Search results for: anterior crucial ligament reconstruction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3962

Search results for: anterior crucial ligament reconstruction

3212 Data-Driven Analysis of Velocity Gradient Dynamics Using Neural Network

Authors: Nishant Parashar, Sawan S. Sinha, Balaji Srinivasan

Abstract:

We perform an investigation of the unclosed terms in the evolution equation of the velocity gradient tensor (VGT) in compressible decaying turbulent flow. Velocity gradients in a compressible turbulent flow field influence several important nonlinear turbulent processes like cascading and intermittency. In an attempt to understand the dynamics of the velocity gradients various researchers have tried to model the unclosed terms in the evolution equation of the VGT. The existing models proposed for these unclosed terms have limited applicability. This is mainly attributable to the complex structure of the higher order gradient terms appearing in the evolution equation of VGT. We investigate these higher order gradients using the data from direct numerical simulation (DNS) of compressible decaying isotropic turbulent flow. The gas kinetic method aided with weighted essentially non-oscillatory scheme (WENO) based flow- reconstruction is employed to generate DNS data. By applying neural-network to the DNS data, we map the structure of the unclosed higher order gradient terms in the evolution of the equation of the VGT with VGT itself. We validate our findings by performing alignment based study of the unclosed higher order gradient terms obtained using the neural network with the strain rate eigenvectors.

Keywords: compressible turbulence, neural network, velocity gradient tensor, direct numerical simulation

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3211 The Presence of Dogs in Nursing Homes: Experiences Concerning the Mental Health of Residents

Authors: Ellen Dahl Gundersen, Berit Johannessen

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Introduction: Dementia and depression are common mental disorders of nursing home residents. The care of these residents consists of providing both physical, social and mental care. Too often, the physical needs are given priority, and municipal health services are urged to focus more on the patients mental and social needs. The presence of dogs may have positive impact on the mental health of nursing home residents by improving mood, social interaction and enjoyment of the visits. The voluntary organization Red Cross, has given priority to this subject by training and certifying dogs and owners (equipages), committed for regular visits at local nursing homes. Focus of this study: How do the dog owners and employees experience the presence of a dog equipage concerning the mental health of nursing home residents? Method: Individual interviews with 8-10 certified dog owners who are volunteers from Red Cross, contributing with regular visits at local nursing homes. Focus group interviews with 10 employees working in two different nursing homes. Preliminary results: Five to seven residents and one or two employees attended weekly dog equipage visits during a period of six months. The presence of an equipage seems to have made the residents calm and more social orientated with a lighter mood and better verbal expression. Some of the residents with dementia remembered the name of the dog from one week to another. The informants also reported positive outcome for the residents by their opportunity to give and get close through physical contact with a dog. Further, the presence of an equipage affected the atmosphere at the nursing home positively by promoting joy and initiating conversations about dogs. A conscious approach by the dog owners towards the residents seems to be of significance to this matter. The positive attitude and support from employees also seem to be of crucial importance for the maintenance of these visits. Conclusion: The presence of trained dog equipages in nursing homes seems to have had an overall positive impact on the mental health of residents. A conscious approach from the dog owners as well as positive support from employees seems to have a crucial impact on the success and maintenance of the visits. These findings correspond well to former research and can thereby give implications for more extended use of dogs as a mental health promoting initiative towards geriatric consumers of municipal health care services. Further research through larger studies is needed.

Keywords: animal assisted intervention, geriatric mental health, nursing home, resident

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3210 A Study of Relationship between Leadership Style and Organisational Culture in Private Organisations

Authors: Shreya Sirohi, Vineeta Sirohi

Abstract:

In the 21st century, the nature of work has become quite complex and dynamic, and in response to this, the organizational culture continues to change and develop new perspectives. Organizational culture and leadership are important elements of any organization. Organization’s performance and success to a large extent, depend upon these two factors. The ability of a leader lies in confronting with the challenge of evolving and adapting the culture of the organization as per the situational demands. Leadership and organizational culture are conceptually intertwined. Leadership is a key ingredient for the successful transformation of any organization, and a favorable organizational culture helps to motivate the employees towards their work. Organizational culture and leadership style plays a crucial role in achieving the specified objectives of an organization. The harmony between culture and leader within organization undoubtedly affects relationships, processes, and employee performance. The present investigation aimed to study the Leadership style and Organisational Culture of private organizations and the relationship between the two. The study was carried out on a sample of 100 employees from five private organizations located in the cities of Gurgaon and Delhi in India. The data was collected by employing organisational culture profile and multifactor leadership questionnaire. The findings of the study indicate that the selected organizations had dominant transformation leadership style, whereas the organizational culture varied from one organization to another. However, technocratic culture was found to be prominent, followed by entrepreneurial organizational culture. A low positive correlation was found between leadership style and organizational culture. The transformational leaders have a positive and significant relationship with employee’s satisfaction, productivity, and organization’s culture. The leaders practicing transformational leadership style inspire their followers, are innovative and are aware of their needs as well as of their followers. Such leadership style has a positive impact both on employees and working culture. Employees of such organization are able to come up with innovative ideas and are efficient in handling situations and making effective decisions. However, low correlation is self indicative of the fact that a single leadership style or a single culture type alone cannot contribute solely towards the growth of an organization. There is a need to blend the culture types and leadership styles suiting the needs of the organization. Organisational culture represents the deeper values and beliefs of the employees and influences organizational performance; hence, the leader has a crucial role to play in creating and managing organizational culture in aligning to the requirements of the present era of competitiveness, globalization and technological advancement.

Keywords: leadership style, organizational culture, technocratic, transformational

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3209 Fault Tolerant Control System Using a Multiple Time Scale SMC Technique and a Geometric Approach

Authors: Ghodbane Azeddine, Saad Maarouf, Boland Jean-Francois, Thibeault Claude

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This paper proposes a new design of an active fault-tolerant flight control system against abrupt actuator faults. This overall system combines a multiple time scale sliding mode controller for fault compensation and a geometric approach for fault detection and diagnosis. The proposed control system is able to accommodate several kinds of partial and total actuator failures, by using available healthy redundancy actuators. The overall system first estimates the correct fault information using the geometric approach. Then, and based on that, a new reconfigurable control law is designed based on the multiple time scale sliding mode technique for on-line compensating the effect of such faults. This approach takes advantages of the fact that there are significant difference between the time scales of aircraft states that have a slow dynamics and those that have a fast dynamics. The closed-loop stability of the overall system is proved using Lyapunov technique. A case study of the non-linear model of the F16 fighter, subject to the rudder total loss of control confirms the effectiveness of the proposed approach.

Keywords: actuator faults, fault detection and diagnosis, fault tolerant flight control, sliding mode control, multiple time scale approximation, geometric approach for fault reconstruction, lyapunov stability

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3208 Construction Engineering and Cocoa Agriculture: A Synergistic Approach for Improved Livelihoods of Farmers

Authors: Felix Darko-Amoah, Daniel Acquah

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In contemporary ecosystems for developing countries like Ghana, the need to explore innovative solutions for sustainable livelihoods of farmers is more important than ever. With Ghana’s population growing steadily and the demand for food, fiber and shelter increasing, it is imperative that the construction industry and agriculture come together to address the challenges faced by farmers in the country. In order to enhance the livelihoods of cocoa farmers in Ghana, this paper provides an innovative strategy that aims to integrate the areas of civil engineering and cash crop agriculture. This study focuses on cocoa cultivation in poorer nations, where farmers confront a variety of difficulties include restricted access to financing, subpar infrastructure, and insufficient support services. We seek to improve farmers' access to financing, improve infrastructure, and provide support services that are essential to their success by combining the fields of building engineering and cocoa production. The findings of the study are beneficial to cocoa producers, community extension agents, and construction engineers. In order to accomplish our objectives, we conducted 307 of field investigations in particular cocoa growing communities in the Western Region of Ghana. Several studies have shown that there is a lack of adequate infrastructure and financing, leading to low yields, subpar beans, and low farmer profitability in developing nations like Ghana. Our goal is to give farmers access to better infrastructure, better financing, and support services that are crucial to their success through the fusion of construction engineering and cocoa production. Based on data gathered from the field investigations, the results show that the employment of appropriate technology and methods for developing structures, roads, and other infrastructure in rural regions is one of the essential components of this strategy. For instance, we find that using affordable, environmentally friendly materials like bamboo, rammed earth, and mud bricks can assist to cut expenditures while also protecting the environment. By applying simple relational techniques to the data gathered, the results also show that construction engineers are crucial in planning and building infrastructure that is appropriate for the local environment and circumstances and resilient to natural disasters like floods. Thus, the convergence of construction engineering and cash crop cultivation is another crucial component of the agriculture-construction interplay. For instance, farmers can receive financial assistance to buy essential inputs, such as seeds, fertilizer, and tools, as well as training in proper farming methods. Moreover, extension services can be offered to assist farmers in marketing their crops and enhancing their livelihoods and revenue. In conclusion, our analysis of responses from the 307 participants depicts that the combination of construction engineering and cash crop agriculture offers an innovative approach to improving farmers' livelihoods in cocoa farming communities in Ghana. In conclusion, by inculcating the findings of this study into core decision-making, policymakers can help farmers build sustainable and profitable livelihoods by addressing challenges such as limited access to financing, poor infrastructure, and inadequate support services.

Keywords: cocoa agriculture, construction engineering, farm buildings and equipment, improved livelihoods of farmers

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3207 Knowledge Loss Risk Assessment for Departing Employees: An Exploratory Study

Authors: Muhammad Saleem Ullah Khan Sumbal, Eric Tsui, Ricky Cheong, Eric See To

Abstract:

Organizations are posed to a threat of valuable knowledge loss when employees leave either due to retirement, resignation, job change or because of disabilities e.g. death, etc. Due to changing economic conditions, globalization, and aging workforce, organizations are facing challenges regarding retention of valuable knowledge. On the one hand, large number of employees are going to retire in the organizations whereas on the other hand, younger generation does not want to work in a company for a long time and there is an increasing trend of frequent job change among the new generation. Because of these factors, organizations need to make sure that they capture the knowledge of employee before (s)he walks out of the door. The first step in this process is to know what type of knowledge employee possesses and whether this knowledge is important for the organization. Researchers reveal in the literature that despite the serious consequences of knowledge loss in terms of organizational productivity and competitive advantage, there has not been much work done in the area of knowledge loss assessment of departing employees. An important step in the knowledge retention process is to determine the critical ‘at risk’ knowledge. Thus, knowledge loss risk assessment is a process by which organizations can gauge the importance of knowledge of the departing employee. The purpose of this study is to explore this topic of knowledge loss risk assessment by conducting a qualitative study in oil and gas sector. By engaging in dialogues with managers and executives of the organizations through in-depth interviews and adopting a grounded methodology approach, the research will explore; i) Are there any measures adopted by organizations to assess the risk of knowledge loss from departing employees? ii) Which factors are crucial for knowledge loss assessment in the organizations? iii) How can we prioritize the employees for knowledge retention according to their criticality? Grounded theory approach is used when there is not much knowledge available in the area under research and thus new knowledge is generated about the topic through an in-depth exploration of the topic by using methods such as interviews and using a systematic approach to analyze the data. The outcome of the study will generate a model for the risk of knowledge loss through factors such as the likelihood of knowledge loss, the consequence/impact of knowledge loss and quality of the knowledge loss of departing employees. Initial results show that knowledge loss assessment is quite crucial for the organizations and it helps in determining what types of knowledge employees possess e.g. organizations knowledge, subject matter expertise or relationships knowledge. Based on that, it can be assessed which employee is more important for the organizations and how to prioritize the knowledge retention process for departing employees.

Keywords: knowledge loss, risk assessment, departing employees, Hong Kong organizations

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3206 Work with Children's Music Group: Important Aspects of Didactic and Artistic Performance

Authors: Eudjen Cinc

Abstract:

Work with a human voice, especially with a child s voice and cultivating the sound of the choir, presents an area of crucial importance for a conductor. We use the term conductor because it needs to be understood that regardless of whether we have in front of us an amateur or a professional choir, whether they are singers with a wealth of experience or children who are still developing and educating their inner ear so that in the future they could contribute to the development of choir music, the person who stands in front of the group and works with them, needs to have the characteristics of a conductor. Voice formation is a long-term process, without which there is no success in both solo and collective music performance.

Keywords: music group, conductor, collective, performance

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3205 Gas Flotation Unit in Kuwait Oil Company Operations

Authors: Homoud Bourisli, Haitham Safar

Abstract:

Oil is one of main resources of energy in the world. As conventional oil is drying out, oil recovery is crucial to maintain the same level of oil production. Since water injection is one of the commonly used methods to increase and maintain pressure in oil wells, oil-water separation processes of the water associated with oil production for water injection oil recovery is very essential. Therefore, Gas Flotation Units are used for oil-water separation to be able to re-inject the treated water back into the wells to increase pressure.

Keywords: Kuwait oil company, dissolved gas flotation unit, induced gas flotation unit, oil-water separation

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3204 Structuring Paraphrases: The Impact Sentence Complexity Has on Key Leader Engagements

Authors: Meaghan Bowman

Abstract:

Soldiers are taught about the importance of effective communication with repetition of the phrase, “Communication is key.” They receive training in preparing for, and carrying out, interactions between foreign and domestic leaders to gain crucial information about a mission. These interactions are known as Key Leader Engagements (KLEs). For the training of KLEs, doctrine mandates the skills needed to conduct these “engagements” such as how to: behave appropriately, identify key leaders, and employ effective strategies. Army officers in training learn how to confront leaders, what information to gain, and how to ask questions respectfully. Unfortunately, soldiers rarely learn how to formulate questions optimally. Since less complex questions are easier to understand, we hypothesize that semantic complexity affects content understanding, and that age and education levels may have an effect on one’s ability to form paraphrases and judge their quality. In this study, we looked at paraphrases of queries as well as judgments of both the paraphrases’ naturalness and their semantic similarity to the query. Queries were divided into three complexity categories based on the number of relations (the first number) and the number of knowledge graph edges (the second number). Two crowd-sourced tasks were completed by Amazon volunteer participants, also known as turkers, to answer the research questions: (i) Are more complex queries harder to paraphrase and judge and (ii) Do age and education level affect the ability to understand complex queries. We ran statistical tests as follows: MANOVA for query understanding and two-way ANOVA to understand the relationship between query complexity and education and age. A probe of the number of given-level queries selected for paraphrasing by crowd-sourced workers in seven age ranges yielded promising results. We found significant evidence that age plays a role and marginally significant evidence that education level plays a role. These preliminary tests, with output p-values of 0.0002 and 0.068, respectively, suggest the importance of content understanding in a communication skill set. This basic ability to communicate, which may differ by age and education, permits reproduction and quality assessment and is crucial in training soldiers for effective participation in KLEs.

Keywords: engagement, key leader, paraphrasing, query complexity, understanding

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3203 Analysis of Expression of SP and NOS in the Porcine Nodose Ganglion (NG) Sensory Neurons Supplying Prepyloric Stomach Region after Intragastric Hydrochloric Acid Infusion

Authors: Liliana Rytel, Jarosław Całka

Abstract:

One of the diseases that are very common health problem of modern man is the stomach hyperacidity. It is well known that this pathological state, during which gastric glands secrete too much of hydrochloric acid can be caused due to various factors such as stress, eating habits, alcohol, smoking and some, especially anti-inflammatory drugs. Moreover, hyperacidity is recognized as one of factors leading to development of peptic ulcer disease. Therefore, we analyzed expression of substance P (SP) and neuronal isoform of nitric oxide synthase (nNOS) in the porcine nodose ganglion sensory neurons innervating prepyloric stomach region in physiological state and following intragastric infusion of hydrochloric acid. The study was performed on 8 immature gilts of the Large White Polish breed. All animals were injected retrograde marker Fast Blue (FB) into the anterior prepyloric stomach wall. After injections of FB, pigs were divided into two groups: control (group C; n = 4) and experimental (HCL group, n = 4) and after convalescence period of 23 days, animals of HCL group were subjected to renewed anaesthesia. Then, 0.25 M aqueous solution of hydrochloric acid with a dose of 5 ml/kg body weight was administered intragastrically with use of a stomach tube. On 28th day, all control and HCL pigs were euthanized and bilateral reght (rNG) and left (lNG) were collected. Cryostat sections were processed for double immunofluorescence using anibodies against SP and NOS. Immunofluorescence staining in the even-numbered ganglia nodes showed the presence of FB-positive cells expressing SP (45,9 ± 3,38% in rNG and 60,4 ± 1,71% in lNG), and nNOS (34,9 ± 6,83% in rNG and 49,9 ± 9,32% in lNG). In HCL group increased expression of both SP (54,8 ± 5,34% in rNG and 56,9 ± 3,28 % in lNG) as well as nNOS (54,9 ± 4,45% in rNG and 52,5 ± 2,17 % in lNG) in FB+ perikaria was found. The acquired results suggest that SP and nNOS are neurotransmitters and/ or neuromodulators participating in the sensory regulation of the prepyloric region of porcine stomach function as well as their potential role in development of the stomach inflamatory state.

Keywords: nNOS, nodose ganglion, pig, SP

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3202 A Geometric Interpolation Scheme in Overset Meshes for the Piecewise Linear Interface Calculation Volume of Fluid Method in Multiphase Flows

Authors: Yanni Chang, Dezhi Dai, Albert Y. Tong

Abstract:

Piecewise linear interface calculation (PLIC) schemes are widely used in the volume-of-fluid (VOF) method to capture interfaces in numerical simulations of multiphase flows. Dynamic overset meshes can be especially useful in applications involving component motions and complex geometric shapes. In the present study, the VOF value of an acceptor cell is evaluated in a geometric way that transfers the fraction field between the meshes precisely with reconstructed interfaces from the corresponding donor elements. The acceptor cell value is evaluated by using a weighted average of its donors for most of the overset interpolation schemes for continuous flow variables. The weighting factors are obtained by different algebraic methods. Unlike the continuous flow variables, the VOF equation is a step function near the interfaces, which ranges from zero to unity rapidly. A geometric interpolation scheme of the VOF field in overset meshes for the PLIC-VOF method has been proposed in the paper. It has been tested successfully in quadrilateral/hexahedral overset meshes by employing several VOF advection tests with imposed solenoidal velocity fields. The proposed algorithm has been shown to yield higher accuracy in mass conservation and interface reconstruction compared with three other algebraic ones.

Keywords: interpolation scheme, multiphase flows, overset meshes, PLIC-VOF method

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3201 The Developments Trend of Islamic Inscriptions in the Building Portals of Dezfoul City

Authors: Mahnoush Mahmoudi, Ali Chaeedeh

Abstract:

In the architecture of Iranian traditional houses, the ornamentations available in the inscriptions of houses entrance portal express the identity of architects and personality of houses owners and are rooted in their religious and national beliefs and faiths. The main hypothesis of this research is changing the physique and application of religious contents in compliance with the thoughts and beliefs of people in Dezfoul historical city in the epigraphs of houses entrance portals. The objective of this study is reviewing the development trend of texts, concepts and physique of inscriptions as well as analyzing the factors effective on the quality and diversity of application of inscriptions. The present research is an applied study and descriptive-analytical method has been applied, and the data was collected by library and survey studies. The population of this research includes historical houses, houses damaged in war (Iran & Iraq) and renovated and new tissue and new-built houses of Dezfoul, from Qajar era so far. Random sampling method has been applied in this study and dispersal area includes the city. Data analysis method in this study is qualitative and quantitative. The results of this study indicate that today the inscriptions available in the entrance portal of houses in Dezfoul comparing to inscriptions in Qajar1 and Pahlavi2 era is very simple and has lower aesthetic value. One of the causes for such superficial and contextual gap between inscriptions seems to be the war and renovations during and after destruction.

Keywords: architecture, islamic architecture, reconstruction, epigraph, inscription, entrance portal, Dezfoul

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3200 Smartphones in the (Class) Room in Pandemic and Post-pandemic Times: a Study in an Ecological Perspective

Authors: Junia Braga, Antonio carlos Martins, Marcos Racilan

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Drawing on the ecological approach, this paper reports a qualitative study that aims to understand how mobile technologies were integrated during the pandemic in the context of language teaching and the use of these technologies in post-pandemic times. Seventy-six teachers answered a questionnaire about their experiences. The findings show how the network with peers scaffolded this experience and played a crucial role in their appropriation of those technologies. They also suggest that this network may have contributed to the normalisation of digital technology use.

Keywords: ecological perspective, language teaching, mobile technologies, teacher education

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3199 An Ergonomic Evaluation of Three Load Carriage Systems for Reducing Muscle Activity of Trunk and Lower Extremities during Giant Puppet Performing Tasks

Authors: Cathy SW. Chow, Kristina Shin, Faming Wang, B. C. L. So

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During some dynamic giant puppet performances, an ergonomically designed load carrier system is necessary for the puppeteers to carry a giant puppet body’s heavy load with minimum muscle stress. A load carrier (i.e. prototype) was designed with two small wheels on the foot; and a hybrid spring device on the knee in order to assist the sliding and knee bending movements respectively. Thus, the purpose of this study was to evaluate the effect of three load carriers including two other commercially available load mounting systems, Tepex and SuitX, and the prototype. Ten male participants were recruited for the experiment. Surface electromyography (sEMG) was used to collect the participants’ muscle activities during forward moving and bouncing and with and without load of 11.1 kg that was 60 cm above the shoulder. Five bilateral muscles including the lumbar erector spinae (LES), rectus femoris (RF), bicep femoris (BF), tibialis anterior (TA), and gastrocnemius (GM) were selected for data collection. During forward moving task, the sEMG data showed smallest muscle activities by Tepex harness which exhibited consistently the lowest, compared with the prototype and SuitX which were significantly higher on left LES 68.99% and 64.99%, right LES 26.57% and 82.45%; left RF 87.71% and 47.61%, right RF 143.57% and 24.28%; left BF 80.21% and 22.23%, right BF 96.02% and 21.83%; right TA 6.32% and 4.47%; left GM 5.89% and 12.35% respectively. The result above reflected mobility was highly restricted by tested exoskeleton devices. On the other hand, the sEMG data from bouncing task showed the smallest muscle activities by prototype which exhibited consistently the lowest, compared with the Tepex harness and SuitX which were significantly lower on lLES 6.65% and 104.93, rLES 23.56% and 92.19%; lBF 33.21% and 93.26% and rBF 24.70% and 81.16%; lTA 46.51% and 191.02%; rTA 12.75% and 125.76%; IGM 31.54% and 68.36%; rGM 95.95% and 96.43% respectively.

Keywords: exoskeleton, giant puppet performers, load carriage system, surface electromyography

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3198 Advancing Early Intervention Strategies for United States Adolescents and Young Adults with Schizophrenia in the Post-COVID-19 Era

Authors: Peggy M. Randon, Lisa Randon

Abstract:

Introduction: The post-COVID-19 era has presented unique challenges for addressing complex mental health issues, particularly due to exacerbated stress, increased social isolation, and disrupted continuity of care. This article outlines relevant health disparities and policy implications within the context of the United States while maintaining international relevance. Methods: A comprehensive literature review (including studies, reports, and policy documents) was conducted to examine concerns related to childhood-onset schizophrenia and the impact on patients and their families. Qualitative and quantitative data were synthesized to provide insights into the complex etiology of schizophrenia, the effects of the pandemic, and the challenges faced by socioeconomically disadvantaged populations. Case studies were employed to illustrate real-world examples and areas requiring policy reform. Results: Early intervention in childhood is crucial for preventing or mitigating the long-term impact of complex psychotic disorders, particularly schizophrenia. A comprehensive understanding of the genetic, environmental, and physiological factors contributing to the development of schizophrenia is essential. The COVID-19 pandemic worsened symptoms and disrupted treatment for many adolescent patients with schizophrenia, emphasizing the need for adaptive interventions and the utilization of virtual platforms. Health disparities, including stigma, financial constraints, and language or cultural barriers, further limit access to care, especially for socioeconomically disadvantaged populations. Policy implications: Current US health policies inadequately support patients with schizophrenia. The limited availability of longitudinal care, insufficient resources for families, and stigmatization represent ongoing policy challenges. Addressing these issues necessitates increased research funding, improved access to affordable treatment plans, and cultural competency training for healthcare providers. Public awareness campaigns are crucial to promote knowledge, awareness, and acceptance of mental health disorders. Conclusion: The unique challenges faced by children and families in the US affected by schizophrenia and other psychotic disorders have yet to be adequately addressed on institutional and systemic levels. The relevance of findings to an international audience is emphasized by examining the complex factors contributing to the onset of psychotic disorders and their global policy implications. The broad impact of the COVID-19 pandemic on mental health underscores the need for adaptive interventions and global responses. Addressing policy challenges, improving access to care, and reducing the stigma associated with mental health disorders are crucial steps toward enhancing the lives of adolescents and young adults with schizophrenia and their family members. The implementation of virtual platforms can help overcome barriers and ensure equitable access to support and resources for all patients, enabling them to lead healthy and fulfilling lives.

Keywords: childhood, schizophrenia, policy, United, States, health, disparities

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3197 Rationale of Eye Pupillary Diameter for the UV Protection for Sunglasses

Authors: Liliane Ventura, Mauro Masili

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Ultraviolet (UV) protection is critical for sunglasses, and mydriasis, as well as miosis, are relevant parameters to consider. The literature reports that for sunglasses, ultraviolet protection is critical because sunglasses can cause the opposite effect if the lenses do not provide adequate UV protection due to the greater dilation of the pupil when wearing sunglasses. However, the scientific literature does not properly quantify to support this rationale. The reasoning may be misleading by ignoring not only the inherent absorption of UV by the sunglass lens materials but also by ignoring the absorption of the anterior structures of the eye, i.e., the cornea and aqueous humor. Therefore, we estimate the pupil diameter and calculate the solar ultraviolet influx through the pupil of the human eye for two situations of an individual wearing and not wearing sunglasses. We quantify the dilation of the pupil as a function of the luminance of the surrounding. Therefore, we calculate the influx of solar UV through the pupil of the eye for two situations for an individual wearing sunglass and for the eyes free of shade. A typical boundary condition for the calculation is an individual in an upright position wearing sunglasses, staring at the horizon as if the sun is in the zenith. The calculation was done for the latitude of the geographic center of the state of São Paulo (-22º04'11.8'' S) from sunrise to sunset. A model from the literature is used for determining the sky luminance. The initial approach is to obtain pupil diameter as a function of luminance. Therefore, as a preliminary result, we calculate the pupil diameter as a function of the time of day, as the sun moves, for a particular day of the year. The working range for luminance is daylight (10⁻⁴ – 10⁵ cd/m²). We are able to show how the pupil adjusts to brightness change (~2 - ~7.8 mm). At noon, with the sun higher, the direct incidence of light on the pupil is lower if compared to mid-morning or mid-afternoon, when the sun strikes more directly into the eye. Thus, the pupil is larger at midday. As expected, the two situations have opposite behaviors since higher luminance implies a smaller pupil. With these results, we can progress in the short term to obtain the transmittance spectra of sunglasses samples and quantify how light attenuation provided by the spectacles affects pupil diameter.

Keywords: sunglasses, UV protection, pupil diameter, solar irradiance, luminance

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3196 Immunologically Non-Treated Vascular Xenografts in Long-Term Survival Animals

Authors: W. G. Kim, J. M. Chang, W. S. Kim

Abstract:

Immunologically non-treated and acellularized porcine xenografts were implanted as an arterial graft in goats and comparatively analyzed for the explanted grafts with gross observation, as well as light microscopy and immunohistochemistry, following the predetermined periods. For immunologically non-treated xenografts, bilateral porcine carotid arteries were harvested, and after short-term freezing at -70°C, were implanted into goats. The preparation of acellularized xenograft vessels has been performed with Nacl-SDS solution and stored at the freezer until use. The goats were randomly assigned for three periods of observation (3, 6, and 12 months after implantation), four animals were observed at each of these times. Periodic ultrasonographic examinations were performed during observation period. Following the predetermined periods, the explanted grafts were analyzed. Among 12 animals, one goat died prematurely, and a total of 22 grafts were evaluated. Gross observations revealed non-thrombotic patent smooth lumens. Microscopic examinations of the explanted grafts showed satisfactory cellular reconstruction up to the 12-month observation period. The proportions of CD3 positive T lymphocytes among inflammatory cells infiltrations were very low. In conclusion, these findings, as a whole, suggest that porcine vessel xenografts can be clinically acceptably implanted in the goats as a form of small-diameter vascular graft, regardless of the acellularized xenograft or immunologically non-treated xenograft.

Keywords: xenograft, arterial graft, long-term survival animals, immunology

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3195 Tibial Hemimelia Type VIIa: A Case Report

Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

Abstract:

Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

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3194 A Longitudinal Exploration into Computer-Mediated Communication Use (CMC) and Relationship Change between 2005-2018

Authors: Laurie Dempsey

Abstract:

Relationships are considered to be beneficial for emotional wellbeing, happiness and physical health. However, they are also complicated: individuals engage in a multitude of complex and volatile relationships during their lifetime, where the change to or ending of these dynamics can be deeply disruptive. As the internet is further integrated into everyday life and relationships are increasingly mediated, Media Studies’ and Sociology’s research interests intersect and converge. This study longitudinally explores how relationship change over time corresponds with the developing UK technological landscape between 2005-2018. Since the early 2000s, the use of computer-mediated communication (CMC) in the UK has dramatically reshaped interaction. Its use has compelled individuals to renegotiate how they consider their relationships: some argue it has allowed for vast networks to be accumulated and strengthened; others contend that it has eradicated the core values and norms associated with communication, damaging relationships. This research collaborated with UK media regulator Ofcom, utilising the longitudinal dataset from their Adult Media Lives study to explore how relationships and CMC use developed over time. This is a unique qualitative dataset covering 2005-2018, where the same 18 participants partook in annual in-home filmed depth interviews. The interviews’ raw video footage was examined year-on-year to consider how the same people changed their reported behaviour and outlooks towards their relationships, and how this coincided with CMC featuring more prominently in their everyday lives. Each interview was transcribed, thematically analysed and coded using NVivo 11 software. This study allowed for a comprehensive exploration into these individuals’ changing relationships over time, as participants grew older, experienced marriages or divorces, conceived and raised children, or lost loved ones. It found that as technology developed between 2005-2018, everyday CMC use was increasingly normalised and incorporated into relationship maintenance. It played a crucial role in altering relationship dynamics, even factoring in the breakdown of several ties. Three key relationships were identified as being shaped by CMC use: parent-child; extended family; and friendships. Over the years there were substantial instances of relationship conflict: for parents renegotiating their dynamic with their child as they tried to both restrict and encourage their child’s technology use; for estranged family members ‘forced’ together in the online sphere; and for friendships compelled to publicly display their relationship on social media, for fear of social exclusion. However, it was also evident that CMC acted as a crucial lifeline for these participants, providing opportunities to strengthen and maintain their bonds via previously unachievable means, both over time and distance. A longitudinal study of this length and nature utilising the same participants does not currently exist, thus provides crucial insight into how and why relationship dynamics alter over time. This unique and topical piece of research draws together Sociology and Media Studies, illustrating how the UK’s changing technological landscape can reshape one of the most basic human compulsions. This collaboration with Ofcom allows for insight that can be utilised in both academia and policymaking alike, making this research relevant and impactful across a range of academic fields and industries.

Keywords: computer mediated communication, longitudinal research, personal relationships, qualitative data

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3193 Flexicommute: A Web-Based Application to Help with Car Rental Services in the Philippines

Authors: Mico Kenshee C. Samarista, John Harvey V. Miranda, Janne Audrae Q. Lebosada, Josef Anton R. Benitez, Juan Miguel C. Rubio

Abstract:

This research paper presents the development and evaluation of a web-based application designed to simplify the process of car rental services in the Philippines. As the demand for convenient and efficient access to rental car information grows, the need for a user-friendly platform becomes increasingly crucial. The web-based application serves as a comprehensive central hub, aggregating and organizing rental car listings from various reputable websites across the Philippines. By collecting essential data through surveys and usability testing, we assess the platform's effectiveness in simplifying the rental car selection process.

Keywords: web, application, car, services

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3192 First Experimental Evidence on Feasibility of Molecular Magnetic Particle Imaging of Tumor Marker Alpha-1-Fetoprotein Using Antibody Conjugated Nanoparticles

Authors: Kolja Them, Priyal Chikhaliwala, Sudeshna Chandra

Abstract:

Purpose: The purpose of this work is to examine possibilities for noninvasive imaging and identification of tumor markers for cancer diagnosis. The proposed method uses antibody conjugated iron oxide nanoparticles and multicolor Magnetic Particle Imaging (mMPI). The method has the potential for radiation exposure free real-time estimation of local tumor marker concentrations in vivo. In this study, the method is applied to human Alpha-1-Fetoprotein. Materials and Methods: As tracer material AFP antibody-conjugated Dendrimer-Fe3O4 nanoparticles were used. The nanoparticle bioconjugates were then incubated with bovine serum albumin (BSA) to block any possible nonspecific binding sites. Parts of the resulting solution were then incubated with AFP antigen. MPI measurements were done using the preclinical MPI scanner (Bruker Biospin MRI GmbH) and the multicolor method was used for image reconstruction. Results: In multicolor MPI images the nanoparticles incubated only with BSA were clearly distinguished from nanoparticles incubated with BSA and AFP antigens. Conclusion: Tomographic imaging of human tumor marker Alpha-1-Fetoprotein is possible using AFP antibody conjugated iron oxide nanoparticles in presence of BSA. This opens interesting perspectives for cancer diagnosis.

Keywords: noninvasive imaging, tumor antigens, antibody conjugated iron oxide nanoparticles, multicolor magnetic particle imaging, cancer diagnosis

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3191 Intrastromal Donor Limbal Segments Implantation as a Surgical Treatment of Progressive Keratoconus: Clinical and Functional Results

Authors: Mikhail Panes, Sergei Pozniak, Nikolai Pozniak

Abstract:

Purpose: To evaluate the effectiveness of intrastromal donor limbal segments implantation for treatment of progressive keratoconus considering on main characteristics of corneal endothelial cells. Setting: Outpatient ophthalmic clinic. Methods: Twenty patients (20 eyes) with progressive keratoconus II-III of Amsler classification were recruited. The worst eye was treated with the transplantation of donor limbal segments in the recipient corneal stroma, while the fellow eye was left untreated as a control of functional and morphological changes. Furthermore, twenty patients (20 eyes) without progressive keratoconus was used as a control of corneal endothelial cells changes. All patients underwent a complete ocular examination including uncorrected and corrected distance visual acuity (UDVA, CDVA), slit lamp examination fundus examination, corneal topography and pachymetry, auto-keratometry, Anterior Segment Optical Coherence Tomography and Corneal Endothelial Specular Microscopy. Results: After two years, statistically significant improvement in the UDVA and CDVA (on the average on two lines for UDVA and three-four lines for CDVA) were noted. Besides corneal astigmatism decreased from 5.82 ± 2.64 to 1.92 ± 1.4 D. Moreover there were no statistically significant differences in the changes of mean spherical equivalent, keratometry and pachymetry indicators. It should be noted that after two years there were no significant differences in the changes of the number and form of corneal endothelial cells. It can be regarded as a process stabilization. In untreated control eyes, there was a general trend towards worsening of UDVA, CDVA and corneal thickness, while corneal astigmatism was increased. Conclusion: Intrastromal donor segments implantation is a safe technique for keratoconus treatment. Intrastromal donor segments implantation is an efficient procedure to stabilize and improve progressive keratoconus.

Keywords: corneal endothelial cells, intrastromal donor limbal segments, progressive keratoconus, surgical treatment of keratoconus

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3190 Development of a Data-Driven Method for Diagnosing the State of Health of Battery Cells, Based on the Use of an Electrochemical Aging Model, with a View to Their Use in Second Life

Authors: Desplanches Maxime

Abstract:

Accurate estimation of the remaining useful life of lithium-ion batteries for electronic devices is crucial. Data-driven methodologies encounter challenges related to data volume and acquisition protocols, particularly in capturing a comprehensive range of aging indicators. To address these limitations, we propose a hybrid approach that integrates an electrochemical model with state-of-the-art data analysis techniques, yielding a comprehensive database. Our methodology involves infusing an aging phenomenon into a Newman model, leading to the creation of an extensive database capturing various aging states based on non-destructive parameters. This database serves as a robust foundation for subsequent analysis. Leveraging advanced data analysis techniques, notably principal component analysis and t-Distributed Stochastic Neighbor Embedding, we extract pivotal information from the data. This information is harnessed to construct a regression function using either random forest or support vector machine algorithms. The resulting predictor demonstrates a 5% error margin in estimating remaining battery life, providing actionable insights for optimizing usage. Furthermore, the database was built from the Newman model calibrated for aging and performance using data from a European project called Teesmat. The model was then initialized numerous times with different aging values, for instance, with varying thicknesses of SEI (Solid Electrolyte Interphase). This comprehensive approach ensures a thorough exploration of battery aging dynamics, enhancing the accuracy and reliability of our predictive model. Of particular importance is our reliance on the database generated through the integration of the electrochemical model. This database serves as a crucial asset in advancing our understanding of aging states. Beyond its capability for precise remaining life predictions, this database-driven approach offers valuable insights for optimizing battery usage and adapting the predictor to various scenarios. This underscores the practical significance of our method in facilitating better decision-making regarding lithium-ion battery management.

Keywords: Li-ion battery, aging, diagnostics, data analysis, prediction, machine learning, electrochemical model, regression

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3189 Comparative Performance of Standing Whole Body Monitor and Shielded Chair Counter for In-vivo Measurements

Authors: M. Manohari, S. Priyadharshini, K. Bajeer Sulthan, R. Santhanam, S. Chandrasekaran, B. Venkatraman

Abstract:

In-vivo monitoring facility at Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, caters to the monitoring of internal exposure of occupational radiation workers from various radioactive facilities of IGCAR. Internal exposure measurement is done using Na(Tl) based Scintillation detectors. Two types of whole-body counters, namely Shielded Chair Counter (SC) and Standing Whole-Body Monitor (SWBM), are being used. The shielded Chair is based on a NaI detector of 20.3 cm diameter and 10.15 cm thick. The chair of the system is shielded using lead shots of 10 cm lead equivalent and the detector with 8 cm lead bricks. Counting geometry is sitting geometry. Calibration is done using 95 percentile BOMAB phantom. The minimum Detectable Activity (MDA) for 137Cs for the 60s is 1150 Bq. Standing Wholebody monitor (SWBM) has two NaI(Tl) detectors of size 10.16 x 10.16 x 40.64 cm3 positioned serially, one over the other. It has a shielding thickness of 5cm lead equivalent. Counting is done in standup geometry. Calibration is done with the help of Ortec Phantom, having a uniform distribution of mixed radionuclides for the thyroid, thorax and pelvis. The efficiency of SWBM is 2.4 to 3.5 times higher than that of the shielded chair in the energy range of 279 to 1332 keV. MDA of 250 Bq for 137Cs can be achieved with a counting time of 60s. MDA for 131I in the thyroid was estimated as 100 Bq from the MDA of whole-body for one-day post intake. Standing whole body monitor is better in terms of efficiency, MDA and ease of positioning. In case of emergency situations, the optimal MDAs for in-vivo monitoring service are 1000 Bq for 137Cs and 100 Bq for 131I. Hence, SWBM is more suitable for the rapid screening of workers as well as the public in the case of an emergency. While a person reports for counting, there is a potential for external contamination. In SWBM, there is a feasibility to discriminate them as the subject can be counted in anterior or posterior geometry which is not possible in SC.

Keywords: minimum detectable activity, shielded chair, shielding thickness, standing whole body monitor

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3188 Investigating Role of Novel Molecular Players in Forebrain Roof-Plate Midline Invagination

Authors: Mohd Ali Abbas Zaidi, Meenu Sachdeva, Jonaki Sen

Abstract:

In the vertebrate embryo, the forebrain anlagen develops from the anterior-most region of the neural tube which is the precursor of the central nervous system (CNS). The roof plate located at the dorsal midline region of the forebrain anlagen, acts as a source of several secreted molecules involved in patterning and morphogenesis of the forebrain. One such key morphogenetic event is the invagination of the forebrain roof plate which results in separation of the single forebrain vesicle into two cerebral hemispheres. Retinoic acid (RA) signaling plays a key role in this process. Blocking RA signaling at the dorsal forebrain midline inhibits dorsal invagination and results in the absence of certain key features of this region, such as thinning of the neuroepithelium and a lowering of cell proliferation. At present we are investigating the possibility of other signaling pathways acting in concert with RA signaling to regulate this process. We have focused on BMP signaling, which we found to be active in a mutually exclusive domain to that of RA signaling within the roof plate. We have also observed that there is a change in BMP signaling activity on modulation of RA signaling indicating an antagonistic relationship between the two. Moreover, constitutive activation of BMP signaling seems to completely inhibit thinning and partially affect invagination, leaving the lowering of cell proliferation in the midline unaffected. We are employing in-silico modeling as well as molecular manipulations to investigate the relative contribution if any, of regional differences in rates of cell proliferation and thinning of the neuroepithelium towards the process of invagination. We have found expression of certain cell adhesion molecules in forebrain roof-plate whose mRNA localization across the thickness of neuroepithelium is influenced by Bmp and RA signaling, giving regional rigidity to roof plate and assisting invagination. We also found expression of certain cytoskeleton modifiers in a localized small domains in invaginating forebrain roof plate suggesting that midline invagination is under control of many factors.

Keywords: bone morphogenetic signaling, cytoskeleton, cell adhesion molecules, forebrain roof plate, retinoic acid signaling

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3187 Understanding the Genetic Basis of SUDEP

Authors: Kumar Ashwini, Nayak C. Vinod

Abstract:

Sudden unexpected death in epilepsy (SUDEP) is a rarity. Each year, about one in 150 epileptics, whose seizures are not controlled, may die of SUDEP. It is a leading cause of death in young adults with uncontrolled seizures. Understanding the genetic basis for SUDEP, is crucial given that the rate of sudden death in epilepsy patients is 20 fold that of the general population. We encountered one such case of a young male, a known epileptic, who was brought dead after a sudden collapse. We hereby present a poster discussing the autopsy findings of this case and also highlighting the importance of understanding the genetic basis of SUDEP.

Keywords: sudden death, epilepsy, genetic, autopsy

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3186 Pragmatic Strategies of Selected Online Articles on the Buhari/Jubril Dilemma

Authors: Oluwaseun Amusa

Abstract:

The online space has continued to be a platform for not only private and mundane discussions but also a tribune for voicing critical political and national opinions. Nigerians and the international community have employed the online media, as well as other media platforms to articulate their thoughts on the claims which favour possibilities of the demise of the incumbent president of Nigeria, President Muhammadu Buhari, after a prolonged illness in year 2007 and the ploy of a Jubril of Sudan clone in his place. This study thus examines the pragmatic strategies employed in the online articles on the national dilemma caused by the Buhari/Jubril claims and refutals, in response to the lacuna in the literature on such analytical investigations on the subject. Two online articles titled, 'Buhari: The real, the fake and the dead' and 'Taking the Buhari/Jubril story seriously', authored by two Nigerian writers, Tunde Odesola and Abimbola Adelakun, respectively and retrieved online from 360nobs.com and Nairaland blogs, on December 3, 2018, and December 7, 2018, respectively, served as data for the study. The data were analysed using the Stance Theory and the Pragmatic Act Theory. Findings showed that the writers employed stance acts, rhetorical questions, metaphors, histo-political allusions, name-calling, and derogatives, in achieving the pragmeme of disabusing. This results in a pragmatic reconstruction of readers' views on the issue.

Keywords: Buhari/Jubril claims, online articles, pragmatic strategies, stance theory

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3185 Clinical and Etiological Particularities of Infectious Uveitis in HIV+ and HIV- Patients in the Internal Medicine Department

Authors: N. Jait, M. Maamar, H. Khibri, H. Harmouche, N. Mouatssim, W. Ammouri, Z. Tazimezaelek, M. Adnaoui

Abstract:

Introduction: Uveitis presents with inflammation of the uvea, intraocular, of heterogeneous etiology and presentation. The objective of our study is to describe the clinical and therapeutic characteristics of infectious uveitis in HIV+ and HIV- patients. Patients and Methods: This is a retrospective study conducted at the internal medicine department of CHU Ibn Sina in Rabat over a period of 12 years (2010–2021), collecting 42 cases of infectious uveitis. Results: 42 patients were identified. 34% (14 cases) had acquired immunosuppression (9 cases: 22% had HIV infection and 12% were on chemotherapy), and 66% were immunocompetent. The M/F sex ratio was 1.1. The average age was 39 years old. Uveitis revealed HIV in a single case; 8/9 patients have already been followed, their average viral load is 3.4 log and an average CD4 count is 356/mm³. The revealing functional signs were: ocular redness (27%), decreased visual acuity (63%), visual blurring (40%), ocular pain (18%), scotoma (13%), and headaches (4%). The uveitis was site: anterior (30%), intermediate (6%), posterior (32%), and pan-uveitis (32%); unilateral in 80% of patients and bilateral in 20%. The etiologies of uveitis in HIV+ were: 3 cases of CMV, 2 cases of toxoplasmosis, 1 case of tuberculosis, 1 case of HSV, 1 case of VZV, and 1 case of syphilis. Etiologies of immunocompetent patients: tuberculosis (41%), toxoplasmosis (18%), syphilis (15%), CMV infection (4 cases: 10%), HSV infection (4 cases: 10%) , lepromatous uveitis (1 case: 2%), VZV infection (1 case: 2%), a locoregional infectious cause such as dental abscess (1 case: 2%), and one case of borreliosis (3% ). 50% of tuberculous uveitis was of the pan-uveitis type, 75% of the uveitis by toxoplasmosis was of the posterior type. Uveitis was associated with other pathologies in 2 seropositive cases (cerebral vasculitis, multifocal tuberculosis). A specific treatment was prescribed in all patients. The initial evolution was favorable in 67%, including 12% HIV+. 11% presented relapses of the same seat during uveitis of the toxoplasmic, tuberculous and herpetic type. 47% presented complications, of which 4 patients were HIV+: 3 retinal detachments; 7 Retinal hemorrhages. 6 unilateral blindness (including 2 HIV+ patients). Conclusion: In our series, the etiologies of infectious uveitis differ between HIV+ and HIV- patients. In HIV+ patients most often had toxoplasmosis and CMV, while HIV - patients mainly presented with tuberculosis and toxoplasmosis. The association between HIV and uveitis is undetermined, but HIV infection was an independent risk factor for uveitis.

Keywords: uveitis, HIV, immunosuppression, infection

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3184 Mycophenolate Versus Methotrexate in Non-Infectious Ocular Inflammatory Disease: A Systematic Review and Meta-Analysis

Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi

Abstract:

Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.

Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis

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3183 Delayed Contralateral Prophylactic Mastectomy (CPM): Reasons and Rationale for Patients with Unilateral Breast Cancer

Authors: C. Soh, S. Muktar, C. M. Malata, J. R. Benson

Abstract:

Introduction Reasons for requesting CPM include prevention of recurrence, peace of mind and moving on after breast cancer. Some women seek CPM as a delayed procedure but factors influencing this are poorly understood. Methods A retrospective analysis examined patients undergoing CPM as either an immediate or delayed procedure with or without breast reconstruction (BR) between January 2009 and December 2019. A cross-sectional survey based on validated questionnaires (5 point Likert scale) explored patients’ decision-making process in terms of timing of CPM and any BR. Results A total of 123 patients with unilateral breast cancer underwent CPM with 39 (32.5%) delayed procedures with or without BR. The response rate amongst patients receiving questionnaires (n=33) was 22/33 (66%). Within this delayed CPM cohort were three reconstructive scenarios 1) unilateral immediate BR with CPM (n=12); 2) delayed CPM with concomitant bilateral BR (n=22); 3) delayed bilateral BR after delayed CPM (n=3). Two patients had delayed CPM without BR. The most common reason for delayed CPM was to complete all cancer treatments (including radiotherapy) before surgery on the unaffected breast (score 2.91). The second reason was unavailability of genetic test results at the time of therapeutic mastectomy (score 2.64) whilst the third most cited reason was a subsequent change in family cancer history. Conclusion Factors for delayed CPM are patient-driven with few women spontaneously changing their mind having initially decided against immediate CPM for reasons also including surgical duration. CPM should be offered as a potentially delayed option with informed discussion of risks and benefits.

Keywords: Breast Cancer, CPM, Prophylactic, Rationale

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