. The aim of the current study is to develop a bacteriophage-based product that specifically targets S. aureus. Methods: For the discovery of phage, environmental samples were screened on 118 S. aureus strains isolated from skin samples, followed by multiple enrichment steps. Natural phages were isolated, subjected to Next-generation Sequencing (NGS), and analyzed using proprietary bioinformatics tools for undesirable genes (toxins, antibiotic resistance genes, lysogeny potential), taxonomic classification, and purity. Phage host range was determined by an efficiency of plating (EOP) value above 0.1 and the ability of the cocktail to completely lyse liquid bacterial culture under different growth conditions (e.g., temperature, bacterial stage). Results: Sequencing analysis demonstrated that the 118 S. aureus clinical strains were distributed across the phylogenetic tree of all available Refseq S. aureus (~10,750 strains). Screening environmental samples on the S. aureus isolates resulted in the isolation of 50 lytic phages from different genera, including Silviavirus, Kayvirus, Podoviridae, and a novel unidentified phage. NGS sequencing confirmed the absence of toxic elements in the phages’ genomes. The host range of the individual phages, as measured by the efficiency of plating (EOP), ranged between 41% (48/118) to 79% (93/118). Host range studies in liquid culture revealed that a subset of the phages can infect a broad range of S. aureus strains in different metabolic states, including stationary state. Combining the single-phage EOP results of selected phages resulted in a broad host range cocktail which infected 92% (109/118) of the strains. When tested in vitro in a liquid infection assay, clearance was achieved in 87% (103/118) of the strains, with no evidence of phage resistance throughout the study (24 hours). A S. aureus host was identified that can be used for the production of all the phages in the cocktail at high titers suitable for large-scale manufacturing. This host was validated for the absence of contaminating prophages using advanced NGS methods combined with multiple production cycles. The phages are produced under optimized scale-up conditions and are being used for the development of a topical formulation (BX005) that may be administered to subjects with atopic dermatitis. Conclusions: A cocktail of natural phages targeting S. aureus was effective in reducing bacterial burden across multiple assays. Phage products may offer safe and effective steroid-sparing options for atopic dermatitis.

Keywords: atopic dermatitis, bacteriophage cocktail, host range, Staphylococcus aureus

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Authors: Asma Ameur, Dhafer Malouche

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Nowadays, user comments on the Internet have an important impact on hotel bookings. This confirms that the e-reputation issue can influence the likelihood of customer loyalty to a hotel. In this way, e-reputation has become a real differentiator between hotels. For this reason, we have a unique opportunity in the opinion mining field to analyze the comments. In fact, this field provides the possibility of extracting information related to the polarity of user reviews. This sentimental study (Opinion Mining) represents a new line of research for analyzing the unstructured textual data. Knowing the score of e-reputation helps the hotelier to better manage his marketing strategy. The score we then obtain is translated into the image of hotels to differentiate between them. Therefore, this present research highlights the importance of hotel satisfaction ‘scoring. To calculate the satisfaction score, the sentimental analysis can be manipulated by several techniques of machine learning. In fact, this study treats the extracted textual data by using the Artificial Neural Networks Approach (ANNs). In this context, we adopt the aforementioned technique to extract information from the comments available in the ‘Trip Advisor’ website. This actual paper details the description and the modeling of the ANNs approach for the scoring of online hotel reviews. In summary, the validation of this used method provides a significant model for hotel sentiment analysis. So, it provides the possibility to determine precisely the polarity of the hotel users reviews. The empirical results show that the ANNs are an accurate approach for sentiment analysis. The obtained results show also that this proposed approach serves to the dimensionality reduction for textual data’ clustering. Thus, this study provides researchers with a useful exploration of this technique. Finally, we outline guidelines for future research in the hotel e-reputation field as comparing the ANNs with other technique.

Keywords: clustering, consumer behavior, data mining, e-reputation, machine learning, neural network, online hotel ‘reviews, opinion mining, scoring

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Authors: Xianglu Tang, Zhenxue Jiang, Zhuo Li

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Characterization of shale multi scale heterogeneity is an important part to evaluate size and space distribution of shale gas reservoirs in sedimentary basins. The origin of shale heterogeneity has always been a hot research topic for it determines shale micro characteristics description and macro quality reservoir prediction. Shale multi scale heterogeneity was discussed based on thin section observation, FIB-SEM, QEMSCAN, TOC, XRD, mercury intrusion porosimetry (MIP), and nitrogen adsorption analysis from 30 core samples in Silurian Longmaxi formation. Results show that shale heterogeneity can be characterized by pore structure and mineral composition. The heterogeneity of shale pore is showed by different size pores at nm-μm scale. Macropores (pore diameter > 50 nm) have a large percentage of pore volume than mesopores (pore diameter between 2~ 50 nm) and micropores (pore diameter < 2nm). However, they have a low specific surface area than mesopores and micropores. Fractal dimensions of the pores from nitrogen adsorption data are higher than 2.7, what are higher than 2.8 from MIP data, showing extremely complex pore structure. This complexity in pore structure is mainly due to the organic matter and clay minerals with complex pore network structures, and diagenesis makes it more complicated. The heterogeneity of shale minerals is showed by mineral grains, lamina, and different lithology at nm-km scale under the continuous changing horizon. Through analyzing the change of mineral composition at each scale, random arrangement of mineral equal proportion, seasonal climate changes, large changes of sedimentary environment, and provenance supply are considered to be the main reasons that cause shale minerals heterogeneity from microcosmic to macroscopic. Due to scale effect, the change of shale multi scale heterogeneity is a discontinuous process, and there is a transformation boundary between homogeneous and in homogeneous. Therefore, a shale multi scale heterogeneity changing model is established by defining four types of homogeneous unit at different scales, which can be used to guide the prediction of shale gas distribution from micro scale to macro scale.

Keywords: heterogeneity, homogeneous unit, multiscale, shale

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Authors: V. K. Srivastava

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Graphene has recently attracted an increasing attention in nanocomposites applications because it has 200 times greater strength than steel, making it the strongest material ever tested. Graphene, as the fundamental two-dimensional (2D) carbon structure with exceptionally high crystal and electronic quality, has emerged as a rapidly rising star in the field of material science. Graphene, as defined, as a 2D crystal, is composed of monolayers of carbon atoms arranged in a honeycombed network with six-membered rings, which is the interest of both theoretical and experimental researchers worldwide. The name comes from graphite and alkene. Graphite itself consists of many graphite-sheets stacked together by weak van der Waals forces. This is attributed to the monolayer of carbon atoms densely packed into honeycomb structure. Due to superior inherent properties of graphene nanoplatelets (GnP) over other nanofillers, GnP particles were added in epoxy resin with the variation of weight percentage. It is indicated that the DMA results of storage modulus, loss modulus and tan δ, defined as the ratio of elastic modulus and imaginary (loss) modulus versus temperature were affected with addition of GnP in the epoxy resin. In epoxy resin, damping (tan δ) is usually caused by movement of the molecular chain. The tan δ of the graphene nanoplatelets/epoxy resin composite is much lower than that of epoxy resin alone. This finding suggests that addition of graphene nanoplatelets effectively impedes movement of the molecular chain. The decrease in storage modulus can be interpreted by an increasing susceptibility to agglomeration, leading to less energy dissipation in the system under viscoelastic deformation. The results indicates the tan δ increased with the increase of temperature, which confirms that tan δ is associated with magnetic field strength. Also, the results show that the nanohardness increases with increase of elastic modulus marginally. GnP filled epoxy resin gives higher value than the epoxy resin, because GnP improves the mechanical properties of epoxy resin. Debonding of GnP is clearly observed in the micrograph having agglomeration of fillers and inhomogeneous distribution. Therefore, DMA and nanohardness studies indiacte that the elastic modulus of epoxy resin is increased with the addition of GnP fillers.

Keywords: agglomeration, elastic modulus, epoxy resin, graphene nanoplatelet, loss modulus, nanohardness, storage modulus

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Authors: Siming Wang, Qing Ni, Yu Wu, Ruihai Xu, Hong Ye

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Porous electric heaters, compared to conventional electric heaters, exhibit excellent heating performance due to their large specific surface area. Porous electric heaters employ porous metallic materials or conductive porous ceramics as the heating element. The former attains a low heating power with a fixed current due to the low electrical resistivity of metal. Although the latter can bypass the inherent challenges of porous metallic materials, the fabrication process of the conductive porous ceramics is complicated and high cost. This work proposed a porous ceramic electric heater with dielectric honeycomb ceramic as a substrate and surface conductive coating as a heating element. The conductive coating was prepared by the sol-gel method using silica sol and methyl trimethoxysilane as raw materials and graphite powder as conductive fillers. The conductive mechanism and degradation reason of the conductive coating was studied by electrical resistivity and thermal stability analysis. The heating performance of the proposed heater was experimentally investigated by heating air and deionized water. The results indicate that the electron transfer is achieved by forming the conductive network through the contact of the graphite flakes. With 30 wt% of graphite, the electrical resistivity of the conductive coating can be as low as 0.88 Ω∙cm. The conductive coating exhibits good electrical stability up to 500°C but degrades beyond 600°C due to the formation of many cracks in the coating caused by the weight loss and thermal expansion. The results also show that the working medium has a great influence on the volume power density of the heater. With air under natural convection as the working medium, the volume power density attains 640.85 kW/m3, which can be increased by 5 times when using deionized water as the working medium. The proposed honeycomb ceramic electric heater has the advantages of the simple fabrication method, low cost, and high volume power density, demonstrating great potential in the fluid heating field.

Keywords: conductive coating, honeycomb ceramic electric heater, high specific surface area, high volume power density

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Authors: Ron Dick, P. S. D. V. Prasadarao, Glenn Coltman

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Agenesis of the corpus callosum (ACC) is a failure to develop corpus callosum - the large bundle of fibers of the brain that connects the two cerebral hemispheres. It can occur as a partial or complete absence of the corpus callosum. In the general population, its estimated prevalence rate is 1 in 4000 and a wide range of genetic, infectious, vascular, and toxic causes have been attributed to this heterogeneous condition. The diagnosis of ACC is often achieved by neuroimaging procedures. Though persons with ACC can perform normally on intelligence tests they generally present with a range of neuropsychological and social deficits. The deficit profile is characterized by poor coordination of motor movements, slow reaction time, processing speed and, poor memory. Socially, they present with deficits in communication, language processing, the theory of mind, and interpersonal relationships. The present paper illustrates the role of neuropsychological assessment with implications to psychosocial management in a case of agenesis of the corpus callosum. Method: A 27-year old left handed Caucasian male with a history of ACC was self-referred for a neuropsychological assessment to assist him in his employment options. Parents noted significant difficulties with coordination and balance at an early age of 2-3 years and he was diagnosed with dyspraxia at the age of 14 years. History also indicated visual impairment, hypotonia, poor muscle coordination, and delayed development of motor milestones. MRI scan indicated agenesis of the corpus callosum with ventricular morphology, widely spaced parallel lateral ventricles and mild dilatation of the posterior horns; it also showed colpocephaly—a disproportionate enlargement of the occipital horns of the lateral ventricles which might be affecting his motor abilities and visual defects. The MRI scan ruled out other structural abnormalities or neonatal brain injury. At the time of assessment, the subject presented with such problems as poor coordination, slowed processing speed, poor organizational skills and time management, and difficulty with social cues and facial expressions. A comprehensive neuropsychological assessment was planned and conducted to assist in identifying the current neuropsychological profile to facilitate the formulation of a psychosocial and occupational rehabilitation programme. Results: General intellectual functioning was within the average range and his performance on memory-related tasks was adequate. Significant visuospatial and visuoconstructional deficits were evident across tests; constructional difficulties were seen in tasks such as copying a complex figure, building a tower and manipulating blocks. Poor visual scanning ability and visual motor speed were evident. Socially, the subject reported heightened social anxiety, difficulty in responding to cues in the social environment, and difficulty in developing intimate relationships. Conclusion: Persons with ACC are known to present with specific cognitive deficits and problems in social situations. Findings from the current neuropsychological assessment indicated significant visuospatial difficulties, poor visual scanning and problems in social interactions. His general intellectual functioning was within the average range. Based on the findings from the comprehensive neuropsychological assessment, a structured psychosocial rehabilitation programme was developed and recommended.

Keywords: agenesis, callosum, corpus, neuropsychology, psychosocial, rehabilitation

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Authors: Patricia Portugal Marques de Carvalho Lourenco

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A three-phase methodological multi-lingual path was designed, constructed and carried out using the 2020 Chinese Internet Drama Series We Are All Alone as a case study. Phase one, the backbone of the research, comprised of secondary data analysis, providing the structure on which the next two phases would be built on. Phase one incorporated a Google Scholar and a Baidu Index analysis, Star Network Influence Index and Mydramalist.com top two drama reviews, along with an article written about the drama and scrutiny of Chinese related blogs and websites. Phase two was field research elaborated across Latin Europe, and phase three was social media focused, having into account that perceptions are going to be memory conditioned based on past ideas recall. Overall, research has shown the poor cultural expression of Chinese entertainment in Latin Europe and demonstrated the inexistence of Chinese content in French, Italian, Portuguese and Spanish Business to Consumer retailers; a reflection of their low significance in Latin European markets and the short-life cycle of entertainment products in general, bubble-gum, disposable goods without a mid to long-term effect in consumers lives. The process of conducting comprehensive international research was complex and time-consuming, with data not always available in Mandarin, the researcher’s linguistic deficiency, limited Chinese Cultural Knowledge and cultural equivalence. Despite steps being taken to minimize the international proposed research, theoretical limitations concurrent to Latin Europe and China still occurred. Data accuracy was disputable; sampling, data collection/analysis methods are heterogeneous; ascertaining data requirements and the method of analysis to achieve a construct equivalence was challenging and morose to operationalize. Secondary data was also not often readily available in Mandarin; yet, in spite of the array of limitations, research was done, and results were produced.

Keywords: research methodologies, international research, primary data, secondary data, research limitations, online dramas, china, latin europe

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Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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Authors: Chandrakant Gurav, Md Babar, Ajaykumar Asode

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Morphometric analysis is the first stage of any basin analysis. By using these morphometric parameters we give indirect information about the nature and relations of stream with other streams, Geology of the area, groundwater condition and tectonic history of the basin. In the present study, Yelganga, Shivbhadra and Kohilla rivers, tributaries of the Godavari River in Aurangabad district, Maharashtra, India are considered to compare and study their morphometric characters. The linear, areal and relief morphometric aspects of the sub-basins have been assessed and evaluated in GIS environment. For this study, ArcGIS 10.1 software has been used for delineating, digitizing and generating different thematic maps. The Survey of India (SOI) toposheets maps and Shuttle Radar Topography Mission (SRTM) Digital Elevation Model (DEM) on resolution 30 m downloaded from United States Geological Survey (USGS) have been used for preparation of map and data generation. Geologically, the study area is covered by Central Deccan Volcanic Province (CDVP). It mainly consists of ‘aa’ type of basaltic lava flows of Late (upper) Cretaceous to Early (lower) Eocene age. The total geographical area of Yelganga, Shivbhadra and Kohilla river sub-basins are 185.5 sq. km., 142.6 sq. km and 122.3 sq. km. respectively The stream ordering method as suggested by the Strahler has been employed for present study and found that all the sub-basins are of 5th order streams. The average bifurcation ratio value of the sub-basins is below 5, indicates that there appears to be no strong structural control on drainage development, homogeneous nature of lithology and drainage network is in well-developed stage of erosion. The drainage density of Yelganga, Shivbhadra and Kohilla Sub-basins is 1.79 km/km2, 1.48 km/km2 and 1.89 km/km2 respectively and stream frequency is 1.94 streams/km2, 1.19 streams/km2 and 1.68 streams/km2 respectively, indicating semi-permeable sub-surface. Based on textural ratio values it indicates that the sub-basins have coarse texture. Shape parameters such as form factor ratio, circularity ratio and elongation ratio values shows that all three sub- basins are elongated in shape.

Keywords: GIS, Kohilla, morphometry, Shivbhadra, Yelganga

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Authors: Martin Mensinger, Marjolaine Pfaffinger, Matthias Haslbeck

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The maintenance and expansion of the railway network represents a central task for transport planning in the future. In addition to the ultimate limit states, the aspects of resource conservation and sustainability are increasingly more necessary to include in the basic engineering. Therefore, as part of the AiF research project, ‘Integrated assessment of steel and composite railway bridges in accordance with sustainability criteria’, the entire lifecycle of engineering structures is involved in planning and evaluation, offering a way to optimize the design of steel bridges. In order to reduce the life cycle costs and increase the profitability of steel structures, it is particularly necessary to consider the demands on hanger connections resulting from fatigue. In order for accurate analysis, a number simulations were conducted as part of the research project on a finite element model of a reference bridge, which gives an indication of the internal forces of the individual structural components of a tied arch bridge, depending on the stress incurred by various types of trains. The calculations were carried out on a detailed FE-model, which allows an extraordinarily accurate modeling of the stiffness of all parts of the constructions as it is made up surface elements. The results point to a large impact of the formation of details on fatigue-related changes in stress, on the one hand, and on the other, they could depict construction-specific specifics over the course of adding stress. Comparative calculations with varied axle-stress distribution also provide information about the sensitivity of the results compared to the imposition of stress and axel distribution on the stress-resultant development. The calculated diagrams help to achieve an optimized hanger connection design through improved durability, which helps to reduce the maintenance costs of rail networks and to give practical application notes for the formation of details.

Keywords: fatigue, influence line, life cycle, tied arch bridge

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Authors: Mark Bezner, Shani Deri, Tom Trigano, Kfir Ben-Harush

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Intermediate filament (IF) proteins-based fibers are among the toughest fibers in nature, as was shown by native hagfish slime threads and by synthetic fibers that are based on type V IF-proteins, the nuclear lamins. It is assumed that their mechanical performance stems from two major factors: (1) the transition from elastic -helices to stiff-sheets during tensile load; and (2) the specific organization of the coiled-coil proteins into a hierarchical network of nano-filaments. Here, we investigated the interrelationship between these two factors by using wet-spun fibers based on C. elegans (Ce) lamin. We found that Ce-lamin fibers, whether assembled in aqueous or alcoholic solutions, had the same nonlinear mechanical behavior, with the elastic region ending at ~5%. The pattern of the transition was, however, different: the ratio between -helices and -sheets/random coils was relatively constant until a 20% strain for fibers assembled in an aqueous solution, whereas for fibers assembled in 70% ethanol, the transition ended at a 6% strain. This structural phenomenon in alcoholic solution probably occurred through the transition between compacted and extended conformation of the random coil, and not between -helix and -sheets, as cycle analyses had suggested. The different transition pattern can also be explained by the different higher order organization of Ce-lamins in aqueous or alcoholic solutions, as demonstrated by introducing a point mutation in conserved residue in Ce-lamin gene that alter the structure of the Ce-lamins’ nano-fibrils. In addition, biomimicking the layered structure of silk and hair fibers by coating the Ce-lamin fiber with a hydrophobic layer enhanced fiber toughness and lead to a reversible transition between -helix and the extended conformation. This work suggests that different hierarchical structures, which are formed by specific assembly conditions, lead to diverse secondary structure transitions patterns, which in turn affect the fibers’ mechanical properties.

Keywords: protein-based fibers, intermediate filaments (IF) assembly, toughness, structure-property relationships

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Authors: Ye Xue, Zhenhua Deng

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Objectives: Facial soft tissue thickness (FSTT) data could be obtained from CT scans by measuring the face-to-skull distances at sparsely distributed anatomical landmarks by manually located on face and skull. However, automated measurement using 3D facial and skull models by dense points using open-source software has become a viable option due to the development of computed assisted imaging technologies. By utilizing dense FSTT information, it becomes feasible to generate plausible automated facial approximations. Therefore, establishing a comprehensive and detailed, densely calculated FSTT database is crucial in enhancing the accuracy of facial approximation. Materials and methods: This study utilized head CT scans from 250 Chinese adults of Han ethnicity, with 170 participants originally born and residing in northern China and 80 participants in southern China. The age of the participants ranged from 14 to 82 years, and all samples were divided into five non-overlapping age groups. Additionally, samples were also divided into three categories based on BMI information. The 3D Slicer software was utilized to segment bone and soft tissue based on different Hounsfield Unit (HU) thresholds, and surface models of the face and skull were reconstructed for all samples from CT data. Following procedures were performed unsing MeshLab, including converting the face models into hollowed cropped surface models amd automatically measuring the Hausdorff Distance (referred to as FSTT) between the skull and face models. Hausdorff point clouds were colorized based on depth value and exported as PLY files. A histogram of the depth distributions could be view and subdivided into smaller increments. All PLY files were visualized of Hausdorff distance value of each vertex. Basic descriptive statistics (i.e., mean, maximum, minimum and standard deviation etc.) and distribution of FSTT were analysis considering the sex, age, BMI and birthplace. Statistical methods employed included Multiple Regression Analysis, ANOVA, principal component analysis (PCA). Results: The distribution of FSTT is mainly influenced by BMI and sex, as further supported by the results of the PCA analysis. Additionally, FSTT values exceeding 30mm were found to be more sensitive to sex. Birthplace-related differences were observed in regions such as the forehead, orbital, mandibular, and zygoma. Specifically, there are distribution variances in the depth range of 20-30mm, particularly in the mandibular region. Northern males exhibit thinner FSTT in the frontal region of the forehead compared to southern males, while females shows fewer distribution differences between the northern and southern, except for the zygoma region. The observed distribution variance in the orbital region could be attributed to differences in orbital size and shape. Discussion: This study provides a database of Chinese individuals distribution of FSTT and suggested opening source tool shows fine function for FSTT measurement. By incorporating birthplace as an influential factor in the distribution of FSTT, a greater level of detail can be achieved in facial approximation.

Keywords: forensic anthropology, forensic imaging, cranial facial reconstruction, facial soft tissue thickness, CT, open-source tool

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Authors: Marie-Claude Richard, Amelie Bolduc-Mokhtar, Mathieu Parent

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People who have experienced maltreatment in childhood subsequently face many parenting issues of their own, in particular when it comes to distancing themselves from the abusive behaviors they were exposed and had access to positive role models. Few studies have explored the factors explaining the ability to break the generational cycle of child maltreatment. However, deeper knowledge of the factors associated with intergenerational discontinuity could facilitate the development of innovative interventions and increase the preventive potential of existing programs. This poster presentation will be about a better understanding of the intergenerational transmission of maltreatment (IGTM) from the perspective of both youth protection workers and parents receiving child protection services. The data used to meet this goal were collected from a group interview with eight youth protection workers whose caseloads involved IGTM situations and through semi-structured interviews with four parents with a history of child protection services and who were currently receiving such services for at least one of their children. In the view of the youth protection workers, the IGTM refers to everything that is transmitted and not transmitted from one generation to the next within a family. The study participants painted quite a bleak portrait of the families affected by IGTM. However, three main avenues of intervention were mentioned by the participants: working within the network, favoring long-term interventions and being empathic. The results also show that the mothers were in a trajectory of intergenerational discontinuity in child maltreatment. Support from their families and friends as well as from formal support services brought out some possible explanatory factors for intergenerational discontinuity in child maltreatment. From a prevention perspective, developing meaningful and trusting relationships seems a source of resilience for parents who were placed in the care of the child protection system as children. The small number of participants limits the generalizability of these results. The difficulty of recruiting parents is a substantial challenge regarding gaining knowledge on the intergenerational transmission of child maltreatment. Future studies should examine this question and seek to develop effective strategies to help recruit study participants.

Keywords: child maltreatment, intergenerational transmission, prevention, qualitative data

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Authors: A. M. Khourshid, I. Sabry

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Friction Stir Welding (FSW), a solid state joining technique, is widely being used for joining Al alloys for aerospace, marine automotive and many other applications of commercial importance. FSW were carried out using a vertical milling machine on Al 5083 alloy pipe. These pipe sections are relatively small in diameter, 5mm, and relatively thin walled, 2 mm. In this study, 5083 aluminum alloy pipe were welded as similar alloy joints using (FSW) process in order to investigate mechanical and microstructural properties .rotation speed 1400 r.p.m and weld speed 10,40,70 mm/min. In order to investigate the effect of welding speeds on mechanical properties, metallographic and mechanical tests were carried out on the welded areas. Vickers hardness profile and tensile tests of the joints as a metallurgical feasibility of friction stir welding for joining Al 6061 aluminum alloy welding was performed on pipe with different thickness 2, 3 and 4 mm,five rotational speeds (485,710,910,1120 and 1400) rpm and a traverse speed (4, 8 and 10)mm/min was applied. This work focuses on two methods such as artificial neural networks using software (pythia) and response surface methodology (RSM) to predict the tensile strength, the percentage of elongation and hardness of friction stir welded 6061 aluminum alloy. An artificial neural network (ANN) model was developed for the analysis of the friction stir welding parameters of 6061 pipe. The tensile strength, the percentage of elongation and hardness of weld joints were predicted by taking the parameters Tool rotation speed, material thickness and travel speed as a function. A comparison was made between measured and predicted data. Response surface methodology (RSM) also developed and the values obtained for the response Tensile strengths, the percentage of elongation and hardness are compared with measured values. The effect of FSW process parameter on mechanical properties of 6061 aluminum alloy has been analyzed in detail.

Keywords: friction stir welding (FSW), al alloys, mechanical properties, microstructure

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Authors: Ana Maria G. Sperandio, Murilo U. Malek-Zadeh, João Luiz de S. Areas, Jussara C. Guarnieri

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Intersectoral governance is a requirement for developing healthy cities. However, this achievement is difficult to be succeeded, especially in regions at low resources condition. Therefore, it was developed a cheap investigative procedure to diagnose sectoral wishes related to urban planning and health promotion. This procedure is composed of two phases, which can be applied to different groups in order to compare the results. The first phase is a conversation guided by a list of questions. Some of those questions aim to gather information about how individuals understand concepts such as healthy city or a health promotion and what they believe that constitutes the relation between urban planning and urban health. Other questions investigate local issues, and how citizens would like to promote dialogue between sectors. At second phase individuals stand around the investigated city (or city region) map and are asked to represent their wishes on it. They can represent it by writing text notations or inserting icons on it, with the latter representing a city element, for example, some trees, a square, a playground, a hospital, a cycle track. After groups had represented their wishes, the map can be photographed, and then the results from distinct groups can be compared. This procedure was conducted at a small city in Brazil (Holambra), in 2017 which is the first out of four years of the mayor’s term. The prefecture asked for this tool in order to make Holambra become a city of Potential Healthy Municipalities Network in Brazil. Two sectors were investigated: the government and the urban population. By the end of our investigation, the intersection from the group (i.e., population and government) maps was accounted for creating a map of common wishes. Therefore, the material produced can be used as a guide for promoting dialogue between sectors and as a tool of monitoring politics progress. The report of this procedure was directed to public managers, so they could see the common wishes between themselves and local populations, and use this tool as a guide for creating urban politics which intends to enhance health promotion and to develop a healthy city, even at low resources condition.

Keywords: governance, health promotion, intersectorality, urban planning

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Chukwu Fidelis Ndubuisi, Madufor Michael Ozims, Asogwa Vivian Ndidiamaka, Egenamba Juliet Ngozi, Okonkwo Stephen C., Kamah Chukwudi David

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Deflection of the vertical is a quantity used in reducing geodetic measurements related to geoidal networks to the ellipsoidal plane; and it is essential in Geoid modeling processes. Computing the deflection of the vertical component of a point in a given area is necessary in evaluating the standard errors along north-south and east-west direction. Using combined approach for the determination of deflection of the vertical component provides improved result but labor intensive without appropriate method. Least square method is a method that makes use of redundant observation in modeling a given sets of problem that obeys certain geometric condition. This research work is aimed to computing the deflection of vertical component of Owerri West local government area of Imo State using geometric method as field technique. In this method combination of Global Positioning System on static mode and precise leveling observation were utilized in determination of geodetic coordinate of points established within the study area by GPS observation and the orthometric heights through precise leveling. By least square using Matlab programme; the estimated deflections of vertical component parameters for the common station were -0.0286 and -0.0001 arc seconds for the north-south and east-west components respectively. The associated standard errors of the processed vectors of the network were computed. The computed standard errors of the North-south and East-west components were 5.5911e-005 and 1.4965e-004 arc seconds, respectively. Therefore, including the derived component of deflection of the vertical to the ellipsoidal model will yield high observational accuracy since an ellipsoidal model is not tenable due to its far observational error in the determination of high quality job. It is important to include the determined deflection of the vertical component for Owerri West Local Government in Imo State, Nigeria.

Keywords: deflection of vertical, ellipsoidal height, least square, orthometric height

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Authors: Liang Cheng Chang, Wei Ju Huang, You Cheng Chen

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Investigation and research are keys for conjunctive use of surface and groundwater resources. The hydrogeological structure is an important base for groundwater analysis and simulation. Traditionally, the hydrogeological structure is artificially determined based on geological drill logs, the structure of wells, groundwater levels, and so on. In Taiwan, groundwater observation network has been built and a large amount of groundwater-level observation data are available. The groundwater level is the state variable of the groundwater system, which reflects the system response combining hydrogeological structure, groundwater injection, and extraction. This study applies analytical tools to the observation database to develop a methodology for the identification of confined and unconfined aquifers. These tools include frequency analysis, cross-correlation analysis between rainfall and groundwater level, groundwater regression curve analysis, and decision tree. The developed methodology is then applied to groundwater layer identification of two groundwater systems: Zhuoshui River alluvial fan and Pingtung Plain. The abovementioned frequency analysis uses Fourier Transform processing time-series groundwater level observation data and analyzing daily frequency amplitude of groundwater level caused by artificial groundwater extraction. The cross-correlation analysis between rainfall and groundwater level is used to obtain the groundwater replenishment time between infiltration and the peak groundwater level during wet seasons. The groundwater regression curve, the average rate of groundwater regression, is used to analyze the internal flux in the groundwater system and the flux caused by artificial behaviors. The decision tree uses the information obtained from the above mentioned analytical tools and optimizes the best estimation of the hydrogeological structure. The developed method reaches training accuracy of 92.31% and verification accuracy 93.75% on Zhuoshui River alluvial fan and training accuracy 95.55%, and verification accuracy 100% on Pingtung Plain. This extraordinary accuracy indicates that the developed methodology is a great tool for identifying hydrogeological structures.

Keywords: aquifer identification, decision tree, groundwater, Fourier transform

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Authors: Pablo Chico De Guzman, Cesar Sanchez

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Microservice architectures are increasingly in distributed cloud applications due to the advantages on the software composition, development speed, release cycle frequency and the business logic time to market. On the other hand, these architectures also introduce some challenges on the testing and release phases of applications. Container technology solves some of these issues by providing reproducible environments, easy of software distribution and isolation of processes. However, there are other issues that remain unsolved in current container technology when dealing with multiple machines, such as networking for multi-host communication, service discovery, load balancing or data persistency (even though some of these challenges are already solved by traditional cloud vendors in a very mature and widespread manner). Container cluster management tools, such as Kubernetes, Mesos or Docker Swarm, attempt to solve these problems by introducing a new control layer where the unit of deployment is the container (or the pod — a set of strongly related containers that must be deployed on the same machine). These tools are complex to configure and manage and they do not follow a pure immutable infrastructure approach since servers are reused between deployments. Indeed, these tools introduce dependencies at execution time for solving networking or service discovery problems. If an error on the control layer occurs, which would affect running applications, specific expertise is required to perform ad-hoc troubleshooting. As a consequence, it is not surprising that container cluster support is becoming a source of revenue for consulting services. This paper presents i2kit, a deployment tool based on the immutable infrastructure pattern, where the virtual machine is the unit of deployment. The input for i2kit is a declarative definition of a set of microservices, where each microservice is defined as a pod of containers. Microservices are built into machine images using linuxkit —- a tool for creating minimal linux distributions specialized in running containers. These machine images are then deployed to one or more virtual machines, which are exposed through a cloud vendor load balancer. Finally, the load balancer endpoint is set into other microservices using an environment variable, providing service discovery. The toolkit i2kit reuses the best ideas from container technology to solve problems like reproducible environments, process isolation, and software distribution, and at the same time relies on mature, proven cloud vendor technology for networking, load balancing and persistency. The result is a more robust system with no learning curve for troubleshooting running applications. We have implemented an open source prototype that transforms i2kit definitions into AWS cloud formation templates, where each microservice AMI (Amazon Machine Image) is created on the fly using linuxkit. Even though container cluster management tools have more flexibility for resource allocation optimization, we defend that adding a new control layer implies more important disadvantages. Resource allocation is greatly improved by using linuxkit, which introduces a very small footprint (around 35MB). Also, the system is more secure since linuxkit installs the minimum set of dependencies to run containers. The toolkit i2kit is currently under development at the IMDEA Software Institute.

Keywords: container, deployment, immutable infrastructure, microservice

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Authors: Patricia Shirley Almeida Prado, Liz Brito, Selma Paixão Argollo, Gracie Moreira, Leticia Matos Sobrinho

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Diffuse idiopathic skeletal hyperostosis (DISH) is a degenerative bone disease also known as Forestier´s disease and ankylosing hyperostosis of the spine is characterized by a tendency toward ossification of half the anterior longitudinal spinal ligament without intervertebral disc disease. DISH is not considered to be osteoarthritis, although the two conditions commonly occur together. Diagnostic criteria include fusion of at least four vertebrae by bony bridges arising from the anterolateral aspect of the vertebral bodies. These vertebral bodies have a 'dripping candle wax' appearance, also can be seen periosteal new bone formation on the anterior surface of the vertebral bodies and there is no ankylosis at zygoapophyseal facet joint. Clinically, patients with DISH tend to be asymptomatic some patients mention moderate pain and stiffness in upper back. This disease is more common in man, uncommon in patients younger than 50 years and rare in patients under 40 years old. In modern populations, DISH is found in association with obesity, (type II) diabetes; abnormal vitamin A metabolism and also associated with higher levels of serum uric acid. There is also some association between the increase of risk of stroke or other cerebrovascular disease. The DISH condition can be confused with Heterotopic Ossification, what is the bone formation in the soft tissues as the result of trauma, wounding, surgery, burnings, prolonged immobility and some central nervous system disorder. All these conditions have been described extensively as myositis ossificans which can be confused with the fibrodysplasia (myositis) ossificans progressive. As in the DISH symptomatology it can be asymptomatic or extensive enough to impair joint function. A third confusion osteoarthritis disease that can bring confusion are the enthesopathies that occur in the entire skeleton being common on the ischial tuberosities, iliac crests, patellae, and calcaneus. Ankylosis of the sacroiliac joint by bony bridges may also be found. CASE 1: this case is skeletal remains presenting skull, some vertebrae and scapulae. This case remains unidentified and due to lack of bone remains. Sex, age and ancestry profile was compromised, however the DISH pathognomonic findings and diagnostic helps to estimate sex and age characteristics. Moreover to presenting DISH these skeletal remains also showed some bone alterations and non-metrics as fusion of the first vertebrae with occipital bone, maxillae and palatine torus and scapular foramen on the right scapulae. CASE 2: this skeleton remains shows an extensive bone heterotopic ossification on the great trochanter area of left femur, right fibula showed a healed fracture in its body however in its inteosseous crest there is an extensive bone growth, also in the Ilium at the region of inferior gluteal line can be observed some pronounced bone growth and the skull presented a pronounced mandibular, maxillary and palatine torus. Despite all these pronounced heterotopic ossification the whole skeleton presents moderate bone overgrowth that is not linked with aging, since the skeleton belongs to a young unidentified individual. The appropriate osteopathological diagnosis support the human identification process through medical reports and also assist with epidemiological data that can strengthen vulnerable anthropological estimates.

Keywords: bone disease, DISH, human identification, human remains

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Authors: Atiya Khan

Abstract:

Recent research on the condition of school education in India has reaffirmed the importance of quality teacher professional development, especially in light of the rapid changes in teaching methods, learning theories, curriculum, and major shifts in information and technology that education systems are experiencing around the world. However, the quality of programs of teacher professional development in India is often uneven, in some cases non-existing. The educational authorities in India have long recognized this and have developed a range of programs to assist in-service teacher education. But, these programs have been mostly inadequate at improving the quality of teachers in India. Policy literature and reports indicate that the unevenness of these programs and more generally the lack of quality teacher professional development in India are due to factors such as a large number of teachers, budgetary constraints, top-down decision making, teacher overload, lack of infrastructure, and little or no follow-up. The disparity between the government stated goals for quality teacher professional development in India and its inability to meet the learning needs of teachers suggests that new interventions are needed. The realization that globalization has brought about an increase in the social, cultural, political and economic interconnectedness between countries has also given rise to transnational opportunities for education systems, such as India’s, aiming to build their capacity to support teacher professional development. Moreover, new developments in communication technologies seem to present a plausible means of achieving high-quality professional development for teachers through the creation of social learning spaces, such as transnational learning networks. This case study investigates the potential of one such transnational learning network to support the quality of teacher professional development in India, namely the Australia-Asia BRIDGE School Partnerships Project. It explores the participation of some fifteen teachers and their principals from BRIDGE participating schools in Delhi region of India; focusing on their professional development expectations from the BRIDGE program and account for their experiences in the program, in order to determine the program’s potential for the professional development of teachers in this study.

Keywords: case study, Australia-Asia BRIDGE Project, teacher professional development, transnational learning networks

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