Search results for: Software as a Service (SaaS)
Commenced in January 2007
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Edition: International
Paper Count: 7974

Search results for: Software as a Service (SaaS)

174 Characterizing and Developing the Clinical Grade Microbiome Assay with a Robust Bioinformatics Pipeline for Supporting Precision Medicine Driven Clinical Development

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

Abstract:

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

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

Procedia PDF Downloads 143
173 Modern Technology-Based Methods in Neurorehabilitation for Social Competence Deficit in Children with Acquired Brain Injury

Authors: M. Saard, A. Kolk, K. Sepp, L. Pertens, L. Reinart, C. Kööp

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Introduction: Social competence is often impaired in children with acquired brain injury (ABI), but evidence-based rehabilitation for social skills has remained undeveloped. Modern technology-based methods create effective and safe learning environments for pediatric social skills remediation. The aim of the study was to implement our structured model of neuro rehab for socio-cognitive deficit using multitouch-multiuser tabletop (MMT) computer-based platforms and virtual reality (VR) technology. Methods: 40 children aged 8-13 years (yrs) have participated in the pilot study: 30 with ABI -epilepsy, traumatic brain injury and/or tic disorder- and 10 healthy age-matched controls. From the patients, 12 have completed the training (M = 11.10 yrs, SD = 1.543) and 20 are still in training or in the waiting-list group (M = 10.69 yrs, SD = 1.704). All children performed the first individual and paired assessments. For patients, second evaluations were performed after the intervention period. Two interactive applications were implemented into rehabilitation design: Snowflake software on MMT tabletop and NoProblem on DiamondTouch Table (DTT), which allowed paired training (2 children at once). Also, in individual training sessions, HTC Vive VR device was used with VR metaphors of difficult social situations to treat social anxiety and train social skills. Results: At baseline (B) evaluations, patients had higher deficits in executive functions on the BRIEF parents’ questionnaire (M = 117, SD = 23.594) compared to healthy controls (M = 22, SD = 18.385). The most impaired components of social competence were emotion recognition, Theory of Mind skills (ToM), cooperation, verbal/non-verbal communication, and pragmatics (Friendship Observation Scale scores only 25-50% out of 100% for patients). In Sentence Completion Task and Spence Anxiety Scale, the patients reported a lack of friends, behavioral problems, bullying in school, and social anxiety. Outcome evaluations: Snowflake on MMT improved executive and cooperation skills and DTT developed communication skills, metacognitive skills, and coping. VR, video modelling and role-plays improved social attention, emotional attitude, gestural behaviors, and decreased social anxiety. NEPSY-II showed improvement in Affect Recognition [B = 7, SD = 5.01 vs outcome (O) = 10, SD = 5.85], Verbal ToM (B = 8, SD = 3.06 vs O = 10, SD = 4.08), Contextual ToM (B = 8, SD = 3.15 vs O = 11, SD = 2.87). ToM Stories test showed an improved understanding of Intentional Lying (B = 7, SD = 2.20 vs O = 10, SD = 0.50), and Sarcasm (B=6, SD = 2.20 vs O = 7, SD = 2.50). Conclusion: Neurorehabilitation based on the Structured Model of Neurorehab for Socio-Cognitive Deficit in children with ABI were effective in social skills remediation. The model helps to understand theoretical connections between components of social competence and modern interactive computerized platforms. We encourage therapists to implement these next-generation devices into the rehabilitation process as MMT and VR interfaces are motivating for children, thus ensuring good compliance. Improving children’s social skills is important for their and their families’ quality of life and social capital.

Keywords: acquired brain injury, children, social skills deficit, technology-based neurorehabilitation

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172 Nature of Forest Fragmentation Owing to Human Population along Elevation Gradient in Different Countries in Hindu Kush Himalaya Mountains

Authors: Pulakesh Das, Mukunda Dev Behera, Manchiraju Sri Ramachandra Murthy

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Large numbers of people living in and around the Hindu Kush Himalaya (HKH) region, depends on this diverse mountainous region for ecosystem services. Following the global trend, this region also experiencing rapid population growth, and demand for timber and agriculture land. The eight countries sharing the HKH region have different forest resources utilization and conservation policies that exert varying forces in the forest ecosystem. This created a variable spatial as well altitudinal gradient in rate of deforestation and corresponding forest patch fragmentation. The quantitative relationship between fragmentation and demography has not been established before for HKH vis-à-vis along elevation gradient. This current study was carried out to attribute the overall and different nature in landscape fragmentations along the altitudinal gradient with the demography of each sharing countries. We have used the tree canopy cover data derived from Landsat data to analyze the deforestation and afforestation rate, and corresponding landscape fragmentation observed during 2000 – 2010. Area-weighted mean radius of gyration (AMN radius of gyration) was computed owing to its advantage as spatial indicator of fragmentation over non-spatial fragmentation indices. Using the subtraction method, the change in fragmentation was computed during 2000 – 2010. Using the tree canopy cover data as a surrogate of forest cover, highest forest loss was observed in Myanmar followed by China, India, Bangladesh, Nepal, Pakistan, Bhutan, and Afghanistan. However, the sequence of fragmentation was different after the maximum fragmentation observed in Myanmar followed by India, China, Bangladesh, and Bhutan; whereas increase in fragmentation was seen following the sequence of as Nepal, Pakistan, and Afghanistan. Using SRTM-derived DEM, we observed higher rate of fragmentation up to 2400m that corroborated with high human population for the year 2000 and 2010. To derive the nature of fragmentation along the altitudinal gradients, the Statistica software was used, where the user defined function was utilized for regression applying the Gauss-Newton estimation method with 50 iterations. We observed overall logarithmic decrease in fragmentation change (area-weighted mean radius of gyration), forest cover loss and population growth during 2000-2010 along the elevation gradient with very high R2 values (i.e., 0.889, 0.895, 0.944 respectively). The observed negative logarithmic function with the major contribution in the initial elevation gradients suggest to gap filling afforestation in the lower altitudes to enhance the forest patch connectivity. Our finding on the pattern of forest fragmentation and human population across the elevation gradient in HKH region will have policy level implication for different nations and would help in characterizing hotspots of change. Availability of free satellite derived data products on forest cover and DEM, grid-data on demography, and utility of geospatial tools helped in quick evaluation of the forest fragmentation vis-a-vis human impact pattern along the elevation gradient in HKH.

Keywords: area-weighted mean radius of gyration, fragmentation, human impact, tree canopy cover

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171 Awareness and Willingness of Signing 'Consent Form in Palliative Care' in Elderly Patients with End Stage Renal Disease

Authors: Hsueh Ping Peng

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End-stage renal disease most commonly occurs in the elderly population. Elderly people are approaching the end of their lives, and when facing major life-threatening situations, apart from aggressive medical treatment, they can also choose treatment methods such as hospice care to improve their quality of life. The purpose of this study was to investigate factors associated with the awareness and willingness to sign hospice and palliative care consent forms in elderly with end-stage renal disease. This study used both quantitative, cross-sectional study designs. In the quantitative section, 110 elderly patients (aged 65 or above) with end-stage renal disease receiving conventional hemodialysis were recruited as study participants from a medical center in Taipei City. Data were collected using structured questionnaires. Study tools included basic demographic data, questionnaires on the awareness and perception of hospice and palliative care, etc. After collecting the data, data analysis was conducted using SPSS 20.0 statistical software, including descriptive statistics, chi-square test, logistic regression, and other inferential statistics. The results showed that the average age of participants was 71.6 years old, more males than females, average years of dialysis was 6.1 years and most subjects rated their self-perceived health status as fair. Results of the study are summarized as follows: Elderly people with end-stage renal disease did not have sufficient knowledge and awareness about hospice and palliative care. Influencing factors included level of education, marital status, years of dialysis and age, etc. Demographic factors influencing the signing of consent forms included gender, marital status, and age, which all showed significant impacts. Factors taken into consideration when signing consent forms included awareness of hospice care, understanding the relevant definitions of hospice care, and understanding that consent may be modified or cancelled at any time; it was predicted that people who knew more about ways to receive hospice care or more related definitions were more willing to sign the consent forms. In the qualitative study section, 10 participants who signed the consent form, five male, and 5 female, between the ages of 65-90, have completed the semi-structured interviews. Analysis of the interviews revealed six themes: (1) passing away peacefully, (2) autonomy on arrangements of life and death, (3) unwillingness to increase family and social burden, (4) friends and relatives’ experience influencing the decision to give consent, (5) sharing information to facilitate the giving of consent, (6) facing each day with ease, to reflect the experience and factors of consideration for elderly with end-stage renal disease when signing consent forms. The results of this study provides the awareness, thoughts and feelings of elderly with end-stage renal disease on signing consent forms, and serve as a future reference for the dialysis unit to enhance the promotion of hospice and palliative care and related caregiving measures, thereby improving the quality of life and care for elderly people with end-stage renal disease.

Keywords: end-stage renal disease, hemodialysis, hospice and palliative care, awareness, willingness

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170 Increasing Student Engagement through Culturally-Responsive Classroom Management

Authors: Catherine P. Bradshaw, Elise T. Pas, Katrina J. Debnam, Jessika H. Bottiani, Michael Rosenberg

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Worldwide, ethnically and culturally diverse students are at increased risk for school failure, discipline problems, and dropout. Despite decades of concern about this issue of disparities in education and other fields (e.g., 'school to prison pipeline'), there has been limited empirical examination of models that can actually reduce these gaps in schools. Moreover, few studies have examined the effectiveness of in-service teacher interventions and supports specifically designed to reduce discipline disparities and improve student engagement. This session provides an overview of the evidence-based Double Check model which serves as a framework for teachers to use culturally-responsive strategies to engage ethnically and culturally diverse students in the classroom and reduce discipline problems. Specifically, Double Check is a school-based prevention program which includes three core components: (a) enhancements to the school-wide Positive Behavioral Interventions and Supports (PBIS) tier-1 level of support; (b) five one-hour professional development training sessions, each of which addresses five domains of cultural competence (i.e., connection to the curriculum, authentic relationships, reflective thinking, effective communication, and sensitivity to students’ culture); and (c) coaching of classroom teachers using an adapted version of the Classroom Check-Up, which intends to increase teachers’ use of effective classroom management and culturally-responsive strategies using research-based motivational interviewing and data-informed problem-solving approaches. This paper presents findings from a randomized controlled trial (RCT) testing the impact of Double Check, on office discipline referrals (disaggregated by race) and independently observed and self-reported culturally-responsive practices and classroom behavior management. The RCT included 12 elementary and middle schools; 159 classroom teachers were randomized either to receive coaching or serve as comparisons. Specifically, multilevel analyses indicated that teacher self-reported culturally responsive behavior management improved over the course of the school year for teachers who received the coaching and professional development. However, the average annual office discipline referrals issued to black students were reduced among teachers who were randomly assigned to receive coaching relative to comparison teachers. Similarly, observations conducted by trained external raters indicated significantly more teacher proactive behavior management and anticipation of student problems, higher student compliance, less student non-compliance, and less socially disruptive behaviors in classrooms led by coached teachers than classrooms led teachers randomly assigned to the non-coached condition. These findings indicated promising effects of the Double Check model on a range of teacher and student outcomes, including disproportionality in office discipline referrals among Black students. These results also suggest that the Double Check model is one of only a few systematic approaches to promoting culturally-responsive behavior management which has been rigorously tested and shown to be associated with improvements in either student or staff outcomes indicated significant reductions in discipline problems and improvements in behavior management. Implications of these findings are considered within the broader context of globalization and demographic shifts, and their impacts on schools. These issues are particularly timely, given growing concerns about immigration policies in the U.S. and abroad.

Keywords: ethnically and culturally diverse students, student engagement, school-based prevention, academic achievement

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169 Provision of Afterschool Programs: Understanding the Educational Needs and Outcomes of Newcomer and Refugee Students in Canada

Authors: Edward Shizha, Edward Makwarimba

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Newcomer and refugee youth feel excluded in the education system in Canada, and the formal education environment does not fully cater for their learning needs. The objective of this study was to build knowledge and understanding of the educational needs and experiences of these youth in Canada and how available afterschool programs can most effectively support their learning needs and academic outcomes. The Employment and Social Development Canada (ESDC), which funded this research, enables and empowers students to advance their educational experience through targeted investments in services that are delivered by youth-serving organizations outside the formal education system through afterschool initiatives. A literature review and a provincial/territorial internet scan were conducted to determine the availability of services and programs that serve the educational needs and academic outcomes of newcomer youth in 10 provinces and 3 territories in Canada. The goal was to identify intersectional factors (e.g., gender, sexuality, culture, social class, race, etc.) that influence educational outcomes of newcomer/refugee students and to recommend ways the ESDC could complement settlement services to enhance students’ educational success. First, data was collected through a literature search of various databases, including PubMed, Web of Science, Scopus, Google docs, ACADEMIA, and grey literature, including government documents, to inform our analysis. Second, a provincial/territorial internet scan was conducted using a template that was created by ESDC staff with the input of the researchers. The objective of the web-search scan was to identify afterschool programs, projects, and initiatives offered to newcomer/refugee youth by service provider organizations. The method for the scan included both qualitative and quantitative data gathering. Both the literature review and the provincial/territorial scan revealed that there are gender disparities in educational outcomes of newcomer and refugee youth. High school completion rates by gender show that boys are at higher risk of not graduating than girls and that girls are more likely than boys to have at least a high school diploma and more likely to proceed to postsecondary education. Findings from literature reveal that afterschool programs are required for refugee youth who experience mental health challenges and miss out on significant periods of schooling, which affect attendance, participation, and graduation from high school. However, some refugee youth use their resilience and ambition to succeed in their educational outcomes. Another finding showed that some immigrant/refugee students, through ethnic organizations and familial affiliation, maintain aspects of their cultural values, parental expectations and ambitious expectations for their own careers to succeed in both high school and postsecondary education. The study found a significant combination of afterschool programs that include academic support, scholarships, bursaries, homework support, career readiness, internships, mentorship, tutoring, non-clinical counselling, mental health and social well-being support, language skills, volunteering opportunities, community connections, peer networking, culturally relevant services etc. These programs assist newcomer youth to develop self-confidence and prepare for academic success and future career development. The study concluded that advantages of afterschool programs are greatest for youth at risk for poor educational outcomes, such as Latino and Black youth, including 2SLGBTQI+ immigrant youth.

Keywords: afterschool programs, educational outcomes, newcomer youth, refugee youth, youth-serving organizations

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168 The Employment of Unmanned Aircraft Systems for Identification and Classification of Helicopter Landing Zones and Airdrop Zones in Calamity Situations

Authors: Marielcio Lacerda, Angelo Paulino, Elcio Shiguemori, Alvaro Damiao, Lamartine Guimaraes, Camila Anjos

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Accurate information about the terrain is extremely important in disaster management activities or conflict. This paper proposes the use of the Unmanned Aircraft Systems (UAS) at the identification of Airdrop Zones (AZs) and Helicopter Landing Zones (HLZs). In this paper we consider the AZs the zones where troops or supplies are dropped by parachute, and HLZs areas where victims can be rescued. The use of digital image processing enables the automatic generation of an orthorectified mosaic and an actual Digital Surface Model (DSM). This methodology allows obtaining this fundamental information to the terrain’s comprehension post-disaster in a short amount of time and with good accuracy. In order to get the identification and classification of AZs and HLZs images from DJI drone, model Phantom 4 have been used. The images were obtained with the knowledge and authorization of the responsible sectors and were duly registered in the control agencies. The flight was performed on May 24, 2017, and approximately 1,300 images were obtained during approximately 1 hour of flight. Afterward, new attributes were generated by Feature Extraction (FE) from the original images. The use of multispectral images and complementary attributes generated independently from them increases the accuracy of classification. The attributes of this work include the Declivity Map and Principal Component Analysis (PCA). For the classification four distinct classes were considered: HLZ 1 – small size (18m x 18m); HLZ 2 – medium size (23m x 23m); HLZ 3 – large size (28m x 28m); AZ (100m x 100m). The Decision Tree method Random Forest (RF) was used in this work. RF is a classification method that uses a large collection of de-correlated decision trees. Different random sets of samples are used as sampled objects. The results of classification from each tree and for each object is called a class vote. The resulting classification is decided by a majority of class votes. In this case, we used 200 trees for the execution of RF in the software WEKA 3.8. The classification result was visualized on QGIS Desktop 2.12.3. Through the methodology used, it was possible to classify in the study area: 6 areas as HLZ 1, 6 areas as HLZ 2, 4 areas as HLZ 3; and 2 areas as AZ. It should be noted that an area classified as AZ covers the classifications of the other classes, and may be used as AZ, HLZ of large size (HLZ3), medium size (HLZ2) and small size helicopters (HLZ1). Likewise, an area classified as HLZ for large rotary wing aircraft (HLZ3) covers the smaller area classifications, and so on. It was concluded that images obtained through small UAV are of great use in calamity situations since they can provide data with high accuracy, with low cost, low risk and ease and agility in obtaining aerial photographs. This allows the generation, in a short time, of information about the features of the terrain in order to serve as an important decision support tool.

Keywords: disaster management, unmanned aircraft systems, helicopter landing zones, airdrop zones, random forest

Procedia PDF Downloads 157
167 Statistical Models and Time Series Forecasting on Crime Data in Nepal

Authors: Dila Ram Bhandari

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Throughout the 20th century, new governments were created where identities such as ethnic, religious, linguistic, caste, communal, tribal, and others played a part in the development of constitutions and the legal system of victim and criminal justice. Acute issues with extremism, poverty, environmental degradation, cybercrimes, human rights violations, crime against, and victimization of both individuals and groups have recently plagued South Asian nations. Everyday massive number of crimes are steadfast, these frequent crimes have made the lives of common citizens restless. Crimes are one of the major threats to society and also for civilization. Crime is a bone of contention that can create a societal disturbance. The old-style crime solving practices are unable to live up to the requirement of existing crime situations. Crime analysis is one of the most important activities of the majority of intelligent and law enforcement organizations all over the world. The South Asia region lacks such a regional coordination mechanism, unlike central Asia of Asia Pacific regions, to facilitate criminal intelligence sharing and operational coordination related to organized crime, including illicit drug trafficking and money laundering. There have been numerous conversations in recent years about using data mining technology to combat crime and terrorism. The Data Detective program from Sentient as a software company, uses data mining techniques to support the police (Sentient, 2017). The goals of this internship are to test out several predictive model solutions and choose the most effective and promising one. First, extensive literature reviews on data mining, crime analysis, and crime data mining were conducted. Sentient offered a 7-year archive of crime statistics that were daily aggregated to produce a univariate dataset. Moreover, a daily incidence type aggregation was performed to produce a multivariate dataset. Each solution's forecast period lasted seven days. Statistical models and neural network models were the two main groups into which the experiments were split. For the crime data, neural networks fared better than statistical models. This study gives a general review of the applied statistics and neural network models. A detailed image of each model's performance on the available data and generalizability is provided by a comparative analysis of all the models on a comparable dataset. Obviously, the studies demonstrated that, in comparison to other models, Gated Recurrent Units (GRU) produced greater prediction. The crime records of 2005-2019 which was collected from Nepal Police headquarter and analysed by R programming. In conclusion, gated recurrent unit implementation could give benefit to police in predicting crime. Hence, time series analysis using GRU could be a prospective additional feature in Data Detective.

Keywords: time series analysis, forecasting, ARIMA, machine learning

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166 Young People and Their Parents Accessing Their Digital Health Data via a Patient Portal: The Ethical and Legal Implications

Authors: Pippa Sipanoun, Jo Wray, Kate Oulton, Faith Gibson

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Background: With rapidly evolving digital health innovation, there is a need for digital health transformation that is accessible and sustainable, that demonstrates utility for all stakeholders while maintaining data safety. Great Ormond Street Hospital for Children aimed to future-proof the hospital by transitioning to an electronic patient record (EPR) system with a tethered patient portal (MyGOSH) in April 2019. MyGOSH patient portal enables patients 12 years or older (with their parent's consent) to access their digital health data. This includes access to results, documentation, and appointments that facilitate communication with their care team. As part of the Going Digital Study conducted between 2018-2021, data were collected from a sample of all relevant stakeholders before and after EPR and MyGOSH implementation. Data collection reach was wide and included the hospital legal and ethics teams. Aims: This study aims to understand the ethical and legal implications of young people and their parents accessing their digital health data. Methods: A focus group was conducted. Recruited participants were members of the Great Ormond Street Hospital Paediatric Bioethics Centre. Participants included expert and lay members from the Committee from a variety of professional or academic disciplines. Written informed consent was provided by all participants (n=7). The focus group was recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Six themes were identified: access, competence and capacity - granting access to the system; inequalities in access resulting in inequities; burden, uncertainty and responding to change - managing expectations; documenting, risks and data safety; engagement, empowerment and understanding – how to use and manage personal information; legal considerations and obligations. Discussion: If healthcare professionals are to empower young people to be more engaged in their care, the importance of including them in decisions about their health is paramount, especially when they are approaching the age of becoming the consenter for treatment. Complexities exist in assessing competence or capacity when granting system access, when disclosing sensitive information, and maintaining confidentiality. Difficulties are also present in managing clinician burden, managing user expectations whilst providing an equitable service, and data management that meets professional and legal requirements. Conclusion: EPR and tethered-portal implementation at Great Ormond Street Hospital for Children was not only timely, due to the need for a rapid transition to remote consultations during the COVID-19 pandemic, which would not have been possible had EPR/MyGOSH not been implemented, but also integral to the digital health revolution required in healthcare today. This study is highly relevant in understanding the complexities around young people and their parents accessing their digital health data and, although the focus of this research related to portal use and access, the findings translate to young people in the wider digital health context. Ongoing support is required for all relevant stakeholders following MyGOSH patient portal implementation to navigate the ethical and legal complexities. Continued commitment is needed to balance the benefits and burdens, promote inclusion and equity, and ensure portal utility for patient benefit, whilst maintaining an individualized approach to care.

Keywords: patient portal, young people and their parents, ethical, legal

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165 W-WING: Aeroelastic Demonstrator for Experimental Investigation into Whirl Flutter

Authors: Jiri Cecrdle

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This paper describes the concept of the W-WING whirl flutter aeroelastic demonstrator. Whirl flutter is the specific case of flutter that accounts for the additional dynamic and aerodynamic influences of the engine rotating parts. The instability is driven by motion-induced unsteady aerodynamic propeller forces and moments acting in the propeller plane. Whirl flutter instability is a serious problem that may cause the unstable vibration of a propeller mounting, leading to the failure of an engine installation or an entire wing. The complicated physical principle of whirl flutter required the experimental validation of the analytically gained results. W-WING aeroelastic demonstrator has been designed and developed at Czech Aerospace Research Centre (VZLU) Prague, Czechia. The demonstrator represents the wing and engine of the twin turboprop commuter aircraft. Contrary to the most of past demonstrators, it includes a powered motor and thrusting propeller. It allows the changes of the main structural parameters influencing the whirl flutter stability characteristics. Propeller blades are adjustable at standstill. The demonstrator is instrumented by strain gauges, accelerometers, revolution-counting impulse sensor, sensor of airflow velocity, and the thrust measurement unit. Measurement is supported by the in house program providing the data storage and real-time depiction in the time domain as well as pre-processing into the form of the power spectral densities. The engine is linked with a servo-drive unit, which enables maintaining of the propeller revolutions (constant or controlled rate ramp) and monitoring of immediate revolutions and power. Furthermore, the program manages the aerodynamic excitation of the demonstrator by the aileron flapping (constant, sweep, impulse). Finally, it provides the safety guard to prevent any structural failure of the demonstrator hardware. In addition, LMS TestLab system is used for the measurement of the structure response and for the data assessment by means of the FFT- and OMA-based methods. The demonstrator is intended for the experimental investigations in the VZLU 3m-diameter low-speed wind tunnel. The measurement variant of the model is defined by the structural parameters: pitch and yaw attachment stiffness, pitch and yaw hinge stations, balance weight station, propeller type (duralumin or steel blades), and finally, angle of attack of the propeller blade 75% section (). The excitation is provided either by the airflow turbulence or by means of the aerodynamic excitation by the aileron flapping using a frequency harmonic sweep. The experimental results are planned to be utilized for validation of analytical methods and software tools in the frame of development of the new complex multi-blade twin-rotor propulsion system for the new generation regional aircraft. Experimental campaigns will include measurements of aerodynamic derivatives and measurements of stability boundaries for various configurations of the demonstrator.

Keywords: aeroelasticity, flutter, whirl flutter, W WING demonstrator

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164 Vascular Targeted Photodynamic Therapy Monitored by Real-Time Laser Speckle Imaging

Authors: Ruth Goldschmidt, Vyacheslav Kalchenko, Lilah Agemy, Rachel Elmoalem, Avigdor Scherz

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Vascular Targeted Photodynamic therapy (VTP) is a new modality for selective cancer treatment that leads to the complete tumor ablation. A photosensitizer, a bacteriochlorophyll derivative in our case, is first administered to the patient and followed by the illumination of the tumor area, by a near-IR laser for its photoactivation. The photoactivated drug releases reactive oxygen species (ROS) in the circulation, which reacts with blood cells and the endothelium leading to the occlusion of the blood vasculature. If the blood vessels are only partially closed, the tumor may recover, and cancer cells could survive. On the other hand, excessive treatment may lead to toxicity of healthy tissues nearby. Simultaneous VTP monitoring and image processing independent of the photoexcitation laser has not yet been reported, to our knowledge. Here we present a method for blood flow monitoring, using a real-time laser speckle imaging (RTLSI) in the tumor during VTP. We have synthesized over the years a library of bacteriochlorophyll derivatives, among them WST11 and STL-6014. Both are water soluble derivatives that are retained in the blood vasculature through their partial binding to HSA. WST11 has been approved in Mexico for VTP treatment of prostate cancer at a certain drug dose, and time/intensity of illumination. Application to other bacteriochlorophyll derivatives or other cancers may require different treatment parameters (such as light/drug administration). VTP parameters for STL-6014 are still under study. This new derivative mainly differs from WST11 by its lack of the central Palladium, and its conjugation to an Arg-Gly-Asp (RGD) sequence. RGD is a tumor-specific ligand that is used for targeting the necrotic tumor domains through its affinity to αVβ3 integrin receptors. This enables the study of cell-targeted VTP. We developed a special RTLSI module, based on Labview software environment for data processing. The new module enables to acquire raw laser speckle images and calculate the values of the laser temporal statistics of time-integrated speckles in real time, without additional off-line processing. Using RTLSI, we could monitor the tumor’s blood flow following VTP in a CT26 colon carcinoma ear model. VTP with WST11 induced an immediate slow down of the blood flow within the tumor and a complete final flow arrest, after some sporadic reperfusions. If the irradiation continued further, the blood flow stopped also in the blood vessels of the surrounding healthy tissue. This emphasizes the significance of light dose control. Using our RTLSI system, we could prevent any additional healthy tissue damage by controlling the illumination time and restrict blood flow arrest within the tumor only. In addition, we found that VTP with STL-6014 was the most effective when the photoactivation was conducted 4h post-injection, in terms of tumor ablation success in-vivo and blood vessel flow arrest. In conclusion, RTSLI application should allow to optimize VTP efficacy vs. toxicity in both the preclinical and clinical arenas.

Keywords: blood vessel occlusion, cancer treatment, photodynamic therapy, real time imaging

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163 Prevalence and Risk Factors of Cardiovascular Diseases among Bangladeshi Adults: Findings from a Cross Sectional Study

Authors: Fouzia Khanam, Belal Hossain, Kaosar Afsana, Mahfuzar Rahman

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Aim: Although cardiovascular diseases (CVD) has already been recognized as a major cause of death in developed countries, its prevalence is rising in developing countries as well, and engendering a challenge for the health sector. Bangladesh has experienced an epidemiological transition from communicable to non-communicable diseases over the last few decades. So, the rising prevalence of CVD and its risk factors are imposing a major problem for the country. We aimed to examine the prevalence of CVDs and socioeconomic and lifestyle factors related to it from a population-based survey. Methods: The data used for this study were collected as a part of a large-scale cross-sectional study conducted to explore the overall health status of children, mothers and senior citizens of Bangladesh. Multistage cluster random sampling procedure was applied by considering unions as clusters and households as the primary sampling unit to select a total of 11,428 households for the base survey. Present analysis encompassed 12338 respondents of ≥ 35 years, selected from both rural areas and urban slums of the country. Socio-economic, demographic and lifestyle information were obtained through individual by a face-to-face interview which was noted in ODK platform. And height, weight, blood pressure and glycosuria were measured using standardized methods. Chi-square test, Univariate modified Poisson regression model, and multivariate modified Poisson regression model were done using STATA software (version 13.0) for analysis. Results: Overall, the prevalence of CVD was 4.51%, of which 1.78% had stroke and 3.17% suffered from heart diseases. Male had higher prevalence of stroke (2.20%) than their counterparts (1.37%). Notably, thirty percent of respondents had high blood pressure and 5% population had diabetes and more than half of the population was pre-hypertensive. Additionally, 20% were overweight, 77% were smoker or consumed smokeless tobacco and 28% of respondents were physically inactive. Eighty-two percent of respondents took extra salt while eating and 29% of respondents had deprived sleep. Furthermore, the prevalence of risk factor of CVD varied according to gender. Women had a higher prevalence of overweight, obesity and diabetes. Women were also less physically active compared to men and took more extra salt. Smoking was lower in women compared to men. Moreover, women slept less compared to their counterpart. After adjusting confounders in modified Poisson regression model, age, gender, occupation, wealth quintile, BMI, extra salt intake, daily sleep, tiredness, diabetes, and hypertension remained as risk factors for CVD. Conclusion: The prevalence of CVD is significant in Bangladesh, and there is an evidence of rising trend for its risk factors such as hypertension, diabetes especially in older population, women and high-income groups. Therefore, in this current epidemiological transition, immediate public health intervention is warranted to address the overwhelming CVD risk.

Keywords: cardiovascular diseases, diabetes, hypertension, stroke

Procedia PDF Downloads 361
162 In-situ Mental Health Simulation with Airline Pilot Observation of Human Factors

Authors: Mumtaz Mooncey, Alexander Jolly, Megan Fisher, Kerry Robinson, Robert Lloyd, Dave Fielding

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Introduction: The integration of the WingFactors in-situ simulation programme has transformed the education landscape at the Whittington Health NHS Trust. To date, there have been a total of 90 simulations - 19 aimed at Paediatric trainees, including 2 Child and Adolescent Mental Health (CAMHS) scenarios. The opportunity for joint debriefs provided by clinical faculty and airline pilots, has created a new exciting avenue to explore human factors within psychiatry. Through the use of real clinical environments and primed actors; the benefits of high fidelity simulation, interdisciplinary and interprofessional learning has been highlighted. The use of in-situ simulation within Psychiatry is a newly emerging concept and its success here has been recognised by unanimously positive feedback from participants and acknowledgement through nomination for the Health Service Journal (HSJ) Award (Best Education Programme 2021). Methodology: The first CAMHS simulation featured a collapsed patient in the toilet with a ligature tied around her neck, accompanied by a distressed parent. This required participants to consider:; emergency physical management of the case, alongside helping to contain the mother and maintaining situational awareness when transferring the patient to an appropriate clinical area. The second simulation was based on a 17- year- old girl attempting to leave the ward after presenting with an overdose, posing potential risk to herself. The safe learning environment enabled participants to explore techniques to engage the young person and understand their concerns, and consider the involvement of other members of the multidisciplinary team. The scenarios were followed by an immediate ‘hot’ debrief, combining technical feedback with Human Factors feedback from uniformed airline pilots and clinicians. The importance of psychological safety was paramount, encouraging open and honest contributions from all participants. Key learning points were summarized into written documents and circulated. Findings: The in-situ simulations demonstrated the need for practical changes both in the Emergency Department and on the Paediatric ward. The presence of airline pilots provided a novel way to debrief on Human Factors. The following key themes were identified: -Team-briefing (‘Golden 5 minutes’) - Taking a few moments to establish experience, initial roles and strategies amongst the team can reduce the need for conversations in front of a distressed patient or anxious relative. -Use of checklists / guidelines - Principles associated with checklist usage (control of pace, rigor, team situational awareness), instead of reliance on accurate memory recall when under pressure. -Read-back - Immediate repetition of safety critical instructions (e.g. drug / dosage) to mitigate the risks associated with miscommunication. -Distraction management - Balancing the risk of losing a team member to manage a distressed relative, versus it impacting on the care of the young person. -Task allocation - The value of the implementation of ‘The 5A’s’ (Availability, Address, Allocate, Ask, Advise), for effective task allocation. Conclusion: 100% of participants have requested more simulation training. Involvement of airline pilots has led to a shift in hospital culture, bringing to the forefront the value of Human Factors focused training and multidisciplinary simulation. This has been of significant value in not only physical health, but also mental health simulation.

Keywords: human factors, in-situ simulation, inter-professional, multidisciplinary

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161 The Relevance of (Re)Designing Professional Paths with Unemployed Working-Age Adults

Authors: Ana Rodrigues, Maria Cadilhe, Filipa Ferreira, Claudia Pereira, Marta Santos

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Professional paths must be understood in the multiplicity of their possible configurations. While some actors tend to represent their path as a harmonious succession of positions in the life cycle, most recognize the existence of unforeseen and uncontrollable bifurcations, caused, for example, by a work accident or by going through a period of unemployment. Considering the intensified challenges posed by the ongoing societal changes (e.g., technological and demographic), and looking at the Portuguese context, where the unemployment rate continues to be more evident in certain age groups, like in individuals aged 45 years or over, it is essential to support those adults by providing strategies capable of supporting them during professional transitions, being this a joint responsibility of governments, employers, workers, educational institutions, among others. Concerned about those issues, Porto City Council launched the challenge of designing and implementing a Lifelong Career Guidance program, which was answered with the presentation of a customized conceptual and operational model: groWing|Lifelong Career Guidance. A pilot project targeting working-age adults (35 or older) who were unemployed was carried out, aiming to support them to reconstruct their professional paths, through the recovery of their past experiences and through a reflection about dimensions such as skills, interests, constraints, and labor market. A research action approach was used to assess the proposed model, namely the perceived relevance of the theme and of the project, by adults themselves (N=44), employment professionals (N=15) and local companies (N=15), in an integrated manner. A set of activities were carried out: a train the trainer course and a monitoring session with employment professionals; collective and individual sessions with adults, including a monitoring session as well; and a workshop with local companies. Support materials for individual/collective reflection about professional paths were created and adjusted for each involved agent. An evaluation model was co-build by different stakeholders. Assessment was carried through a form created for the purpose, completed at the end of the different activities, which allowed us to collect quantitative and qualitative data. Statistical analysis was carried through SPSS software. Results showed that the participants, as well as the employment professionals and the companies involved, considered both the topic and the project as extremely relevant. Also, adults saw the project as an opportunity to reflect on their paths and become aware of the opportunities and the necessary conditions to achieve their goals; the professionals highlighted the support given by an integrated methodology and the existence of tools to assist the process; companies valued the opportunity to think about the topic and the possible initiatives they could implement within the company to diversify their recruitment pool. The results allow us to conclude that, in the local context under study, there is an alignment between different agents regarding the pertinence of supporting adults with work experience in professional transitions, seeing the project as a relevant strategy to address this issue, which justifies that it can be extended in time and to other working-age adults in the future.

Keywords: professional paths, research action, turning points, lifelong career guidance, relevance

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160 Determination of Slope of Hilly Terrain by Using Proposed Method of Resolution of Forces

Authors: Reshma Raskar-Phule, Makarand Landge, Saurabh Singh, Vijay Singh, Jash Saparia, Shivam Tripathi

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For any construction project, slope calculations are necessary in order to evaluate constructability on the site, such as the slope of parking lots, sidewalks, and ramps, the slope of sanitary sewer lines, slope of roads and highways. When slopes and grades are to be determined, designers are concerned with establishing proper slopes and grades for their projects to assess cut and fill volume calculations and determine inverts of pipes. There are several established instruments commonly used to determine slopes, such as Dumpy level, Abney level or Hand Level, Inclinometer, Tacheometer, Henry method, etc., and surveyors are very familiar with the use of these instruments to calculate slopes. However, they have some other drawbacks which cannot be neglected while major surveying works. Firstly, it requires expert surveyors and skilled staff. The accessibility, visibility, and accommodation to remote hilly terrain with these instruments and surveying teams are difficult. Also, determination of gentle slopes in case of road and sewer drainage constructions in congested urban places with these instruments is not easy. This paper aims to develop a method that requires minimum field work, minimum instruments, no high-end technology or instruments or software, and low cost. It requires basic and handy surveying accessories like a plane table with a fixed weighing machine, standard weights, alidade, tripod, and ranging rods should be able to determine the terrain slope in congested areas as well as in remote hilly terrain. Also, being simple and easy to understand and perform the people of that local rural area can be easily trained for the proposed method. The idea for the proposed method is based on the principle of resolution of weight components. When any object of standard weight ‘W’ is placed on an inclined surface with a weighing machine below it, then its cosine component of weight is presently measured by that weighing machine. The slope can be determined from the relation between the true or actual weight and the apparent weight. A proper procedure is to be followed, which includes site location, centering and sighting work, fixing the whole set at the identified station, and finally taking the readings. A set of experiments for slope determination, mild and moderate slopes, are carried out by the proposed method and by the theodolite instrument in a controlled environment, on the college campus, and uncontrolled environment actual site. The slopes determined by the proposed method were compared with those determined by the established instruments. For example, it was observed that for the same distances for mild slope, the difference in the slope obtained by the proposed method and by the established method ranges from 4’ for a distance of 8m to 2o15’20” for a distance of 16m for an uncontrolled environment. Thus, for mild slopes, the proposed method is suitable for a distance of 8m to 10m. The correlation between the proposed method and the established method shows a good correlation of 0.91 to 0.99 for various combinations, mild and moderate slope, with the controlled and uncontrolled environment.

Keywords: surveying, plane table, weight component, slope determination, hilly terrain, construction

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159 An Innovation Decision Process View in an Adoption of Total Laboratory Automation

Authors: Chia-Jung Chen, Yu-Chi Hsu, June-Dong Lin, Kun-Chen Chan, Chieh-Tien Wang, Li-Ching Wu, Chung-Feng Liu

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With fast advances in healthcare technology, various total laboratory automation (TLA) processes have been proposed. However, adopting TLA needs quite high funding. This study explores an early adoption experience by Taiwan’s large-scale hospital group, the Chimei Hospital Group (CMG), which owns three branch hospitals (Yongkang, Liouying and Chiali, in order by service scale), based on the five stages of Everett Rogers’ Diffusion Decision Process. 1.Knowledge stage: Over the years, two weaknesses exists in laboratory department of CMG: 1) only a few examination categories (e.g., sugar testing and HbA1c) can now be completed and reported within a day during an outpatient clinical visit; 2) the Yongkang Hospital laboratory space is dispersed across three buildings, resulting in duplicated investment in analysis instruments and inconvenient artificial specimen transportation. Thus, the senior management of the department raised a crucial question, was it time to process the redesign of the laboratory department? 2.Persuasion stage: At the end of 2013, Yongkang Hospital’s new building and restructuring project created a great opportunity for the redesign of the laboratory department. However, not all laboratory colleagues had the consensus for change. Thus, the top managers arranged a series of benchmark visits to stimulate colleagues into being aware of and accepting TLA. Later, the director of the department proposed a formal report to the top management of CMG with the results of the benchmark visits, preliminary feasibility analysis, potential benefits and so on. 3.Decision stage: This TLA suggestion was well-supported by the top management of CMG and, finally, they made a decision to carry out the project with an instrument-leasing strategy. After the announcement of a request for proposal and several vendor briefings, CMG confirmed their laboratory automation architecture and finally completed the contracts. At the same time, a cross-department project team was formed and the laboratory department assigned a section leader to the National Taiwan University Hospital for one month of relevant training. 4.Implementation stage: During the implementation, the project team called for regular meetings to review the results of the operations and to offer an immediate response to the adjustment. The main project tasks included: 1) completion of the preparatory work for beginning the automation procedures; 2) ensuring information security and privacy protection; 3) formulating automated examination process protocols; 4) evaluating the performance of new instruments and the instrument connectivity; 5)ensuring good integration with hospital information systems (HIS)/laboratory information systems (LIS); and 6) ensuring continued compliance with ISO 15189 certification. 5.Confirmation stage: In short, the core process changes include: 1) cancellation of signature seals on the specimen tubes; 2) transfer of daily examination reports to a data warehouse; 3) routine pre-admission blood drawing and formal inpatient morning blood drawing can be incorporated into an automatically-prepared tube mechanism. The study summarizes below the continuous improvement orientations: (1) Flexible reference range set-up for new instruments in LIS. (2) Restructure of the specimen category. (3) Continuous review and improvements to the examination process. (4) Whether installing the tube (specimen) delivery tracks need further evaluation.

Keywords: innovation decision process, total laboratory automation, health care

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158 Interpretable Deep Learning Models for Medical Condition Identification

Authors: Dongping Fang, Lian Duan, Xiaojing Yuan, Mike Xu, Allyn Klunder, Kevin Tan, Suiting Cao, Yeqing Ji

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Accurate prediction of a medical condition with straight clinical evidence is a long-sought topic in the medical management and health insurance field. Although great progress has been made with machine learning algorithms, the medical community is still, to a certain degree, suspicious about the model's accuracy and interpretability. This paper presents an innovative hierarchical attention deep learning model to achieve good prediction and clear interpretability that can be easily understood by medical professionals. This deep learning model uses a hierarchical attention structure that matches naturally with the medical history data structure and reflects the member’s encounter (date of service) sequence. The model attention structure consists of 3 levels: (1) attention on the medical code types (diagnosis codes, procedure codes, lab test results, and prescription drugs), (2) attention on the sequential medical encounters within a type, (3) attention on the medical codes within an encounter and type. This model is applied to predict the occurrence of stage 3 chronic kidney disease (CKD3), using three years’ medical history of Medicare Advantage (MA) members from a top health insurance company. The model takes members’ medical events, both claims and electronic medical record (EMR) data, as input, makes a prediction of CKD3 and calculates the contribution from individual events to the predicted outcome. The model outcome can be easily explained with the clinical evidence identified by the model algorithm. Here are examples: Member A had 36 medical encounters in the past three years: multiple office visits, lab tests and medications. The model predicts member A has a high risk of CKD3 with the following well-contributed clinical events - multiple high ‘Creatinine in Serum or Plasma’ tests and multiple low kidneys functioning ‘Glomerular filtration rate’ tests. Among the abnormal lab tests, more recent results contributed more to the prediction. The model also indicates regular office visits, no abnormal findings of medical examinations, and taking proper medications decreased the CKD3 risk. Member B had 104 medical encounters in the past 3 years and was predicted to have a low risk of CKD3, because the model didn’t identify diagnoses, procedures, or medications related to kidney disease, and many lab test results, including ‘Glomerular filtration rate’ were within the normal range. The model accurately predicts members A and B and provides interpretable clinical evidence that is validated by clinicians. Without extra effort, the interpretation is generated directly from the model and presented together with the occurrence date. Our model uses the medical data in its most raw format without any further data aggregation, transformation, or mapping. This greatly simplifies the data preparation process, mitigates the chance for error and eliminates post-modeling work needed for traditional model explanation. To our knowledge, this is the first paper on an interpretable deep-learning model using a 3-level attention structure, sourcing both EMR and claim data, including all 4 types of medical data, on the entire Medicare population of a big insurance company, and more importantly, directly generating model interpretation to support user decision. In the future, we plan to enrich the model input by adding patients’ demographics and information from free-texted physician notes.

Keywords: deep learning, interpretability, attention, big data, medical conditions

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157 Finite Element Analysis of Hollow Structural Shape (HSS) Steel Brace with Infill Reinforcement under Cyclic Loading

Authors: Chui-Hsin Chen, Yu-Ting Chen

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Special concentrically braced frames is one of the seismic load resisting systems, which dissipates seismic energy when bracing members within the frames undergo yielding and buckling while sustaining their axial tension and compression load capacities. Most of the inelastic deformation of a buckling bracing member concentrates in the mid-length region. While experiencing cyclic loading, the region dissipates most of the seismic energy being input into the frame. Such a concentration makes the braces vulnerable to failure modes associated with low-cycle fatigue. In this research, a strategy to improve the cyclic behavior of the conventional steel bracing member is proposed by filling the Hollow Structural Shape (HSS) member with reinforcement. It prevents the local section from concentrating large plastic deformation caused by cyclic loading. The infill helps spread over the plastic hinge region into a wider area hence postpone the initiation of local buckling or even the rupture of the braces. The finite element method is introduced to simulate the complicated bracing member behavior and member-versus-infill interaction under cyclic loading. Fifteen 3-D-element-based models are built by ABAQUS software. The verification of the FEM model is done with unreinforced (UR) HSS bracing members’ cyclic test data and aluminum honeycomb plates’ bending test data. Numerical models include UR and filled HSS bracing members with various compactness ratios based on the specification of AISC-2016 and AISC-1989. The primary variables to be investigated include the relative bending stiffness and the material of the filling reinforcement. The distributions of von Mises stress and equivalent plastic strain (PEEQ) are used as indices to tell the strengths and shortcomings of each model. The result indicates that the change of relative bending stiffness of the infill is much more influential than the change of material in use to increase the energy dissipation capacity. Strengthen the relative bending stiffness of the reinforcement results in additional energy dissipation capacity to the extent of 24% and 46% in model based on AISC-2016 (16-series) and AISC-1989 (89-series), respectively. HSS members with infill show growth in 𝜂Local Buckling, normalized energy cumulated until the happening of local buckling, comparing to UR bracing members. The 89-series infill-reinforced members have more energy dissipation capacity than unreinforced 16-series members by 117% to 166%. The flexural rigidity of infills should be less than 29% and 13% of the member section itself for 16-series and 89-series bracing members accordingly, thereby guaranteeing the spread over of the plastic hinge and the happening of it within the reinforced section. If the parameters are properly configured, the ductility, energy dissipation capacity, and fatigue-life of HSS SCBF bracing members can be improved prominently by the infill-reinforced method.

Keywords: special concentrically braced frames, HSS, cyclic loading, infill reinforcement, finite element analysis, PEEQ

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156 Masstige and the New Luxury: An Exploratory Study on Cosmetic Brands Among Black African Woman

Authors: Melanie Girdharilall, Anjli Himraj, Shivan Bhagwandin, Marike Venter De Villiers

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The allure of luxury has long been attractive, fashionable, mystifying, and complex. As globalisation and the popularity of social media continue to evolve, consumers are seeking status products. However, in emerging economies like South Africa, where 60% of the country lives in poverty, this desire is often far-fetched and out of reach to most of the consumers. As a result, luxury brands are introducing masstige products: products that are associated with luxury and status but within financial reach to the middle-class consumer. The biggest challenge that this industry faces is the lack of knowledge and expertise on black female’s hair composition and offering products that meet their intricate requirements. African consumers have unique hair types, and global brands often do not accommodate for the complex nature of their hair and their product needs. By gaining insight into this phenomenon, global cosmetic brands can benefit from brand expansion, product extensions, increased brand awareness, brand knowledge, and brand equity. The purpose of this study is to determine how cosmetic brands can leverage the concept of masstige products to cater to the needs of middle-income black African woman. This study explores the 18- to 35-year-old black female cohort, which comprises approximately 17% of the South African population. The black hair care industry in Africa is expected a 6% growth rate over the next 5 years. The study is grounded in Paul’s (2019) 3-phase model for masstige marketing. This model demonstrates that product, promotion, and place strategies play a significant role in masstige value creation and the impact of these strategies on the branding dimensions (brand trust, brand association, brand positioning, brand preference, etc.).More specifically, this theoretical framework encompasses nine stages, or dimensions, that are of critical importance to companies who plan to infiltrate the masstige market. In short, the most critical components to consider are the positioning of the product and its competitive advantage in comparison to competitors. Secondly, advertising appeals and use of celebrities, and lastly, distribution channels such as online or in-store while maintain the exclusivity of the brand. By means of an exploratory study, a qualitative approach was undertaken, and focus groups were conducted among black African woman. The focus groups were voice recorded, transcribed, and analysed using Atlas software. The main themes were identified and used to provide brands with insight and direction for developing a comprehensive marketing mix for effectively entering the masstige market. The findings of this study will provide marketing practitioners with in-depth insight into how to effectively position masstige brands in line with consumer needs. It will give direction to both existing and new brands aiming to enter this market, by giving a comprehensive marketing mix for targeting the growing black hair care industry in Africa.

Keywords: africa, masstige, cosmetics, hard care, black females

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155 A Cross-Sectional Study Assessing Communication Practices among Doctors at a University Hospital in Pakistan

Authors: Muhammad Waqas Baqai, Noman Shahzad, Rehman Alvi

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Communication among health care givers is the essence of quality patient care and any compromise results in errors and inefficiency leading to cumbersome outcomes. The use of smartphone among health professionals has increased tremendously. Almost every health professional carries it and majority of them uses a third party communication software called whatsApp for work related communications. It gives instant access to the person responsible for any particular query and therefore helps in efficient and timely decision making. It is also an easy way of sharing medical documents, multimedia and provides platform for consensual decision making through group discussions. However clinical communication through whatsApp has some demerits too including reduction in verbal communication, worsening professional relations, unprofessional behavior, risk of confidentiality breach and threats from cyber-attacks. On the other hand the traditional pager device being used in many health care systems is a unidirectional communication that lacks the ability to convey any information other than the number to which the receiver has to respond. Our study focused on these two widely used modalities of communication among doctors of the largest tertiary care center of Pakistan i.e. The Aga Khan University Hospital. Our aim was to note which modality is considered better and has fewer threats to medical data. Approval from ethical review committee of the institute was taken prior to conduction of this study. We submitted an online survey form to all the interns and residents working at our institute and collected their response in a month’s time. 162 submissions were recorded and analyzed using descriptive statistics. Only 20% of them were comfortable with using pagers exclusively, 52% with whatsApp and 28% with both. 65% think that whatsApp is time-saving and quicker than pager. 54% of them considered whatsApp to be causing nuisance from work related notifications in their off-work hours. 60% think that they are more likely to miss information through pager system because of the unidirectional nature. Almost all (96%) of residents and interns found whatsApp to be useful in terms of saving information for future reference. For urgent issues, majority (70%) preferred pager over whatsApp and also pager was considered more valid in terms of hospital policies and legal issues. Among major advantages of whatsApp as listed by them were; easy mass communication, sharing of clinical pictures, universal access and no need of carrying additional device. However the major drawback of using whatsApp for clinical communication that everyone shared was threat to patients’ confidentiality as clinicians usually share pictures of wounds, clinical documents etc. Lastly we asked them if they think there is a need of a separate application for instant communication dedicated to clinical communication only and 90% responded positively. Therefore, we concluded that both modalities have their merits and demerits but the greatest drawback with whatsApp is the risk of breach in patients’ confidentiality and off-work disturbance. Hence, we recommend a more secure, institute-run application for all intra hospital communications where they can share documents, pictures etc. easily under a controlled environment.

Keywords: WhatsApp, pager, clinical communication, confidentiality

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154 Application of Infrared Thermal Imaging, Eye Tracking and Behavioral Analysis for Deception Detection

Authors: Petra Hypšová, Martin Seitl

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One of the challenges of forensic psychology is to detect deception during a face-to-face interview. In addition to the classical approaches of monitoring the utterance and its components, detection is also sought by observing behavioral and physiological changes that occur as a result of the increased emotional and cognitive load caused by the production of distorted information. Typical are changes in facial temperature, eye movements and their fixation, pupil dilation, emotional micro-expression, heart rate and its variability. Expanding technological capabilities have opened the space to detect these psychophysiological changes and behavioral manifestations through non-contact technologies that do not interfere with face-to-face interaction. Non-contact deception detection methodology is still in development, and there is a lack of studies that combine multiple non-contact technologies to investigate their accuracy, as well as studies that show how different types of lies produced by different interviewers affect physiological and behavioral changes. The main objective of this study is to apply a specific non-contact technology for deception detection. The next objective is to investigate scenarios in which non-contact deception detection is possible. A series of psychophysiological experiments using infrared thermal imaging, eye tracking and behavioral analysis with FaceReader 9.0 software was used to achieve our goals. In the laboratory experiment, 16 adults (12 women, 4 men) between 18 and 35 years of age (SD = 4.42) were instructed to produce alternating prepared and spontaneous truths and lies. The baseline of each proband was also measured, and its results were compared to the experimental conditions. Because the personality of the examiner (particularly gender and facial appearance) to whom the subject is lying can influence physiological and behavioral changes, the experiment included four different interviewers. The interviewer was represented by a photograph of a face that met the required parameters in terms of gender and facial appearance (i.e., interviewer likability/antipathy) to follow standardized procedures. The subject provided all information to the simulated interviewer. During follow-up analyzes, facial temperature (main ROIs: forehead, cheeks, the tip of the nose, chin, and corners of the eyes), heart rate, emotional expression, intensity and fixation of eye movements and pupil dilation were observed. The results showed that the variables studied varied with respect to the production of prepared truths and lies versus the production of spontaneous truths and lies, as well as the variability of the simulated interviewer. The results also supported the assumption of variability in physiological and behavioural values during the subject's resting state, the so-called baseline, and the production of prepared and spontaneous truths and lies. A series of psychophysiological experiments provided evidence of variability in the areas of interest in the production of truths and lies to different interviewers. The combination of technologies used also led to a comprehensive assessment of the physiological and behavioral changes associated with false and true statements. The study presented here opens the space for further research in the field of lie detection with non-contact technologies.

Keywords: emotional expression decoding, eye-tracking, functional infrared thermal imaging, non-contact deception detection, psychophysiological experiment

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153 Effectiveness of Participatory Ergonomic Education on Pain Due to Work Related Musculoskeletal Disorders in Food Processing Industrial Workers

Authors: Salima Bijapuri, Shweta Bhatbolan, Sejalben Patel

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Ergonomics concerns the fitting of the environment and the equipment to the worker. Ergonomic principles can be employed in different dimensions of the industrial sector. Participation of all the stakeholders is the key to the formulation of a multifaceted and comprehensive approach to lessen the burden of occupational hazards. Taking responsibility for one’s own work activities by acquiring sufficient knowledge and potential to influence the practices and outcomes is the basis of participatory ergonomics and even hastens the process to identify workplace hazards. The study was aimed to check how participatory ergonomics can be effective in the management of work-related musculoskeletal disorders. Method: A mega kitchen was identified in a twin city of Karnataka, India. Consent was taken, and the screening of workers was done using observation methods. Kitchen work was structured to include different tasks, which included preparation, cooking, distributing, and serving food, packing food to be delivered to schools, dishwashing, cleaning and maintenance of kitchen and equipment, and receiving and storing raw material. Total 100 workers attended the education session on participatory ergonomics and its role in implementing the correct ergonomic practices, thus preventing WRMSDs. Demographic details and baseline data on related musculoskeletal pain and discomfort were collected using the Nordic pain questionnaire and VAS score pre- and post-study. Monthly visits were made, and the education sessions were reiterated on each visit, thus reminding, correcting, and problem-solving of each worker. After 9 months with a total of 4 such education session, the post education data was collected. The software SPSS 20 was used to analyse the collected data. Results: The majority of them (78%), depending on the availability and feasibility, participated in the intervention workshops were arranged four times. The average age of the participants was 39 years. The percentage of female participants was 79.49%, and 20.51% of participants comprised of males. The Nordic Musculoskeletal Questionnaire (NMQ) showed that knee pain was the most commonly reported complaint (62%) from the last 12 months with a mean VAS of 6.27, followed by low back pain. Post intervention, the mean VAS Score was reduced significantly to 2.38. The comparison of pre-post scores was made using Wilcoxon matched pairs test. Upon enquiring, it was found that, the participants learned the importance of applying ergonomics at their workplace which inturn was beneficial for them to handle any problems arising at their workplace on their own with self confidence. Conclusion: The participatory ergonomics proved effective with workers of mega kitchen, and it is a feasible and practical approach. The advantage of the given study area was that it had a sophisticated and ergonomically designed workstation; thus it was the lack of education and practical knowledge to use these stations was of utmost need. There was a significant reduction in VAS scores with the implementation of changes in the working style, and the knowledge of ergonomics helped to decrease physical load and improve musculoskeletal health.

Keywords: ergonomic awareness session, mega kitchen, participatory ergonomics, work related musculoskeletal disorders

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152 Quality of Care for the Maternal Complications at Selected Primary and Secondary Health Facilities of Bangladesh: Lessons Learned from a Formative Research

Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

Abstract:

After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

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151 Surface Adjustments for Endothelialization of Decellularized Porcine Pericardium

Authors: M. Markova, E. Filova, O. Kaplan, R. Matejka, L. Bacakova

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The porcine pericardium is used as a material for cardiac and aortic valves substitutes. Current biological aortic heart valve prosthesis have a limited lifetime period because they undergo degeneration. In order to make them more biocompatible and prolong their lifetime it is necessary to reseed the decellularized prostheses with endothelial cells and with valve interstitial cells. The endothelialization of the prosthesis-surface may be supported by suitable chemical surface modification of the prosthesis. The aim of this study is to prepare bioactive fibrin layers which would both support endothelialization of porcine pericardium and enhance differentiation and maturation of the endothelial cells seeded. As a material for surface adjustments we used layers of fibrin with/without heparin and some of them with adsorbed or chemically bound FGF2, VEGF or their combination. Fibrin assemblies were prepared in 24-well cell culture plate and were seeded with HSVEC (Human Saphenous Vein Endothelial Cells) at a density of 20,000 cells per well in EGM-2 medium with 0.5% FS and without heparin, without FGF2 and without VEGF; medium was supplemented with aprotinin (200 U/mL). As a control, surface polystyrene (PS) was used. Fibrin was also used as homogeneous impregnation of the decellularized porcine pericardium throughout the scaffolds. Morphology, density, and viability of the seeded endothelial cells were observed from micrographs after staining the samples by LIVE/DEAD cytotoxicity/viability assay kit on the days 1, 3, and 7. Endothelial cells were immunocytochemically stained for proteins involved in cell adhesion, i.e. alphaV integrin, vinculin, and VE-cadherin, markers of endothelial cells differentiation and maturation, i.e. von Willebrand factor and CD31, and for extracellular matrix proteins typically produced by endothelial cells, i.e. type IV collagen and laminin. The staining intensities were subsequently quantified using a software. HSVEC cells grew on each of the prepared surfaces better than on control surface. They reached confluency. The highest cell densities were obtained on the surface of fibrin with heparin and both grow factors used together. Intensity of alphaV integrins staining was highest on samples with remained fibrin layer, i.e. on layers with lower cell densities, i.e. on fibrin without heparin. Vinculin staining was apparent, but was rather diffuse, on fibrin with both FGF2 and VEGF and on control PS. Endothelial cells on all samples were positively stained for von Willebrand factor and CD31. VE-cadherin receptors clusters were best developed on fibrin with heparin and growth factors. Significantly stronger staining of type IV collagen was observed on fibrin with heparin and both growth factors. Endothelial cells on all samples produced laminin-1. Decellularized pericardium was homogeneously filled with fibrin structures. These fibrin-modified pericardium samples will be further seeded with cells and cultured in a bioreactor. Fibrin layers with/without heparin and with adsorbed or chemically bound FGF2, VEGF or their combination are good surfaces for endothelialization of cardiovascular prostheses or porcine pericardium based heart valves. Supported by the Ministry of Health, grants No15-29153A and 15-32497A, and the Grant Agency of the Czech Republic, project No. P108/12/G108.

Keywords: aortic valves prosthesis, FGF2, heparin, HSVEC cells, VEGF

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150 Negative Perceptions of Ageing Predicts Greater Dysfunctional Sleep Related Cognition Among Adults Aged 60+

Authors: Serena Salvi

Abstract:

Ageistic stereotypes and practices have become a normal and therefore pervasive phenomenon in various aspects of everyday life. Over the past years, renewed awareness towards self-directed age stereotyping in older adults has given rise to a line of research focused on the potential role of attitudes towards ageing on seniors’ health and functioning. This set of studies has showed how a negative internalisation of ageistic stereotypes would discourage older adults in seeking medical advice, in addition to be associated to negative subjective health evaluation. An important dimension of mental health that is often affected in older adults is represented by sleep quality. Self-reported sleep quality among older adults has shown to be often unreliable when compared to their objective sleep measures. Investigations focused on self-reported sleep quality among older adults have suggested how this portion of the population would tend to accept disrupted sleep if believed to be up to standard for their age. On the other hand, unrealistic expectations, and dysfunctional beliefs towards sleep in ageing, might prompt older adults to report sleep disruption even in the absence of objective disrupted sleep. Objective of this study is to examine an association between personal attitudes towards ageing in adults aged 60+ and dysfunctional sleep related cognition. More in detail, this study aims to investigate a potential association between personal attitudes towards ageing, sleep locus of control and dysfunctional beliefs towards sleep among this portion of the population. Data in this study were statistically analysed in SPSS software. Participants were recruited through the online participants recruitment system Prolific. Inclusion of attention check questions throughout the questionnaire and consistency of responses were looked at. Prior to the commencement of this study, Ethical Approval was granted (ref. 39396). Descriptive statistics were used to determine the frequency, mean, and SDs of the variables. Pearson coefficient was used for interval variables, independent T-test for comparing means between two independent groups, analysis of variance (ANOVA) test for comparing the means in several independent groups, and hierarchical linear regression models for predicting criterion variables based on predictor variables. In this study self-perceptions of ageing were assessed using APQ-B’s subscales, while dysfunctional sleep related cognition was operationalised using the SLOC and the DBAS16 scales. Of the final subscales taken in consideration in the brief version of the APQ questionnaire, Emotional Representations (ER), Control Positive (PC) and Control and Consequences Negative (NC) have shown to be of particularly relevance for the remits of this study. Regression analysis show how an increase in the APQ-B subscale Emotional Representations (ER) predicts an increase in dysfunctional beliefs and attitudes towards sleep in this sample, after controlling for subjective sleep quality, level of depression and chronological age. A second regression analysis showed that APQ-B subscales Control Positive (PC) and Control and Consequences Negative (NC) were significant predictors in the change of variance of SLOC, after controlling for subjective sleep quality, level of depression and dysfunctional beliefs about sleep.

Keywords: sleep-related cognition, perceptions of aging, older adults, sleep quality

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149 Maintaining Energy Security in Natural Gas Pipeline Operations by Empowering Process Safety Principles Through Alarm Management Applications

Authors: Huseyin Sinan Gunesli

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Process Safety Management is a disciplined framework for managing the integrity of systems and processes that handle hazardous substances. It relies on good design principles, well-implemented automation systems, and operating and maintenance practices. Alarm Management Systems play a critically important role in the safe and efficient operation of modern industrial plants. In that respect, Alarm Management is one of the critical factors feeding the safe operations of the plants in the manner of applying effective process safety principles. Trans Anatolian Natural Gas Pipeline (TANAP) is part of the Southern Gas Corridor, which extends from the Caspian Sea to Italy. TANAP transports Natural Gas from the Shah Deniz gas field of Azerbaijan, and possibly from other neighboring countries, to Turkey and through Trans Adriatic Pipeline (TAP) Pipeline to Europe. TANAP plays a crucial role in maintaining Energy Security for the region and Europe. In that respect, the application of Process Safety principles is vital to deliver safe, reliable and efficient Natural Gas delivery to Shippers both in the region and Europe. Effective Alarm Management is one of those Process Safety principles which feeds safe operations of the TANAP pipeline. Alarm Philosophy was designed and implemented in TANAP Pipeline according to the relevant standards. However, it is essential to manage the alarms received in the control room effectively to maintain safe operations. In that respect, TANAP has commenced Alarm Management & Rationalization program as of February 2022 after transferring to Plateau Regime, reaching the design parameters. While Alarm Rationalization started, there were more than circa 2300 alarms received per hour from one of the compressor stations. After applying alarm management principles such as reviewing and removal of bad actors, standing, stale, chattering, fleeting alarms, comprehensive review and revision of alarm set points through a change management principle, conducting alarm audits/design verification and etc., it has been achieved to reduce down to circa 40 alarms per hour. After the successful implementation of alarm management principles as specified above, the number of alarms has been reduced to industry standards. That significantly improved operator vigilance to focus on mainly important and critical alarms to avoid any excursion beyond safe operating limits leading to any potential process safety events. Following the ‟What Gets Measured, Gets Managed” principle, TANAP has identified key Performance Indicators (KPIs) to manage Process Safety principles effectively, where Alarm Management has formed one of the key parameters of those KPIs. However, review and analysis of the alarms were performed manually. Without utilizing Alarm Management Software, achieving full compliance with international standards is almost infeasible. In that respect, TANAP has started using one of the industry-wide known Alarm Management Applications to maintain full review and analysis of alarms and define actions as required. That actually significantly empowered TANAP’s process safety principles in terms of Alarm Management.

Keywords: process safety principles, energy security, natural gas pipeline operations, alarm rationalization, alarm management, alarm management application

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148 Investigating the Thermal Comfort Properties of Mohair Fabrics

Authors: Adine Gericke, Jiri Militky, Mohanapriya Venkataraman

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Mohair, obtained from the Angora goat, is a luxury fiber and recognized as one of the best quality natural fibers. Expansion of the use of mohair into technical and functional textile products necessitates the need for a better understanding of how the use of mohair in fabrics will impact on its thermo-physiological comfort related properties. Despite its popularity, very little information is available on the quantification of the thermal and moisture management properties of mohair fabrics. This study investigated the effect of fibrous matter composition and fabric structural parameters on conductive and convective heat transfers to attain more information on the thermal comfort properties of mohair fabrics. Dry heat transfer through textiles may involve conduction through the fibrous phase, radiation through fabric interstices and convection of air within the structure. Factors that play a major role in heat transfer by conduction are fabric areal density (g/m2) and derived quantities such as cover factor and porosity. Convective heat transfer through fabrics is found in environmental conditions where there is wind-flow or the object is moving (e.g. running or walking). The thermal comfort properties of mohair fibers were objectively evaluated firstly in comparison with other textile fibers and secondly in a variety of fabric structures. Two sample sets were developed for this purpose, with fibre content, yarn structure and fabric design as main variables. SEM and microscopic images were obtained to closely examine the physical structures of the fibers and fabrics. Thermal comfort properties such as thermal resistance and thermal conductivity, as well as fabric thickness, were measured on the well-known Alambeta test instrument. Clothing insulation (clo) was calculated from the above. The thermal properties of fabrics under heat convection was evaluated using a laboratory model device developed at the Technical University of Liberec (referred to as the TP2-instrument). The effects of the different variables on fabric thermal comfort properties were analyzed statistically using TIBCO Statistica Software. The results showed that fabric structural properties, specifically sample thickness, played a significant role in determining the thermal comfort properties of the fabrics tested. It was found that regarding thermal resistance related to conductive heat flow, the effect of fiber type was not always statistically significant, probably as a result of the amount of trapped air within the fabric structure. The very low thermal conductivity of air, compared to that of the fibers, had a significant influence on the total conductivity and thermal resistance of the samples. This was confirmed by the high correlation of these factors with sample thickness. Regarding convective heat flow, the most important factor influencing the ability of the fabric to allow dry heat to move through the structure, was again fabric thickness. However, it would be wrong to totally disregard the effect of fiber composition on the thermal resistance of textile fabrics. In this study, the samples containing mohair or mohair/wool were consistently thicker than the others even though weaving parameters were kept constant. This can be ascribed to the physical properties of the mohair fibers that renders it exceptionally well towards trapping air among fibers (in a yarn) as well as among yarns (inside a fabric structure). The thicker structures trap more air to provide higher thermal insulation, but also prevent the free flow of air that allow thermal convection.

Keywords: mohair fabrics, convective heat transfer, thermal comfort properties, thermal resistance

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147 Hydrogeomatic System for the Economic Evaluation of Damage by Flooding in Mexico

Authors: Alondra Balbuena Medina, Carlos Diaz Delgado, Aleida Yadira Vilchis Fránces

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In Mexico, each year news is disseminated about the ravages of floods, such as the total loss of housing, damage to the fields; the increase of the costs of the food, derived from the losses of the harvests, coupled with health problems such as skin infection, etc. In addition to social problems such as delinquency, damage in education institutions and the population in general. The flooding is a consequence of heavy rains, tropical storms and or hurricanes that generate excess water in drainage systems that exceed its capacity. In urban areas, heavy rains can be one of the main factors in causing flooding, in addition to excessive precipitation, dam breakage, and human activities, for example, excessive garbage in the strainers. In agricultural areas, these can hardly achieve large areas of cultivation. It should be mentioned that for both areas, one of the significant impacts of floods is that they can permanently affect the livelihoods of many families, cause damage, for example in their workplaces such as farmlands, commercial or industry areas and where services are provided. In recent years, Information and Communication Technologies (ICT) have had an accelerated development, being reflected in the growth and the exponential evolution of the innovation giving; as a result, the daily generation of new technologies, updates, and applications. Innovation in the development of Information Technology applications has impacted on all areas of human activity. They influence all the orders of life of individuals, reconfiguring the way of perceiving and analyzing the world such as, for instance, interrelating with people as individuals and as a society, in the economic, political, social, cultural, educational, environmental, etc. Therefore the present work describes the creation of a system of calculation of flood costs for housing areas, retail establishments and agricultural areas from the Mexican Republic, based on the use and application of geotechnical tools being able to be useful for the benefit of the sectors of public, education and private. To generate analysis of hydrometereologic affections and with the obtained results to realize the Geoinformatics tool was constructed from two different points of view: the geoinformatic (design and development of GIS software) and the methodology of flood damage validation in order to integrate a tool that provides the user the monetary estimate of the effects caused by the floods. With information from the period 2000-2014, the functionality of the application was corroborated. For the years 2000 to 2009 only the analysis of the agricultural and housing areas was carried out, incorporating for the commercial establishment's information of the period 2010 - 2014. The method proposed for the resolution of this research project is a fundamental contribution to society, in addition to the tool itself. Therefore, it can be summarized that the problems that are in the physical-geographical environment, conceiving them from the point of view of the spatial analysis, allow to offer different alternatives of solution and also to open up slopes towards academia and research.

Keywords: floods, technological innovation, monetary estimation, spatial analysis

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146 Comparative Study of Outcome of Patients with Wilms Tumor Treated with Upfront Chemotherapy and Upfront Surgery in Alexandria University Hospitals

Authors: Golson Mohamed, Yasmine Gamasy, Khaled EL-Khatib, Anas Al-Natour, Shady Fadel, Haytham Rashwan, Haytham Badawy, Nadia Farghaly

Abstract:

Introduction: Wilm's tumor is the most common malignant renal tumor in children. Much progress has been made in the management of patients with this malignancy over the last 3 decades. Today treatments are based on several trials and studies conducted by the International Society of Pediatric Oncology (SIOP) in Europe and National Wilm's Tumor Study Group (NWTS) in the USA. It is necessary for us to understand why do we follow either of the protocols, NWTS which follows the upfront surgery principle or the SIOP which follows the upfront chemotherapy principle in all stages of the disease. Objective: The aim of is to assess outcome in patients treated with preoperative chemotherapy and patients treated with upfront surgery to compare their effect on overall survival. Study design: to decide which protocol to follow, study was carried out on records for patients aged 1 day to 18 years old suffering from Wilm's tumor who were admitted to Alexandria University Hospital, pediatric oncology, pediatric urology and pediatric surgery departments, with a retrospective survey records from 2010 to 2015, Design and editing of the transfer sheet with a (PRISMA flow study) Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. (11) Qualitative data were described using number and percent. Quantitative data were described using Range (minimum and maximum), mean, standard deviation and median. Comparison between different groups regarding categorical variables was tested using Chi-square test. When more than 20% of the cells have expected count less than 5, correction for chi-square was conducted using Fisher’s Exact test or Monte Carlo correction. The distributions of quantitative variables were tested for normality using Kolmogorov-Smirnov test, Shapiro-Wilk test, and D'Agstino test, if it reveals normal data distribution, parametric tests were applied. If the data were abnormally distributed, non-parametric tests were used. For normally distributed data, a comparison between two independent populations was done using independent t-test. For abnormally distributed data, comparison between two independent populations was done using Mann-Whitney test. Significance of the obtained results was judged at the 5% level. Results: A significantly statistical difference was observed for survival between the two studied groups favoring the upfront chemotherapy(86.4%)as compared to the upfront surgery group (59.3%) where P=0.009. As regard complication, 20 cases (74.1%) out of 27 were complicated in the group of patients treated with upfront surgery. Meanwhile, 30 cases (68.2%) out of 44 had complications in patients treated with upfront chemotherapy. Also, the incidence of intraoperative complication (rupture) was less in upfront chemotherapy group as compared to upfront surgery group. Conclusion: Upfront chemotherapy has superiority over upfront surgery.As the patient who started with upfront chemotherapy shown, higher survival rate, less percent in complication, less percent needed for radiotherapy, and less rate in recurrence.

Keywords: Wilm's tumor, renal tumor, chemotherapy, surgery

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145 Multiple Plant-Based Cell Suspension as a Bio-Ink for 3D Bioprinting Applications in Food Technology

Authors: Yusuf Hesham Mohamed

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Introduction: Three-dimensional printing technology includes multiple procedures that fabricate three-dimensional objects through consecutively layering two-dimensional cross-sections on top of each other. 3D bioprinting is a promising field of 3D printing, which fabricates tissues and organs by accurately controlling the proper arrangement of diverse biological components. 3D bioprinting uses software and prints biological materials and their supporting components layer-by-layer on a substrate or in a tissue culture plate to produce complex live tissues and organs. 3D food printing is an emerging field of 3D bioprinting in which the 3D printed products are food products that are cheap, require less effort to produce, and have more desirable traits. The Aim of the Study is the development of an affordable 3D bioprinter by altering a locally made CNC instrument with an open-source platform to suit the 3D bio-printer purposes. Later, we went through applying the prototype in several applications regarding food technology and drug testing, including the organ-On-Chip. Materials and Methods: An off-the-shelf 3D printer was modified by designing and fabricating the syringe unit, which was designed on the basis of the Milli-fluidics system. Sodium alginate and gelatin hydrogels were prepared, followed by leaf cell suspension preparation from narrow sections of Fragaria’s viable leaves. The desired 3D structure was modeled, and 3D printing preparations took place. Cell-free and cell-laden hydrogels were printed at room temperature under sterile conditions. Post printing curing process was performed. The printed structure was further studied. Results: Positive results have been achieved using the altered 3D bioprinter where a 3D hydrogel construct of two layers made of the combination of sodium alginate to gelatin (15%: 0.5%) has been printed. DLP 3D printer was used to design the syringe component with a transparent PLA-Pro resin for the creation of a microfluidics system having two channels altered to the double extruder. The hydrogel extruder’s design was based on peristaltic pumps, which utilized a stepper motor. The design and fabrication were made using DIY-3D printed parts. Hard plastic PLA was the material utilized for printing. SEM was used to carry out the porous 3D construct imaging. Multiple physical and chemical tests were performed in order to ensure that the cell line was suitable for hosting. Fragaria plant was developed by suspending Fragaria’s cells from its leaves using the 3D bioprinter. Conclusion: 3D bioprinting is considered to be an emerging scientific field that can facilitate and improve many scientific tests and studies. Thus, having a 3D bioprinter in labs is considered to be an essential requirement. 3D bioprinters are very expensive; however, the fabrication of a 3D printer into a 3D bioprinter can lower the cost of the bioprinter. The 3D bioprinter implemented made use of peristaltic pumps instead of syringe-based pumps in order to extend the ability to print multiple types of materials and cells.

Keywords: scaffold, eco on chip, 3D bioprinter, DLP printer

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