Search results for: clinical practice guidelines
Commenced in January 2007
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Edition: International
Paper Count: 8348

Search results for: clinical practice guidelines

98 Official Seals on the Russian-Qing Treaties: Material Manifestations and Visual Enunciations

Authors: Ning Chia

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Each of the three different language texts (Manchu, Russian, and Latin) of the 1689 Treaty of Nerchinsk bore official seals from Imperial Russia and Qing China. These seals have received no academic attention, yet they can reveal a site of a layered and shared material, cultural, political, and diplomatic world of the time in Eastern Eurasia. The very different seal selections from both empires while ratifying the Treaty of Beijing in 1860 have obtained no scholarly advertency either; they can also explicate a tremendously changed relationship with visual and material manifestation. Exploring primary sources in Manchu, Russian, and Chinese languages as well as the images of the visual seals, this study investigates the reasons and purposes of utilizing official seals for the treaty agreement. A refreshed understanding of Russian-Qing diplomacy will be developed by pursuing the following aspects: (i) Analyzing the iconographic meanings of each seal insignia and unearthing a competitive, yet symbols-delivered and seal-generated, 'dialogue' between the two empires (ii) Contextualizing treaty seals within the historical seal cultures, and discovering how domestic seal system in each empire’s political institution developed into treaty-defined bilateral relations (iii) Expounding the seal confiding in each empire’s daily governing routines, and annotating the trust in the seal as a quested promise from the opponent negotiator to fulfill the treaty terms (iv) Contrasting the two seal traditions along two civilization-lines, Eastern vs. Western, and dissecting how the two styles of seal emblems affected the cross-cultural understanding or misunderstanding between the two empires (v) Comprehending the history-making events from the substantial resources such as the treaty seals, and grasping why the seals for the two treaties, so different in both visual design and symbolic value, were chosen in the two relationship eras (vi) Correlating the materialized seal 'expression' and the imperial worldviews based on each empire’s national/or power identity, and probing the seal-represented 'rule under the Heaven' assumption of China and Russian rising role in 'European-American imperialism … centered on East Asia' (Victor Shmagin, 2020). In conclusion, the impact of official seals on diplomatic treaties needs profound knowledge in seal history, insignia culture, and emblem belief to be able to comprehend. The official seals in both Imperial Russia and Qing China belonged to a particular statecraft art in a specific material and visual form. Once utilized in diplomatic treaties, the meticulously decorated and politically institutionalized seals were transformed from the determinant means for domestic administration and social control into the markers of an empire’s sovereign authority. Overlooked in historical practice, the insignia seal created a wire of 'visual contest' between the two rival powers. Through this material lens, the scholarly knowledge of the Russian-Qing diplomatic relationship will be significantly upgraded. Connecting Russian studies, Qing/Chinese studies, and Eurasian studies, this study also ties material culture, political culture, and diplomatic culture together. It promotes the study of official seals and emblem symbols in worldwide diplomatic history.

Keywords: Russia-Qing diplomatic relation, Treaty of Beijing (1860), Treaty of Nerchinsk (1689), Treaty seals

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97 Linguistic Insights Improve Semantic Technology in Medical Research and Patient Self-Management Contexts

Authors: William Michael Short

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Semantic Web’ technologies such as the Unified Medical Language System Metathesaurus, SNOMED-CT, and MeSH have been touted as transformational for the way users access online medical and health information, enabling both the automated analysis of natural-language data and the integration of heterogeneous healthrelated resources distributed across the Internet through the use of standardized terminologies that capture concepts and relationships between concepts that are expressed differently across datasets. However, the approaches that have so far characterized ‘semantic bioinformatics’ have not yet fulfilled the promise of the Semantic Web for medical and health information retrieval applications. This paper argues within the perspective of cognitive linguistics and cognitive anthropology that four features of human meaning-making must be taken into account before the potential of semantic technologies can be realized for this domain. First, many semantic technologies operate exclusively at the level of the word. However, texts convey meanings in ways beyond lexical semantics. For example, transitivity patterns (distributions of active or passive voice) and modality patterns (configurations of modal constituents like may, might, could, would, should) convey experiential and epistemic meanings that are not captured by single words. Language users also naturally associate stretches of text with discrete meanings, so that whole sentences can be ascribed senses similar to the senses of words (so-called ‘discourse topics’). Second, natural language processing systems tend to operate according to the principle of ‘one token, one tag’. For instance, occurrences of the word sound must be disambiguated for part of speech: in context, is sound a noun or a verb or an adjective? In syntactic analysis, deterministic annotation methods may be acceptable. But because natural language utterances are typically characterized by polyvalency and ambiguities of all kinds (including intentional ambiguities), such methods leave the meanings of texts highly impoverished. Third, ontologies tend to be disconnected from everyday language use and so struggle in cases where single concepts are captured through complex lexicalizations that involve profile shifts or other embodied representations. More problematically, concept graphs tend to capture ‘expert’ technical models rather than ‘folk’ models of knowledge and so may not match users’ common-sense intuitions about the organization of concepts in prototypical structures rather than Aristotelian categories. Fourth, and finally, most ontologies do not recognize the pervasively figurative character of human language. However, since the time of Galen the widespread use of metaphor in the linguistic usage of both medical professionals and lay persons has been recognized. In particular, metaphor is a well-documented linguistic tool for communicating experiences of pain. Because semantic medical knowledge-bases are designed to help capture variations within technical vocabularies – rather than the kinds of conventionalized figurative semantics that practitioners as well as patients actually utilize in clinical description and diagnosis – they fail to capture this dimension of linguistic usage. The failure of semantic technologies in these respects degrades the efficiency and efficacy not only of medical research, where information retrieval inefficiencies can lead to direct financial costs to organizations, but also of care provision, especially in contexts of patients’ self-management of complex medical conditions.

Keywords: ambiguity, bioinformatics, language, meaning, metaphor, ontology, semantic web, semantics

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96 Overlaps and Intersections: An Alternative Look at Choreography

Authors: Ashlie Latiolais

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Architecture, as a discipline, is on a trajectory of extension beyond the boundaries of buildings and, more increasingly, is coupled with research that connects to alternative and typically disjointed disciplines. A “both/and” approach and (expanded) definition of architecture, as depicted here, expands the margins that contain the profession. Figuratively, architecture is a series of edges, events, and occurrences that establishes a choreography or stage by which humanity exists. The way in which architecture controls and suggests the movement through these spaces, being within a landscape, city, or building, can be viewed as a datum by which the “dance” of everyday life occurs. This submission views the realm of architecture through the lens of movement and dance as a cross-fertilizer of collaboration, tectonic, and spatial geometry investigations. “Designing on digital programs puts architects at a distance from the spaces they imagine. While this has obvious advantages, it also means that they lose the lived, embodied experience of feeling what is needed in space—meaning that some design ideas that work in theory ultimately fail in practice.” By studying the body in motion through real-time performance, a more holistic understanding of architectural space surfaces and new prospects for theoretical teaching pedagogies emerge. The atypical intersection rethinks how architecture is considered, created, and tested, similar to how “dance artists often do this by thinking through the body, opening pathways and possibilities that might not otherwise be accessible” –this is the essence of this poster submission as explained through unFOLDED, a creative performance work. A new languageismaterialized through unFOLDED, a dynamic occupiable installation by which architecture is investigated through dance, movement, and body analysis. The entry unfolds a collaboration of an architect, dance choreographer, musicians, video artist, and lighting designers to re-create one of the first documented avant-garde performing arts collaborations (Matisse, Satie, Massine, Picasso) from the Ballet Russes in 1917, entitled Parade. Architecturally, this interdisciplinary project orients and suggests motion through structure, tectonic, lightness, darkness, and shadow as it questions the navigation of the dark space (stage) surrounding the installation. Artificial light via theatrical lighting and video graphics brought the blank canvas to life – where the sensitive mix of musicality coordinated with the structure’s movement sequencing was certainly a challenge. The upstage light from the video projections created both flickered contextual imagery and shadowed figures. When the dancers were either upstage or downstage of the structure, both silhouetted figures and revealed bodies are experienced as dancer-controlled installation manipulations occurred throughout the performance. The experimental performance, through structure, prompted moving (dancing) bodies in space, where the architecture served as a key component to the choreography itself. The tectonic of the delicate steel structure allowed for the dancers to interact with the installation, which created a variety of spatial conditions – the contained box of three-dimensional space, to a wall, and various abstracted geometries in between. The development of this research unveils the new role of an Architect as a Choreographer of the built environment.

Keywords: dance, architecture, choreography, installation, architect, choreographer, space

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95 Chronic Progressive External Ophthalmoplegia (CPEO)

Authors: Gagandeep Singh Digra, Pawan Kumar, Mandeep Kaur Sidhu

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INTRODUCTION: Chronic Progressive External Ophthalmoplegia (CPEO), also known as Progressive External Ophthalmoplegia (PEO), is a type of eye disorder characterized by a loss of the muscle functions involved in eye and eyelid movement. CPEO can be caused by mutations in mitochondrial DNA. It typically manifests in young adults with bilateral and progressive ptosis as the most common presentation but can also present with difficulty swallowing (dysphagia) and general weakness of the skeletal muscles (myopathy), particularly in the neck, arms, or legs. CASE PRESENTATION: This is a case discussion of 3 cousins who presented to our clinic. A 23-year-old male with past surgical history (PSH) of ptosis repair 2 years ago presented with a chief complaint of nasal intonation for 1.5 years associated with difficulty swallowing. The patient also complained of nasal regurgitation of liquids. He denied any headaches, fever, seizures, weakness of arms or legs, urinary complaints or changes in bowel habits. Physical Examination was positive for facial muscle weakness, including an inability to lift eyebrows (Frontalis), inability to close eyes tightly (Orbicularis Oculi), corneal reflex absent bilaterally, difficulty clenching jaw (Masseter muscle), difficulty smiling (Zygomaticus major), inability to elevate upper lip (Zygomaticus minor). Another cousin of the first patient, a 25-year-old male with no past medical history, presented with complaints of nasal intonation for 2 years associated with difficulty swallowing. He denied a history of nasal regurgitation, headaches, fever, seizures, weakness, urinary complaints or changes in bowel habits. Physical Examination showed facial muscle weakness of the Frontalis muscle, Orbicularis Oculi muscle, Masseter Muscle, Zygomaticus Major, Zygomaticus Minor and absent corneal reflexes. A 28-year-old male, a cousin of the first two patients, presented with chief complaints of ptosis and nasal intonation for the last 8 years. He also complained of difficulty swallowing and nasal regurgitation of liquids. His physical examination showed facial muscle weakness, including frontalis muscle (inability to lift eyebrows), Orbicularis Oculi (inability to close eyes tightly), absent corneal reflexes bilaterally, Zygomaticus Major (difficulty smiling), and Zygomaticus Minor (inability to elevate upper lip). MRI brain and visual field of all the patients were normal. Differential diagnoses, including Grave’s disease, Myasthenia Gravis and Glioma, were ruled out. Due to financial reasons, muscle biopsy could not be pursued. Pedigree analysis revealed only males were affected, likely due to maternal inheritance, so the clinical diagnosis of CPEO was made. The patients underwent symptomatic management, including ptosis surgical correction for the third patient. CONCLUSION: Chronic Progressive External Ophthalmoplegia (CPEO), a rare case entity, occurs in young adults as a manifestation of mitochondrial myopathy. There are three modes of transmission- maternal transmission associated with mitochondrial point mutations, autosomal recessive, and autosomal dominant. CPEO can sometimes be difficult to diagnose, especially in asymmetric presentation. Therefore, it is crucial to keep it in differential diagnosis to avoid delay in diagnosis.

Keywords: neurology, chronic, progressive, ophthalmoplegia

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94 Community Strengths and Indigenous Resilience as Drivers for Health Reform Change

Authors: Shana Malio-Satele, Lemalu Silao Vaisola Sefo

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Introductory Statement: South Seas Healthcare is Ōtara’s largest Pacific health provider in South Auckland, New Zealand. Our vision is excellent health and well-being for Pacific people and all communities through strong Pacific values. During the DELTA and Omicron outbreak of COVID-19, our Pacific people, indigenous Māori, and the community of South Auckland were disproportionately affected and faced significant hardship with existing inequities magnified. This study highlights the community-based learnings of harnessing community-based strengths such as indigenous resilience, family-informed experiences and stories that provide critical insights that inform health reform changes that will be sustainable and equitable for all indigenous populations. This study is based on critical learnings acquired during COVID-19 that challenge the deficit narrative common in healthcare about indigenous populations. This study shares case studies of marginalised groups and religious groups and the successful application of indigenous cultural strengths, such as collectivism, positive protective factors, and using trusted relationships to create meaningful change in the way healthcare is delivered. The significance of this study highlights the critical conditions needed to adopt a community-informed way of creating integrated healthcare that works and the role that the community can play in being part of the solution. Methodologies: Key methodologies utilised are indigenous and Pacific-informed. To achieve critical learnings from the community, Pacific research methodologies, heavily informed by the Polynesian practice, were applied. Specifically, this includes; Teu Le Va (Understanding the importance of trusted relationships as a way of creating positive health solutions); The Fonofale Methodology (A way of understanding how health incorporates culture, family, the physical, spiritual, mental and other dimensions of health, as well as time, context and environment; The Fonua Methodology – Understanding the overall wellbeing and health of communities, families and individuals and their holistic needs and environmental factors and the Talanoa methodology (Researching through conversation, where understanding the individual and community is through understanding their history and future through stories). Major Findings: Key findings in the study included: 1. The collectivist approach in the community is a strengths-based response specific to populations, which highlights the importance of trusted relationships and cultural values to achieve meaningful outcomes. 2. The development of a “village model” which identified critical components to achieving health reform change; system navigation, a sense of service that was culturally responsive, critical leadership roles, culturally appropriate support, and the ability to influence the system enablers to support an alternative way of working. Concluding Statement: There is a strong connection between community-based strengths being implemented into healthcare strategies and reforms and the sustainable success of indigenous populations and marginalised communities accessing services that are cohesive, equitably resourced, accessible and meaningful for families. This study highlights the successful community-informed approaches and practices used during the COVID-19 response in New Zealand that are now being implemented in the current health reform.

Keywords: indigenous voice, community voice, health reform, New Zealand

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93 Machine Learning Approach for Automating Electronic Component Error Classification and Detection

Authors: Monica Racha, Siva Chandrasekaran, Alex Stojcevski

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The engineering programs focus on promoting students' personal and professional development by ensuring that students acquire technical and professional competencies during four-year studies. The traditional engineering laboratory provides an opportunity for students to "practice by doing," and laboratory facilities aid them in obtaining insight and understanding of their discipline. Due to rapid technological advancements and the current COVID-19 outbreak, the traditional labs were transforming into virtual learning environments. Aim: To better understand the limitations of the physical laboratory, this research study aims to use a Machine Learning (ML) algorithm that interfaces with the Augmented Reality HoloLens and predicts the image behavior to classify and detect the electronic components. The automated electronic components error classification and detection automatically detect and classify the position of all components on a breadboard by using the ML algorithm. This research will assist first-year undergraduate engineering students in conducting laboratory practices without any supervision. With the help of HoloLens, and ML algorithm, students will reduce component placement error on a breadboard and increase the efficiency of simple laboratory practices virtually. Method: The images of breadboards, resistors, capacitors, transistors, and other electrical components will be collected using HoloLens 2 and stored in a database. The collected image dataset will then be used for training a machine learning model. The raw images will be cleaned, processed, and labeled to facilitate further analysis of components error classification and detection. For instance, when students conduct laboratory experiments, the HoloLens captures images of students placing different components on a breadboard. The images are forwarded to the server for detection in the background. A hybrid Convolutional Neural Networks (CNNs) and Support Vector Machines (SVMs) algorithm will be used to train the dataset for object recognition and classification. The convolution layer extracts image features, which are then classified using Support Vector Machine (SVM). By adequately labeling the training data and classifying, the model will predict, categorize, and assess students in placing components correctly. As a result, the data acquired through HoloLens includes images of students assembling electronic components. It constantly checks to see if students appropriately position components in the breadboard and connect the components to function. When students misplace any components, the HoloLens predicts the error before the user places the components in the incorrect proportion and fosters students to correct their mistakes. This hybrid Convolutional Neural Networks (CNNs) and Support Vector Machines (SVMs) algorithm automating electronic component error classification and detection approach eliminates component connection problems and minimizes the risk of component damage. Conclusion: These augmented reality smart glasses powered by machine learning provide a wide range of benefits to supervisors, professionals, and students. It helps customize the learning experience, which is particularly beneficial in large classes with limited time. It determines the accuracy with which machine learning algorithms can forecast whether students are making the correct decisions and completing their laboratory tasks.

Keywords: augmented reality, machine learning, object recognition, virtual laboratories

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92 Integrating Animal Nutrition into Veterinary Science: Enhancing Health, Productivity, and Sustainability through Advanced Nutritional Strategies and Collaborative Approaches

Authors: Namiiro Shirat Umar

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The science of animals and veterinary medicine is a multidisciplinary field dedicated to understanding, managing, and enhancing the health and welfare of animals. This field encompasses a broad spectrum of disciplines, including animal physiology, genetics, nutrition, behavior, and pathology, as well as preventive and therapeutic veterinary care. Veterinary science focuses on diagnosing, treating, and preventing diseases in animals, ensuring their health and well-being. It involves the study of various animal species, from companion animals and livestock to wildlife and exotic species. Through advanced diagnostic techniques, medical treatments, and surgical procedures, veterinarians address a wide range of health issues, from infectious diseases and injuries to chronic conditions and reproductive health. Animal science complements veterinary medicine by providing a deeper understanding of animal biology and behavior, which is essential for effective health management. It includes research on animal breeding, nutrition, and husbandry practices aimed at improving animal productivity and welfare. Incorporating modern technologies and methodologies, such as genomics, bioinformatics, and precision farming, the science of animals and veterinary medicine continually evolves to address emerging challenges. This integrated approach ensures the development of sustainable practices, enhances animal welfare and contributes to public health by monitoring zoonotic diseases and ensuring the safety of animal products. Animal nutrition is a cornerstone of animal and veterinary science, focusing on the dietary needs of animals to promote health, growth, reproduction, and overall well-being. Proper nutrition ensures that animals receive essential nutrients, including macronutrients (carbohydrates, proteins, fats) and micronutrients (vitamins, minerals), tailored to their specific species, life stages, and physiological conditions. By emphasizing a balanced diet, animal nutrition serves as a preventive measure against diseases and enhances recovery from illnesses, reducing the need for pharmaceutical interventions. It addresses key health issues such as metabolic disorders, reproductive inefficiencies, and immune system deficiencies. Moreover, optimized nutrition improves the quality of animal products like meat, milk, and eggs and enhances the sustainability of animal farming by improving feed efficiency and reducing environmental waste. The integration of animal nutrition into veterinary practice necessitates a collaborative approach involving veterinarians, animal nutritionists, and farmers. Advances in nutritional science, such as precision feeding and the use of nutraceuticals, provide innovative solutions to traditional veterinary challenges. Overall, the focus on animal nutrition as a primary aspect of veterinary care leads to more holistic, sustainable, and effective animal health management practices, promoting the welfare and productivity of animals in various settings. This abstract is a trifold in nature as it traverses how education can put more emphasis on animal nutrition as an alternative for improving animal health as an important issue espoused under the discipline of animal and veterinary science; therefore, brief aspects of this paper and they are as follows; animal nutrition, veterinary science and animals.

Keywords: animal nutrition as a way to enhance growth, animal science as a study, veterinary science dealing with health of the animals, animals healthcare dealing with proper sanitation

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91 Urban Dynamics Modelling of Mixed Land Use for Sustainable Urban Development in Indian Context

Authors: Rewati Raman, Uttam K. Roy

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One of the main adversaries of city planning in present times is the ever-expanding problem of urbanization and the antagonistic issues accompanying it. The prevalent challenges in urbanization such as population growth, urban sprawl, poverty, inequality, pollution, congestion, etc. call for reforms in the urban fabric as well as in planning theory and practice. One of the various paradigms of city planning, land use planning, has been the major instruments for spatial planning of cities and regions in India. Zoning regulation based land use planning in the form of land use and development control plans (LUDCP) and development control regulations (DCR) have been considered mainstream guiding principles in land use planning for decades. In spite of many advantages of such zoning based regulations, over a period of time, it has been critiqued by scholars for its own limitations of isolation and lack of vitality, inconvenience in business in terms of proximity to residence and low operating cost, unsuitable environment for small investments, higher travel distance for facilities, amenities and thereby higher expenditure, safety issues etc. Mixed land use has been advocated as a tool to avoid such limitations in city planning by researchers. In addition, mixed land use can offer many advantages like housing variety and density, the creation of an economic blend of compatible land use, compact development, stronger neighborhood character, walkability, and generation of jobs, etc. Alternatively, the mixed land use beyond a suitable balance of use can also bring disadvantages like traffic congestion, encroachments, very high-density housing leading to a slum like condition, parking spill out, non-residential uses operating on residential premises paying less tax, chaos hampering residential privacy, pressure on existing infrastructure facilities, etc. This research aims at studying and outlining the various challenges and potentials of mixed land use zoning, through modeling tools, as a competent instrument for city planning in lieu of the present urban scenario. The methodology of research adopted in this paper involves the study of a mixed land use neighborhood in India, identification of indicators and parameters related to its extent and spatial pattern and the subsequent use of system dynamics as a modeling tool for simulation. The findings from this analysis helped in identifying the various advantages and challenges associated with the dynamic nature of a mixed use urban settlement. The results also confirmed the hypothesis that mixed use neighborhoods are catalysts for employment generation, socioeconomic gains while improving vibrancy, health, safety, and security. It is also seen that certain challenges related to chaos, lack of privacy and pollution prevail in mixed use neighborhoods, which can be mitigated by varying the percentage of mixing as per need, ensuring compatibility of adjoining use, institutional interventions in the form of policies, neighborhood micro-climatic interventions, etc. Therefore this paper gives a consolidated and holistic framework and quantified outcome pertaining to the extent and spatial pattern of mixed land use that should be adopted to ensure sustainable urban planning.

Keywords: mixed land use, sustainable development, system dynamics analysis, urban dynamics modelling

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90 How Can Personal Protective Equipment Be Best Used and Reused: A Human Factors based Look at Donning and Doffing Procedures

Authors: Devin Doos, Ashley Hughes, Trang Pham, Paul Barach, Rami Ahmed

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Over 115,000 Health Care Workers (HCWs) have died from COVID-19, and millions have been infected while caring for patients. HCWs have filed thousands of safety complaints surrounding safety concerns due to Personal Protective Equipment (PPE) shortages, which included concerns around inadequate and PPE reuse. Protocols for donning and doffing PPE remain ambiguous, lacking an evidence-base, and often result in wide deviations in practice. PPE donning and doffing protocol deviations commonly result in self-contamination but have not been thoroughly addressed. No evidence-driven protocols provide guidance on protecting HCW during periods of PPE reuse. Objective: The aim of this study was to examine safety-related threats and risks to Health Care Workers (HCWs) due to the reuse of PPE among Emergency Department personnel. Method: We conducted a prospective observational study to examine the risks of reusing PPE. First, ED personnel were asked to don and doff PPE in a simulation lab. Each participant was asked to don and doff PPE five times, according to the maximum reuse recommendation set by the Centers for Disease Control and Prevention (CDC). Each participant was videorecorded; video recordings were reviewed and coded independently by at least 2 of the 3trained coders for safety behaviors and riskiness of actions. A third coder was brought in when the agreement between the 2 coders could not be reached. Agreement between coders was high (81.9%), and all disagreements (100%) were resolved via consensus. A bowtie risk assessment chart was constructed analyzing the factors that contribute to increased risks HCW are faced with due to PPE use and reuse. Agreement amongst content experts in the field of Emergency Medicine, Human Factors, and Anesthesiology was used to select aspects of health care that both contribute and mitigate risks associated with PPE reuse. Findings: Twenty-eight clinician participants completed five rounds of donning/doffing PPE, yielding 140 PPE donning/doffing sequences. Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE materials. 100% of participants (n= 28) deviated from the CDC recommended order, and most participants (92.85%, n=26) self-contaminated at least once during reuse. Other frequent errors included failure to tie all ties on the PPE (92.85%, n=26) and failure to wash hands after a contamination event occurred (39.28%, n=11). Conclusions: There is wide variation and regular errors in how HCW don and doffPPE while including in reusing PPE that led to self-contamination. Some errors were deemed “recoverable”, such as hand washing after touching a patient-facing surface to remove the contaminant. Other errors, such as using a contaminated mask and accidentally spreading to the neck and face, can lead to compound risks that are unique to repeated PPE use. A more comprehensive understanding of the contributing threats to HCW safety and complete approach to mitigating underlying risks, including visualizing with risk management toolsmay, aid future PPE designand workflow and space solutions.

Keywords: bowtie analysis, health care, PPE reuse, risk management

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89 Deep Learning Based on Image Decomposition for Restoration of Intrinsic Representation

Authors: Hyohun Kim, Dongwha Shin, Yeonseok Kim, Ji-Su Ahn, Kensuke Nakamura, Dongeun Choi, Byung-Woo Hong

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Artefacts are commonly encountered in the imaging process of clinical computed tomography (CT) where the artefact refers to any systematic discrepancy between the reconstructed observation and the true attenuation coefficient of the object. It is known that CT images are inherently more prone to artefacts due to its image formation process where a large number of independent detectors are involved, and they are assumed to yield consistent measurements. There are a number of different artefact types including noise, beam hardening, scatter, pseudo-enhancement, motion, helical, ring, and metal artefacts, which cause serious difficulties in reading images. Thus, it is desired to remove nuisance factors from the degraded image leaving the fundamental intrinsic information that can provide better interpretation of the anatomical and pathological characteristics. However, it is considered as a difficult task due to the high dimensionality and variability of data to be recovered, which naturally motivates the use of machine learning techniques. We propose an image restoration algorithm based on the deep neural network framework where the denoising auto-encoders are stacked building multiple layers. The denoising auto-encoder is a variant of a classical auto-encoder that takes an input data and maps it to a hidden representation through a deterministic mapping using a non-linear activation function. The latent representation is then mapped back into a reconstruction the size of which is the same as the size of the input data. The reconstruction error can be measured by the traditional squared error assuming the residual follows a normal distribution. In addition to the designed loss function, an effective regularization scheme using residual-driven dropout determined based on the gradient at each layer. The optimal weights are computed by the classical stochastic gradient descent algorithm combined with the back-propagation algorithm. In our algorithm, we initially decompose an input image into its intrinsic representation and the nuisance factors including artefacts based on the classical Total Variation problem that can be efficiently optimized by the convex optimization algorithm such as primal-dual method. The intrinsic forms of the input images are provided to the deep denosing auto-encoders with their original forms in the training phase. In the testing phase, a given image is first decomposed into the intrinsic form and then provided to the trained network to obtain its reconstruction. We apply our algorithm to the restoration of the corrupted CT images by the artefacts. It is shown that our algorithm improves the readability and enhances the anatomical and pathological properties of the object. The quantitative evaluation is performed in terms of the PSNR, and the qualitative evaluation provides significant improvement in reading images despite degrading artefacts. The experimental results indicate the potential of our algorithm as a prior solution to the image interpretation tasks in a variety of medical imaging applications. This work was supported by the MISP(Ministry of Science and ICT), Korea, under the National Program for Excellence in SW (20170001000011001) supervised by the IITP(Institute for Information and Communications Technology Promotion).

Keywords: auto-encoder neural network, CT image artefact, deep learning, intrinsic image representation, noise reduction, total variation

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88 Admissibility as a Property of Evidence in Modern Conditions

Authors: Iryna Teslenko

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According to the provisions of the current criminal procedural legislation of Ukraine, the issue of admissibility of evidence is closely related to both the right to a fair trial and the presumption of innocence. The general rule is that evidence obtained improperly or illegally cannot be taken into account in a court case. Therefore, the evidence base of the prosecution, collected at the stage of the pre-trial investigation, compliance with the requirements of the law during the collection of evidence, is of crucial importance for the criminal process, the violation of which entails the recognition of the relevant evidence as inadmissible, which can nullify all the efforts of the pre-trial investigation body and the prosecution. Therefore, the issue of admissibility of evidence in criminal proceedings is fundamentally important and decisive for the entire process. Research on this issue began in December 2021. At that time, there was still no clear understanding of what needed to be conveyed to the scientific community. In February 2022, the lives of all citizens of Ukraine have totally changed. A war broke out in the country. At a time when the entire world community is on the path of humanizing society, respecting the rights and freedoms of man and citizen, a military conflict has arisen in the middle of Europe - one country attacked another, war crimes are being committed. The world still cannot believe it, but it is happening here and now, people are dying, infrastructure is being destroyed, war crimes are being committed, contrary to the signed and ratified international conventions, and contrary to all the acquisitions and development of world law. At this time, the life of the world has divided into before and after February 24, 2022, the world cannot be the same as it was before, and the approach to solving legal issues in the criminal process, in particular, issues of proving the commission of crimes and the involvement of certain persons in their commission. An international criminal has appeared in the humane European world, who disregards all norms of law and morality, and does not adhere to any principles. Until now, the practice of the European Court of Human Rights and domestic courts of Ukraine treated with certain formalism, such a property of evidence in criminal proceedings as the admissibility of evidence. Currently, we have information that the Office of the Prosecutor of the International Criminal Court in The Hague has started an investigation into war crimes in Ukraine and is documenting them. In our opinion, the world cannot allow formalism in bringing a war criminal to justice. There is a war going on in Ukraine, the cities are under round-the-clock missile fire from the aggressor country, which makes it impossible to carry out certain investigative actions. If due to formal deficiencies, the collected evidence is declared inadmissible, it may lead to the fact that the guilty people will not be punished. And this, in turn, sends a message to other terrorists in the world about the impunity of their actions, the system of deterring criminals from committing criminal offenses (crimes) will collapse due to the understanding of the inevitability of punishment, and this will affect the entire world security and European security in particular. Therefore, we believe that the world cannot allow chaos in the issue of general security, there should be a transformation of the approach in general to such a property of evidence in the criminal process as admissibility in order to ensure the inevitability of the punishment of criminals. We believe that the scientific and legal community should not allow criminals to avoid responsibility. The evil that is destroying Ukraine should be punished. We must all together prove that legal norms are not just words written on paper but rules of behavior of all members of society, their non-observance leads to mandatory responsibility. Everybody who commits crimes will be punished, which is inevitable, and this principle is the guarantor of world security in the future.

Keywords: admissibility of evidence, criminal process, war, Ukraine

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87 ESRA: An End-to-End System for Re-identification and Anonymization of Swiss Court Decisions

Authors: Joel Niklaus, Matthias Sturmer

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The publication of judicial proceedings is a cornerstone of many democracies. It enables the court system to be made accountable by ensuring that justice is made in accordance with the laws. Equally important is privacy, as a fundamental human right (Article 12 in the Declaration of Human Rights). Therefore, it is important that the parties (especially minors, victims, or witnesses) involved in these court decisions be anonymized securely. Today, the anonymization of court decisions in Switzerland is performed either manually or semi-automatically using primitive software. While much research has been conducted on anonymization for tabular data, the literature on anonymization for unstructured text documents is thin and virtually non-existent for court decisions. In 2019, it has been shown that manual anonymization is not secure enough. In 21 of 25 attempted Swiss federal court decisions related to pharmaceutical companies, pharmaceuticals, and legal parties involved could be manually re-identified. This was achieved by linking the decisions with external databases using regular expressions. An automated re-identification system serves as an automated test for the safety of existing anonymizations and thus promotes the right to privacy. Manual anonymization is very expensive (recurring annual costs of over CHF 20M in Switzerland alone, according to an estimation). Consequently, many Swiss courts only publish a fraction of their decisions. An automated anonymization system reduces these costs substantially, further leading to more capacity for publishing court decisions much more comprehensively. For the re-identification system, topic modeling with latent dirichlet allocation is used to cluster an amount of over 500K Swiss court decisions into meaningful related categories. A comprehensive knowledge base with publicly available data (such as social media, newspapers, government documents, geographical information systems, business registers, online address books, obituary portal, web archive, etc.) is constructed to serve as an information hub for re-identifications. For the actual re-identification, a general-purpose language model is fine-tuned on the respective part of the knowledge base for each category of court decisions separately. The input to the model is the court decision to be re-identified, and the output is a probability distribution over named entities constituting possible re-identifications. For the anonymization system, named entity recognition (NER) is used to recognize the tokens that need to be anonymized. Since the focus lies on Swiss court decisions in German, a corpus for Swiss legal texts will be built for training the NER model. The recognized named entities are replaced by the category determined by the NER model and an identifier to preserve context. This work is part of an ongoing research project conducted by an interdisciplinary research consortium. Both a legal analysis and the implementation of the proposed system design ESRA will be performed within the next three years. This study introduces the system design of ESRA, an end-to-end system for re-identification and anonymization of Swiss court decisions. Firstly, the re-identification system tests the safety of existing anonymizations and thus promotes privacy. Secondly, the anonymization system substantially reduces the costs of manual anonymization of court decisions and thus introduces a more comprehensive publication practice.

Keywords: artificial intelligence, courts, legal tech, named entity recognition, natural language processing, ·privacy, topic modeling

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86 Image Segmentation with Deep Learning of Prostate Cancer Bone Metastases on Computed Tomography

Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai

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Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.

Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics

Procedia PDF Downloads 83
85 Effects of Applying Low-Dye Taping in Performing Double-Leg Squat on Electromyographic Activity of Lower Extremity Muscles for Collegiate Basketball Players with Excessive Foot Pronation

Authors: I. M. K. Ho, S. K. Y. Chan, K. H. P. Lam, G. M. W. Tong, N. C. Y. Yeung, J. T. C. Luk

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Low-dye taping (LDT) is commonly used for treating foot problems, such as plantar fasciitis, and supporting foot arch for runners and non-athletes patients with pes planus. The potential negative impact of pronated feet leading to tibial and femoral internal rotation via the entire kinetic chain reaction was postulated and identified. The changed lower limb biomechanics potentially leading to poor activation of hip and knee stabilizers, such as gluteus maximus and medius, may associate with higher risk of knee injuries including patellofemoral pain syndrome and ligamentous sprain in many team sports players. It is therefore speculated that foot arch correction with LDT might enhance the use of gluteal muscles. The purpose of this study was to investigate the effect of applying LDT on surface electromyographic (sEMG) activity of superior gluteus maximus (SGMax), inferior gluteus maximus (IGMax), gluteus medius (GMed) and tibialis anterior (TA) during double-leg squat. 12 male collegiate basketball players (age: 21.72.5 years; body fat: 12.43.6%; navicular drop: 13.72.7mm) with at least three years regular basketball training experience participated in this study. Participants were excluded if they had recent history of lower limb injuries, over 16.6% body fat and lesser than 10mm drop in navicular drop (ND) test. Recruited subjects visited the laboratory once for the within-subject crossover study. Maximum voluntary isometric contraction (MVIC) tests on all selected muscles were performed in randomized order followed by sEMG test on double-leg squat during LDT and non-LDT conditions in counterbalanced order. SGMax, IGMax, GMed and TA activities during the entire 2-second concentric and 2-second eccentric phases were normalized and interpreted as %MVIC. The magnitude of the difference between taped and non-taped conditions of each muscle was further assessed via standardized effect90% confidence intervals (CI) with non-clinical magnitude-based inference. Paired samples T-test showed a significant decrease (4.71.4mm) in ND (95% CI: 3.8, 5.6; p < 0.05) while no significant difference was observed between taped and non-taped conditions in sEMG tests for all muscles and contractions (p > 0.05). On top of traditional significant testing, magnitude-based inference showed possibly increase in IGMax activity (small standardized effect: 0.270.44), likely increase in GMed activity (small standardized effect: 0.340.34) and possibly increase in TA activity (small standardized effect: 0.220.29) during eccentric phase. It is speculated that the decrease of navicular drop supported by LDT application could potentially enhance the use of inferior gluteus maximus and gluteus medius especially during eccentric phase in this study. As the eccentric phase of double-leg squat is an important component of landing activities in basketball, further studies on the onset and amount of gluteal activation during jumping and landing activities with LDT are recommended. Since both hip and knee kinematics were not measured in this study, the underlying cause of the observed increase in gluteal activation during squat after LDT is inconclusive. In this regard, the investigation of relationships between LDT application, ND, hip and knee kinematics, and gluteal muscle activity during sports specific jumping and landing tasks should be focused in the future.

Keywords: flat foot, gluteus maximus, gluteus medius, injury prevention

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84 Benefits of Environmental Aids to Chronobiology Management and Its Impact on Depressive Mood in an Operational Setting

Authors: M. Trousselard, D. Steiler, C. Drogou, P. van-Beers, G. Lamour, S. N. Crosnier, O. Bouilland, P. Dubost, M. Chennaoui, D. Léger

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According to published data, undersea navigation for long periods (nuclear-powered ballistic missile submarine, SSBN) constitutes an extreme environment in which crews are subjected to multiple stresses, including the absence of natural light, illuminance below 1,000 lux, and watch schedules that do not respect natural chronobiological rhythms, for a period of 60-80 days. These stresses seem clearly detrimental to the submariners’ sleep, with consequences for their affective (seasonal affective disorder-like) and cognitive functioning. In the long term, there are abundant publications regarding the consequences of sleep disruption for the occurrence of organic cardiovascular, metabolic, immunological or malignant diseases. It seems essential to propose countermeasures for the duration of the patrol in order to reduce the negative physiological effects on the sleep and mood of submariners. Light therapy, the preferred treatment for dysfunctions of the internal biological clock and the resulting seasonal depression, cannot be used without data to assist knowledge of submariners’ chronobiology (melatonin secretion curve) during patrols, given the unusual characteristics of their working environment. These data are not available in the literature. The aim of this project was to assess, in the course of two studies, the benefits of two environmental techniques for managing chronobiological stress: techniques for optimizing potential (TOP; study 1)3, an existing programme to help in the psychophysiological regulation of stress and sleep in the armed forces, and dawn and dusk simulators (DDS, study 2). For each experiment, psychological, physiological (sleep) or biological (melatonin secretion) data were collected on D20 and D50 of patrol. In the first experiment, we studied sleep and depressive distress in 19 submariners in an operational setting on board an SSBM during a first patrol, and assessed the impact of TOP on the quality of sleep and depressive distress in these same submariners over the course of a second patrol. The submariners were trained in TOP between the two patrols for a 2-month period, at a rate of 1 h of training per week, and assigned daily informal exercises. Results show moderate disruptions in sleep pattern and duration associated with the intensity of depressive distress. The use of TOP during the following patrol improved sleep and depressive mood only in submariners who regularly practiced the techniques. In light of these limited benefits, we assessed, in a second experiment, the benefits of DDS on chronobiology (daily secretion of melatonin) and depressive distress. Ninety submariners were randomly allocated to two groups, group 1 using DDS daily, and group 2 constituting the control group. Although the placebo effect was not controlled, results showed a beneficial effect on chronobiology and depressive mood for submariners with a morning chronotype. Conclusions: These findings demonstrate the difficulty of practicing the tools of psychophysiological management in real life. They raise the question of the subjects’ autonomy with respect to using aids that involve regular practice. It seems important to study autonomy in future studies, as a cognitive resource resulting from the interaction between internal positive resources and “coping” resources, to gain a better understanding of compliance problems.

Keywords: chronobiology, light therapy, seasonal affective disorder, sleep, stress, stress management, submarine

Procedia PDF Downloads 447
83 Academic Staff Identity and Emotional Labour: Exploring Pride, Motivation, and Relationships in Universities

Authors: Keith Schofield, Garry R. Prentice

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The perceptions of the work an academic does, and the environment in which they do it, contributes to the professional identity of that academic. In turn, this has implications for the level of involvement they have in their job, their satisfaction, and their work product. This research explores academic identities in British and Irish institutions and considers the complex interplay between identity, practice, and participation. Theoretical assumptions made in this paper assert that meaningful work has positive effects on work pride, organisational commitment, organisational citizenship, and motivation; when employees participate enthusiastically they are likely to be more engaged, more successful, and more satisfied. Further examination is given to the context in which this participation happens; the nature of institutional process, management, and relationships with colleagues, team members, and students is considered. The present study follows a mixed-methods approach to explore work satisfaction constructs in a number of academic contexts in the UK and Ireland. The quantitative component of this research (Convenience Sample: 155 academics, and support/ administrative staff; 36.1% male, 63.9% female; 60.8% academic staff, 39.2% support/ administration staff; across a number of universities in the UK and Ireland) was based on an established emotional labour model and was tested across gender groups, job roles, and years of service. This was complimented by qualitative semi-structured interviews (Purposive Sample: 10 academics, and 5 support/ administrative staff across the same universities in the UK and Ireland) to examine various themes including values within academia, work conditions, professional development, and transmission of knowledge to students. Experiences from both academic and support perspectives were sought in order to gain a holistic view of academia and to provide an opportunity to explore the dynamic of the academic/administrator relationship within the broader institutional context. The quantitative emotional labour model, tested via a path analysis, provided a robust description of the relationships within the data. The significant relationships found within the quantitative emotional labour model included a link between non-expression of true feelings resulting in emotional labourious work and lower levels of intrinsic motivation and higher levels of extrinsic motivation. Higher levels of intrinsic motivation also linked positively to work pride. These findings were further explored in the qualitative elements of the research where themes emerged including the disconnection between faculty management and staff, personal fulfilment and the friction between the identities of teacher, researcher/ practitioner and administrator. The implications of the research findings from this study are combined and discussed in relation to possible identity-related and emotional labour management-related interventions. Further, suggestions are made to institutions concerning the application of these findings including the development of academic practices, with specific reference to the duality of identity required to service the combined teacher/ researcher role. Broader considerations of the paper include how individuals and institutions may engage with the changing nature of students-as-consumers as well as a recommendation to centralise personal fulfillment through the development of professional academic identities.

Keywords: academic work, emotional labour, identity friction, mixed methods

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82 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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81 Measuring Entrepreneurship Intentions among Nigerian University Graduates: A Structural Equation Modeling Technique

Authors: Eunice Oluwakemi Chukwuma-Nwuba

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Nigeria is a developing country with an increasing rate of graduate unemployment. This has triggered successive government administrations to promote the variety of programmes to address the situation. However, none of these efforts yielded the desired outcome. Accordingly, in 2006 the government included entrepreneurship module in the curriculum of universities as a compulsory general programme for all undergraduate courses. This is in the hope that the programme will help to promote entrepreneurial mind-set and new venture creation among graduates and as a result reduce the rate of graduate unemployment. The study explores the effectiveness of entrepreneurship education in promoting entrepreneurship. This study is significant in view of the endemic graduate unemployment in Nigeria and the social consequences such as youth restiveness and militancy. It is guided by the theory of planned behaviour. It employed the two-stage structural equation modelling (AMOS) to model entrepreneurial intentions as a function of innovative teaching methods, traditional teaching methods and culture Personal attitude and subjective norm are proposed to mediate the relationships between the exogenous and the endogenous variables. The first stage was tested using multi-group confirmatory factor analysis (MGCFA) framework to confirm that the two groups assign the same meaning to the scale items and to obtain goodness-of-fit indices. The multi-group confirmatory factor analysis included the tests of configural, metric and scalar invariance. With the attainment of full configural invariance and partial metric and scalar invariance, the second stage – the structural model was applied hypothesising that, the entrepreneurial intentions of graduates (respondents who have participated in the compulsory entrepreneurship programme) will be higher than those of undergraduates (respondents who are yet to participate in the programme). The study uses the quasi-experimental design. The samples comprised 409 graduates (experimental group) and 402 undergraduates (control group) from six federal universities in Nigeria. Our findings suggest that personal attitude is positively related with entrepreneurial intentions, largely confirming prior literature. However, unlike previous studies, our results indicate that subjective norm has significant direct and indirect impact on entrepreneurial intentions indicating that reference people of the participants have important roles to play in their decision to be entrepreneurial. Furthermore, unlike the assertions in prior studies, the result suggests that traditional teaching methods have indirect effect on entrepreneurial intentions supporting that since personal characteristics can change in an educational situation, an education purposively directed at entrepreneurship might achieve similar results if not better. This study has implication for practice and theory. The research extends to the theoretical understanding of the formation of entrepreneurial intentions and explains the role of the reference others in relation to how graduates perceive entrepreneurship. Further, the study adds to the body of knowledge on entrepreneurship education in Nigeria universities and provides a developing country perspective. It proposes further research in the exploration of entrepreneurship education and entrepreneurial intentions of graduates from across the country’s universities as necessary and imperative.

Keywords: entrepreneurship education, entrepreneurial intention, structural equation modeling, theory of planned behaviour

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80 A Parallel Cellular Automaton Model of Tumor Growth for Multicore and GPU Programming

Authors: Manuel I. Capel, Antonio Tomeu, Alberto Salguero

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Tumor growth from a transformed cancer-cell up to a clinically apparent mass spans through a range of spatial and temporal magnitudes. Through computer simulations, Cellular Automata (CA) can accurately describe the complexity of the development of tumors. Tumor development prognosis can now be made -without making patients undergo through annoying medical examinations or painful invasive procedures- if we develop appropriate CA-based software tools. In silico testing mainly refers to Computational Biology research studies of application to clinical actions in Medicine. To establish sound computer-based models of cellular behavior, certainly reduces costs and saves precious time with respect to carrying out experiments in vitro at labs or in vivo with living cells and organisms. These aim to produce scientifically relevant results compared to traditional in vitro testing, which is slow, expensive, and does not generally have acceptable reproducibility under the same conditions. For speeding up computer simulations of cellular models, specific literature shows recent proposals based on the CA approach that include advanced techniques, such the clever use of supporting efficient data structures when modeling with deterministic stochastic cellular automata. Multiparadigm and multiscale simulation of tumor dynamics is just beginning to be developed by the concerned research community. The use of stochastic cellular automata (SCA), whose parallel programming implementations are open to yield a high computational performance, are of much interest to be explored up to their computational limits. There have been some approaches based on optimizations to advance in multiparadigm models of tumor growth, which mainly pursuit to improve performance of these models through efficient memory accesses guarantee, or considering the dynamic evolution of the memory space (grids, trees,…) that holds crucial data in simulations. In our opinion, the different optimizations mentioned above are not decisive enough to achieve the high performance computing power that cell-behavior simulation programs actually need. The possibility of using multicore and GPU parallelism as a promising multiplatform and framework to develop new programming techniques to speed-up the computation time of simulations is just starting to be explored in the few last years. This paper presents a model that incorporates parallel processing, identifying the synchronization necessary for speeding up tumor growth simulations implemented in Java and C++ programming environments. The speed up improvement that specific parallel syntactic constructs, such as executors (thread pools) in Java, are studied. The new tumor growth parallel model is proved using implementations with Java and C++ languages on two different platforms: chipset Intel core i-X and a HPC cluster of processors at our university. The parallelization of Polesczuk and Enderling model (normally used by researchers in mathematical oncology) proposed here is analyzed with respect to performance gain. We intend to apply the model and overall parallelization technique presented here to solid tumors of specific affiliation such as prostate, breast, or colon. Our final objective is to set up a multiparadigm model capable of modelling angiogenesis, or the growth inhibition induced by chemotaxis, as well as the effect of therapies based on the presence of cytotoxic/cytostatic drugs.

Keywords: cellular automaton, tumor growth model, simulation, multicore and manycore programming, parallel programming, high performance computing, speed up

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79 National Core Indicators - Aging and Disabilities: A Person-Centered Approach to Understanding Quality of Long-Term Services and Supports

Authors: Stephanie Giordano, Rosa Plasencia

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In the USA, in 2013, public service systems such as Medicaid, aging, and disability systems undertook an effort to measure the quality of service delivery by examining the experiences and outcomes of those receiving public services. The goal of this effort was to develop a survey to measure the experiences and outcomes of those receiving public services, with the goal of measuring system performance for quality improvement. The performance indicators were developed through with input from directors of state aging and disability service systems, along with experts and stakeholders in the field across the United States. This effort, National Core Indicators –Aging and Disabilities (NCI-AD), grew out of National Core Indicators –Intellectual and Developmental Disabilities, an effort to measure developmental disability (DD) systems across the States. The survey tool and administration protocol underwent multiple rounds of testing and revision between 2013 and 2015. The measures in the final tool – called the Adult Consumer Survey (ACS) – emphasize not just important indicators of healthcare access and personal safety but also includes indicators of system quality based on person-centered outcomes. These measures indicate whether service systems support older adults and people with disabilities to live where they want, maintain relationships and engage in their communities and have choice and control in their everyday lives. Launched in 2015, the NCI-AD Adult Consumer Survey is now used in 23 states in the US. Surveys are conducted by NCI-AD trained surveyors via direct conversation with a person receiving public long-term services and supports (LTSS). Until 2020, surveys were only conducted in person. However, after a pilot to test the reliability of videoconference and telephone survey modes, these modes were adopted as an acceptable practice. The nature of the survey is that of a “guided conversation” survey administration allows for surveyor to use wording and terminology that is best understand by the person surveyed. The survey includes a subset of questions that may be answered by a proxy respondent who knows the person well if the person is receiving services in unable to provide valid responses on their own. Surveyors undergo a standardized training on survey administration to ensure the fidelity of survey administration. In addition to the main survey section, a Background Information section collects data on personal and service-related characteristics of the person receiving services; these data are typically collected through state administrative record. This information is helps provide greater context around the characteristics of people receiving services. It has also been used in conjunction with outcomes measures to look at disparity (including by race and ethnicity, gender, disability, and living arrangements). These measures of quality are critical for public service delivery systems to understand the unique needs of the population of older adults and improving the lives of older adults as well as people with disabilities. Participating states may use these data to identify areas for quality improvement within their service delivery systems, to advocate for specific policy change, and to better understand the experiences of specific populations of people served.

Keywords: quality of life, long term services and supports, person-centered practices, aging and disability research, survey methodology

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78 A Proposed Framework for Better Managing Small Group Projects on an Undergraduate Foundation Programme at an International University Campus

Authors: Sweta Rout-Hoolash

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Each year, selected students from around 20 countries begin their degrees at Middlesex University with the International Foundation Program (IFP), developing the skills required for academic study at a UK university. The IFP runs for 30 learning/teaching weeks at Middlesex University Mauritius Branch Campus, which is an international campus of UK’s Middlesex University. Successful IFP students join their degree courses already settled into life at their chosen campus (London, Dubai, Mauritius or Malta) and confident that they understand what is required for degree study. Although part of the School of Science and Technology, in Mauritius it prepares students for undergraduate level across all Schools represented on campus – including disciplines such as Accounting, Business, Computing, Law, Media and Psychology. The researcher has critically reviewed the framework and resources in the curriculum for a particular six week period of IFP study (dedicated group work phase). Despite working together closely for 24 weeks, IFP students approach the final 6 week small group work project phase with mainly inhibitive feelings. It was observed that students did not engage effectively in the group work exercise. Additionally, groups who seemed to be working well did not necessarily produce results reflecting effective collaboration, nor individual members’ results which were better than prior efforts. The researcher identified scope for change and innovation in the IFP curriculum and how group work is introduced and facilitated. The study explores the challenges of groupwork in the context of the Mauritius campus, though it is clear that the implications of the project are not restricted to one campus only. The presentation offers a reflective review on the previous structure put in place for the management of small group assessed projects on the programme from both the student and tutor perspective. The focus of the research perspective is the student voice, by taking into consideration past and present IFP students’ experiences as written in their learning journals. Further, it proposes the introduction of a revised framework to help students take greater ownership of the group work process in order to engage more effectively with the learning outcomes of this crucial phase of the programme. The study has critically reviewed recent and seminal literature on how to achieve greater student ownership during this phase especially under an environment of assessed multicultural group work. The presentation proposes several new approaches for encouraging students to take more control of the collaboration process. Detailed consideration is given to how the proposed changes impact on the work of other stakeholders, or partners to student learning. Clear proposals are laid out for evaluation of the different approaches intended to be implemented during the upcoming academic year (student voice through their own submitted reflections, focus group interviews and through the assessment results). The proposals presented are all realistic and have the potential to transform students’ learning. Furthermore, the study has engaged with the UK Professional Standards Framework for teaching and supporting learning in higher education, and demonstrates practice at the level of ‘fellow’ of the Higher Education Academy (HEA).

Keywords: collaborative peer learning, enhancing learning experiences, group work assessment, learning communities, multicultural diverse classrooms, studying abroad

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77 Climate Safe House: A Community Housing Project Tackling Catastrophic Sea Level Rise in Coastal Communities

Authors: Chris Fersterer, Col Fay, Tobias Danielmeier, Kat Achterberg, Scott Willis

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New Zealand, an island nation, has an extensive coastline peppered with small communities of iconic buildings known as Bachs. Post WWII, these modest buildings were constructed by their owners as retreats and generally were small, low cost, often using recycled material and often they fell below current acceptable building standards. In the latter part of the 20th century, real estate prices in many of these communities remained low and these areas became permanent residences for people attracted to this affordable lifestyle choice. The Blueskin Resilient Communities Trust (BRCT) is an organisation that recognises the vulnerability of communities in low lying settlements as now being prone to increased flood threat brought about by climate change and sea level rise. Some of the inhabitants of Blueskin Bay, Otago, NZ have already found their properties to be un-insurable because of increased frequency of flood events and property values have slumped accordingly. Territorial authorities also acknowledge this increased risk and have created additional compliance measures for new buildings that are less than 2 m above tidal peaks. Community resilience becomes an additional concern where inhabitants are attracted to a lifestyle associated with a specific location and its people when this lifestyle is unable to be met in a suburban or city context. Traditional models of social housing fail to provide the sense of community connectedness and identity enjoyed by the current residents of Blueskin Bay. BRCT have partnered with the Otago Polytechnic Design School to design a new form of community housing that can react to this environmental change. It is a longitudinal project incorporating participatory approaches as a means of getting people ‘on board’, to understand complex systems and co-develop solutions. In the first period, they are seeking industry support and funding to develop a transportable and fully self-contained housing model that exploits current technologies. BRCT also hope that the building will become an educational tool to highlight climate change issues facing us today. This paper uses the Climate Safe House (CSH) as a case study for education in architectural sustainability through experiential learning offered as part of the Otago Polytechnics Bachelor of Design. Students engage with the project with research methodologies, including site surveys, resident interviews, data sourced from government agencies and physical modelling. The process involves collaboration across design disciplines including product and interior design but also includes connections with industry, both within the education institution and stakeholder industries introduced through BRCT. This project offers a rich learning environment where students become engaged through project based learning within a community of practice, including architecture, construction, energy and other related fields. The design outcomes are expressed in a series of public exhibitions and forums where community input is sought in a truly participatory process.

Keywords: community resilience, problem based learning, project based learning, case study

Procedia PDF Downloads 275
76 Use of Machine Learning Algorithms to Pediatric MR Images for Tumor Classification

Authors: I. Stathopoulos, V. Syrgiamiotis, E. Karavasilis, A. Ploussi, I. Nikas, C. Hatzigiorgi, K. Platoni, E. P. Efstathopoulos

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Introduction: Brain and central nervous system (CNS) tumors form the second most common group of cancer in children, accounting for 30% of all childhood cancers. MRI is the key imaging technique used for the visualization and management of pediatric brain tumors. Initial characterization of tumors from MRI scans is usually performed via a radiologist’s visual assessment. However, different brain tumor types do not always demonstrate clear differences in visual appearance. Using only conventional MRI to provide a definite diagnosis could potentially lead to inaccurate results, and so histopathological examination of biopsy samples is currently considered to be the gold standard for obtaining definite diagnoses. Machine learning is defined as the study of computational algorithms that can use, complex or not, mathematical relationships and patterns from empirical and scientific data to make reliable decisions. Concerning the above, machine learning techniques could provide effective and accurate ways to automate and speed up the analysis and diagnosis for medical images. Machine learning applications in radiology are or could potentially be useful in practice for medical image segmentation and registration, computer-aided detection and diagnosis systems for CT, MR or radiography images and functional MR (fMRI) images for brain activity analysis and neurological disease diagnosis. Purpose: The objective of this study is to provide an automated tool, which may assist in the imaging evaluation and classification of brain neoplasms in pediatric patients by determining the glioma type, grade and differentiating between different brain tissue types. Moreover, a future purpose is to present an alternative way of quick and accurate diagnosis in order to save time and resources in the daily medical workflow. Materials and Methods: A cohort, of 80 pediatric patients with a diagnosis of posterior fossa tumor, was used: 20 ependymomas, 20 astrocytomas, 20 medulloblastomas and 20 healthy children. The MR sequences used, for every single patient, were the following: axial T1-weighted (T1), axial T2-weighted (T2), FluidAttenuated Inversion Recovery (FLAIR), axial diffusion weighted images (DWI), axial contrast-enhanced T1-weighted (T1ce). From every sequence only a principal slice was used that manually traced by two expert radiologists. Image acquisition was carried out on a GE HDxt 1.5-T scanner. The images were preprocessed following a number of steps including noise reduction, bias-field correction, thresholding, coregistration of all sequences (T1, T2, T1ce, FLAIR, DWI), skull stripping, and histogram matching. A large number of features for investigation were chosen, which included age, tumor shape characteristics, image intensity characteristics and texture features. After selecting the features for achieving the highest accuracy using the least number of variables, four machine learning classification algorithms were used: k-Nearest Neighbour, Support-Vector Machines, C4.5 Decision Tree and Convolutional Neural Network. The machine learning schemes and the image analysis are implemented in the WEKA platform and MatLab platform respectively. Results-Conclusions: The results and the accuracy of images classification for each type of glioma by the four different algorithms are still on process.

Keywords: image classification, machine learning algorithms, pediatric MRI, pediatric oncology

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75 Design Thinking and Project-Based Learning: Opportunities, Challenges, and Possibilities

Authors: Shoba Rathilal

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High unemployment rates and a shortage of experienced and qualified employees appear to be a paradox that currently plagues most countries worldwide. In a developing country like South Africa, the rate of unemployment is reported to be approximately 35%, the highest recorded globally. At the same time, a countrywide deficit in experienced and qualified potential employees is reported in South Africa, which is causing fierce rivalry among firms. Employers have reported that graduates are very rarely able to meet the demands of the job as there are gaps in their knowledge and conceptual understanding and other 21st-century competencies, attributes, and dispositions required to successfully negotiate the multiple responsibilities of employees in organizations. In addition, the rates of unemployment and suitability of graduates appear to be skewed by race and social class, the continued effects of a legacy of inequitable educational access. Higher Education in the current technologically advanced and dynamic world needs to serve as an agent of transformation, aspiring to develop graduates to be creative, flexible, critical, and with entrepreneurial acumen. This requires that higher education curricula and pedagogy require a re-envisioning of our selection, sequencing, and pacing of the learning, teaching, and assessment. At a particular Higher education Institution in South Africa, Design Thinking and Project Based learning are being adopted as two approaches that aim to enhance the student experience through the provision of a “distinctive education” that brings together disciplinary knowledge, professional engagement, technology, innovation, and entrepreneurship. Using these methodologies forces the students to solve real-time applied problems using various forms of knowledge and finding innovative solutions that can result in new products and services. The intention is to promote the development of skills for self-directed learning, facilitate the development of self-awareness, and contribute to students being active partners in the application and production of knowledge. These approaches emphasize active and collaborative learning, teamwork, conflict resolution, and problem-solving through effective integration of theory and practice. In principle, both these approaches are extremely impactful. However, at the institution in this study, the implementation of the PBL and DT was not as “smooth” as anticipated. This presentation reports on the analysis of the implementation of these two approaches within higher education curricula at a particular university in South Africa. The study adopts a qualitative case study design. Data were generated through the use of surveys, evaluation feedback at workshops, and content analysis of project reports. Data were analyzed using document analysis, content, and thematic analysis. Initial analysis shows that the forces constraining the implementation of PBL and DT range from the capacity to engage with DT and PBL, both from staff and students, educational contextual realities of higher education institutions, administrative processes, and resources. At the same time, the implementation of DT and PBL was enabled through the allocation of strategic funding and capacity development workshops. These factors, however, could not achieve maximum impact. In addition, the presentation will include recommendations on how DT and PBL could be adapted for differing contexts will be explored.

Keywords: design thinking, project based learning, innovative higher education pedagogy, student and staff capacity development

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74 Speciation of Bacteria Isolated from Clinical Canine and Feline Urine Samples by Using ChromID CPS Elite Agar: A Preliminary Study

Authors: Delsy Salinas, Andreia Garcês, Augusto Silva, Paula Brilhante Simões

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Urinary tract infection (UTI) is a common disease affecting dogs and cats in both community and hospital environment. Bacteria is the most frequent agent isolated, fewer than 1% of infections are due to parasitic, fungal, or viral agents. Common symptoms and laboratory abnormalities includeabdominal pain, pyrexia, renomegaly, and neutrophilia with left shift. A rapid and precise identification of the bacterial agent is still a challenge in veterinarian laboratories. Therefore, this cross-sectional study aims to describe bacterial colony patterns of urine samples by using chromID™ CPS® EliteAgar (BioMérieux, France) from canine and feline specimens submitted to a veterinary laboratory in Portugal (INNO Veterinary Laboratory, Braga)from January to March2022. All urine samples were cultivated in CPS Elite Agar with calibrated 1 µL inoculating loop and incubated at 37ºC for 18-24h. Color,size, and shape (regular or irregular outline)were recorded for all samples. All colonies were classified as Gram-negative or Gram-positive bacteriausing Gram stain (PREVI® Color BioMérieux, France) and determined if they were pure colonies. Identification of bacteria species was performed using GP and GN cards inVitek 2® Compact(BioMérieux, France). A total of 256/1003 submitted urine samples presented bacterial growth, from which 172 isolates were included in this study. The sample’s population included 111 dogs (n=45 males and n=66 females) and 61 cats (n=35 males and n=26 females). The most frequent isolated bacteria wasEscherichia coli (44,7%), followed by Proteus mirabilis (13,4%). All Escherichia coli isolates presented red to burgundy colonies, a colony diameter between 2 to 6 mm, and regular or irregular outlines. Similarly, 100% of Proteus mirabilis isolates were dark yellow colonies with a diffuse pigment and the same size and shape as Escherichia coli. White and pink pale colonies where Staphylococcus species exclusively and S. pseudintermedius was the most frequent (8,2 %). Cian to blue colonies were mostly Enterococcusspp. (8,2%) and Streptococcus spp. (4,6%). Beige to brown colonies were Pseudomonas aeruginosa (2,9%) and Citrobacter spp. (1,2%).Klebsiella spp.,Serratia spp. and Enterobacter spp were green colonies. All Gram-positive isolates were 1 to 2 mm diameter long and had a regular outline, meanwhile, Gram-negative rods presented variable patterns. This results showed that theprevalence of E coli and P. mirabilis as uropathogenic agents follows the same trends in Europe as previously described in other studies. Both agents presented a particular color pattern in CPS Elite Agar to identify them without needing complementary tests. No other bacteria genus could be correlated strongly to a specific color pattern, and similar results have been observed instudies using human’s samples. Chromogenic media shows a great advantage for common urine bacteria isolation than traditional COS, McConkey, and CLEDAgar mediums in a routine context, especially when mixed fermentative Gram-negative agents grow simultaneously. In addition, CPS Elite Agar is versatile for Artificial Intelligent Reading Plates Systems. Routine veterinarian laboratories could use CPS Elite Agar for a rapid screening for bacteria identification,mainlyE coli and P.mirabilis, saving 6h to 10h of automatized identification.

Keywords: cats, CPS elite agar, dogs, urine pathogens

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73 Optimization of Geometric Parameters of Microfluidic Channels for Flow-Based Studies

Authors: Parth Gupta, Ujjawal Singh, Shashank Kumar, Mansi Chandra, Arnab Sarkar

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Microfluidic devices have emerged as indispensable tools across various scientific disciplines, offering precise control and manipulation of fluids at the microscale. Their efficacy in flow-based research, spanning engineering, chemistry, and biology, relies heavily on the geometric design of microfluidic channels. This work introduces a novel approach to optimise these channels through Response Surface Methodology (RSM), departing from the conventional practice of addressing one parameter at a time. Traditionally, optimising microfluidic channels involved isolated adjustments to individual parameters, limiting the comprehensive understanding of their combined effects. In contrast, our approach considers the simultaneous impact of multiple parameters, employing RSM to efficiently explore the complex design space. The outcome is an innovative microfluidic channel that consumes an optimal sample volume and minimises flow time, enhancing overall efficiency. The relevance of geometric parameter optimization in microfluidic channels extends significantly in biomedical engineering. The flow characteristics of porous materials within these channels depend on many factors, including fluid viscosity, environmental conditions (such as temperature and humidity), and specific design parameters like sample volume, channel width, channel length, and substrate porosity. This intricate interplay directly influences the performance and efficacy of microfluidic devices, which, if not optimized, can lead to increased costs and errors in disease testing and analysis. In the context of biomedical applications, the proposed approach addresses the critical need for precision in fluid flow. it mitigate manufacturing costs associated with trial-and-error methodologies by optimising multiple geometric parameters concurrently. The resulting microfluidic channels offer enhanced performance and contribute to a streamlined, cost-effective process for testing and analyzing diseases. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing.

Keywords: microfluidic device, minitab, statistical optimization, response surface methodology

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72 Micro-Oculi Facades as a Sustainable Urban Facade

Authors: Ok-Kyun Im, Kyoung Hee Kim

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We live in an era that faces global challenges of climate changes and resource depletion. With the rapid urbanization and growing energy consumption in the built environment, building facades become ever more important in architectural practice and environmental stewardship. Furthermore, building facade undergoes complex dynamics of social, cultural, environmental and technological changes. Kinetic facades have drawn attention of architects, designers, and engineers in the field of adaptable, responsive and interactive architecture since 1980’s. Materials and building technologies have gradually evolved to address the technical implications of kinetic facades. The kinetic façade is becoming an independent system of the building, transforming the design methodology to sustainable building solutions. Accordingly, there is a need for a new design methodology to guide the design of a kinetic façade and evaluate its sustainable performance. The research objectives are two-fold: First, to establish a new design methodology for kinetic facades and second, to develop a micro-oculi façade system and assess its performance using the established design method. The design approach to the micro-oculi facade is comprised of 1) façade geometry optimization and 2) dynamic building energy simulation. The façade geometry optimization utilizes multi-objective optimization process, aiming to balance the quantitative and qualitative performances to address the sustainability of the built environment. The dynamic building energy simulation was carried out using EnergyPlus and Radiance simulation engines with scripted interfaces. The micro-oculi office was compared with an office tower with a glass façade in accordance with ASHRAE 90.1 2013 to understand its energy efficiency. The micro-oculi facade is constructed with an array of circular frames attached to a pair of micro-shades called a micro-oculus. The micro-oculi are encapsulated between two glass panes to protect kinetic mechanisms with longevity. The micro-oculus incorporates rotating gears that transmit the power to adjacent micro-oculi to minimize the number of mechanical parts. The micro-oculus rotates around its center axis with a step size of 15deg depending on the sun’s position while maximizing daylighting potentials and view-outs. A 2 ft by 2ft prototyping was undertaken to identify operational challenges and material implications of the micro-oculi facade. In this research, a systematic design methodology was proposed, that integrates multi-objectives of kinetic façade design criteria and whole building energy performance simulation within a holistic design process. This design methodology is expected to encourage multidisciplinary collaborations between designers and engineers to collaborate issues of the energy efficiency, daylighting performance and user experience during design phases. The preliminary energy simulation indicated that compared to a glass façade, the micro-oculi façade showed energy savings due to its improved thermal properties, daylighting attributes, and dynamic solar performance across the day and seasons. It is expected that the micro oculi façade provides a cost-effective, environmentally-friendly, sustainable, and aesthetically pleasing alternative to glass facades. Recommendations for future studies include lab testing to validate the simulated data of energy and optical properties of the micro-oculi façade. A 1:1 performance mock-up of the micro-oculi façade can suggest in-depth understanding of long-term operability and new development opportunities applicable for urban façade applications.

Keywords: energy efficiency, kinetic facades, sustainable architecture, urban facades

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71 A Two-Step, Temperature-Staged, Direct Coal Liquefaction Process

Authors: Reyna Singh, David Lokhat, Milan Carsky

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The world crude oil demand is projected to rise to 108.5 million bbl/d by the year 2035. With reserves estimated at 869 billion tonnes worldwide, coal is an abundant resource. This work was aimed at producing a high value hydrocarbon liquid product from the Direct Coal Liquefaction (DCL) process at, comparatively, mild operating conditions. Via hydrogenation, the temperature-staged approach was investigated. In a two reactor lab-scale pilot plant facility, the objectives included maximising thermal dissolution of the coal in the presence of a hydrogen donor solvent in the first stage, subsequently promoting hydrogen saturation and hydrodesulphurization (HDS) performance in the second. The feed slurry consisted of high grade, pulverized bituminous coal on a moisture-free basis with a size fraction of < 100μm; and Tetralin mixed in 2:1 and 3:1 solvent/coal ratios. Magnetite (Fe3O4) at 0.25wt% of the dry coal feed was added for the catalysed runs. For both stages, hydrogen gas was used to maintain a system pressure of 100barg. In the first stage, temperatures of 250℃ and 300℃, reaction times of 30 and 60 minutes were investigated in an agitated batch reactor. The first stage liquid product was pumped into the second stage vertical reactor, which was designed to counter-currently contact the hydrogen rich gas stream and incoming liquid flow in the fixed catalyst bed. Two commercial hydrotreating catalysts; Cobalt-Molybdenum (CoMo) and Nickel-Molybdenum (NiMo); were compared in terms of their conversion, selectivity and HDS performance at temperatures 50℃ higher than the respective first stage tests. The catalysts were activated at 300°C with a hydrogen flowrate of approximately 10 ml/min prior to the testing. A gas-liquid separator at the outlet of the reactor ensured that the gas was exhausted to the online VARIOplus gas analyser. The liquid was collected and sampled for analysis using Gas Chromatography-Mass Spectrometry (GC-MS). Internal standard quantification methods for the sulphur content, the BTX (benzene, toluene, and xylene) and alkene quality; alkanes and polycyclic aromatic hydrocarbon (PAH) compounds in the liquid products were guided by ASTM standards of practice for hydrocarbon analysis. In the first stage, using a 2:1 solvent/coal ratio, an increased coal to liquid conversion was favoured by a lower operating temperature of 250℃, 60 minutes and a system catalysed by magnetite. Tetralin functioned effectively as the hydrogen donor solvent. A 3:1 ratio favoured increased concentrations of the long chain alkanes undecane and dodecane, unsaturated alkenes octene and nonene and PAH compounds such as indene. The second stage product distribution showed an increase in the BTX quality of the liquid product, branched chain alkanes and a reduction in the sulphur concentration. As an HDS performer and selectivity to the production of long and branched chain alkanes, NiMo performed better than CoMo. CoMo is selective to a higher concentration of cyclohexane. For 16 days on stream each, NiMo had a higher activity than CoMo. The potential to cover the demand for low–sulphur, crude diesel and solvents from the production of high value hydrocarbon liquid in the said process, is thus demonstrated.

Keywords: catalyst, coal, liquefaction, temperature-staged

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70 The Role of a Specialized Diet for Management of Fibromyalgia Symptoms: A Systematic Review

Authors: Siddhant Yadav, Rylea Ranum, Hannah Alberts, Abdul Kalaiger, Brent Bauer, Ryan Hurt, Ann Vincent, Loren Toussaint, Sanjeev Nanda

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Background and significance: Fibromyalgia (FM) is a chronic pain disorder also characterized by chronic fatigue, morning stiffness, sleep, and cognitive symptoms, psychological disturbances (anxiety, depression), and is comorbid with multiple medical and psychiatric conditions. It has an incidence of 2-4% in the general population and is reported more commonly in women. Oxidative stress and inflammation are thought to contribute to pain in patients with FM, and the adoption of an antioxidant/anti-inflammatory diet has been suggested as a modality to alleviate symptoms. The aim of this systematic review was to evaluate the efficacy of specialized diets (ketogenic, gluten free, Mediterranean, and low carbohydrate) in improving FM symptoms. Methodology: A comprehensive search of the following databases from inception to July 15th, 2021, was conducted: Ovid MEDLINE and Epub ahead of print, in-process and other non-indexed citations and daily, Ovid Embase, Ovid EBM reviews, Cochrane central register of controlled trials, EBSCO host CINAHL with full text, Elsevier Scopus, website and citation index, web of science emerging sources citation and clinicaltrials.gov. We included randomized controlled trials, non-randomized experimental studies, cross-sectional studies, cohort studies, case series, and case reports in adults with fibromyalgia. The risk of bias was assessed with the Agency for Health Care Research and Quality designed, specific recommended criteria (AHRQ). Results: Thirteen studies were eligible for inclusion. This included a total of 761 participants. Twelve out of the 13 studies reported improvement in widespread body pain, joint stiffness, sleeping pattern, mood, and gastrointestinal symptoms, and one study reported no changes in symptomatology in patients with FM on specialized diets. None of the studies showed the worsening of symptoms associated with a specific diet. Most of the patient population was female, with the mean age at which fibromyalgia was diagnosed being 48.12 years. Improvement in symptoms was reported by the patient's adhering to a gluten-free diet, raw vegan diet, tryptophan- and magnesium-enriched Mediterranean diet, aspartame- and msg- elimination diet, and specifically a Khorasan wheat diet. Risk of bias assessment noted that 6 studies had a low risk of bias (5 clinical trials and 1 case series), four studies had a moderate risk of bias, and 3 had a high risk of bias. In many of the studies, the allocation of treatment (diets) was not adequately concealed, and the researchers did not rule out any potential impact from a concurrent intervention or an unintended exposure that might have biased the results. On the other hand, there was a low risk of attrition bias in all the trials; all were conducted with an intention-to-treat, and the inclusion/exclusion criteria, exposures/interventions, and primary outcomes were valid, reliable, and implemented consistently across all study participants. Concluding statement: Patients with fibromyalgia who followed specialized diets experienced a variable degree of improvement in their widespread body pain. Improvement was also seen in stiffness, fatigue, moods, sleeping patterns, and gastrointestinal symptoms. Additionally, the majority of the patients also reported improvement in overall quality of life.

Keywords: fibromyalgia, specialized diet, vegan, gluten free, Mediterranean, systematic review

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69 Uterine Leiomyomas and Urological Complications

Authors: Dharshini Selvarajah, Nicula Lui, Karen Kong

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Background: Uterine fibroids are a common benign gynaecologic neoplasm in reproductive-aged women. Fibroids may become symptomatic in a vast majority of nulliparous women. Their diagnosis and management is often coordinated between gyneacologists, radiologists and urologists depending on the anatomical location, growth, size and the fibroids sarcomatous evolvement. Some patients may develop obstructive uropathy symptoms, either uni or bilateral secondary urethral obstruction causing hydronephrosis. Uterine artery emoblisation (UAE) has previously shown to effectively resolve symptoms as well as relieve urethral obstruction and resolve the hydronephrosis. UAE has now established itself as an organ preserving and minimally invasive procedure in the management of symptomatic uterine fibroids. It is a safe and effective alternative to hysterectomy for resolving fibroid related pressure symptoms. The case presented examines the clinical manifestations and impact of uterine fibroids on the urinary tract system. The therapeutic options to relieve the urological symptoms as well as preserve fertility are explored and presented. Case: The case is a 29-year-old Nepalese female admitted to hospital with recurrent urosepsis with multiresistant organisms. This was on a background of an enlarged uterus (measuring 17cm x11cm) with multiple subserosal, intramural and exophytic fibroids- causing external ureteric compression. She had bilateral ureteric stents insitu and required bilateral right and left nephrostomies during repeated episodes of urosepsis and bilateral ureteric obstruction. The left nephrostomy was removed a month prior to admission and her most recent CT KUB demonstrated hypofunctioning ureteric stents with bilateral hydronephrosis. Options of hysterectomy versus uterine artery emoblisation (UAE) were extensively explored. The patient was keen to preserve fertility. Risks associated with UAE such as expulsion of the submucosal component of the fibroids and the possibilities of sepsis in the setting of ongoing ureteric colonisation were particularly high. The patient opted to trial UAE even though the risks of recurrent hospital admissions with urosepsis were going to be particularly high. In the event, the uterus fails to shrink adequately enough to relieve the obstructed ureters a hysterectomy would inevitably be required in future. Day 3 post UAE the patient developed fevers, was hypotensive and tachycardic post-receiving prophylactic meropenem and fluconazole pre emoblisation. She was noted to have a CRP of 293 with the most recent urine culture during this time growing Candida albicans. The patient was recommenced on oral fluconazole and IV meropenem, with good effect. Her repeat renal tract ultrasound post-UAE showed ongoing marked left hydronephrosis relatively unchanged from the scan one month prior to the procedure, however the right-sided hydronephrosis had resolved. The patient was discharged on a 2-week course of antibiotics. The patient will have a repeat renal tract ultrasound and MRI of the ureters to re-evaluate the degree of hydronephrosis and progress- this was unavailable at the time of abstract submission and will be presented at the conference. Conclusion: Fibroids are a common benign tumour of the uterus and can frequently impact the lower urinary system resulting in significant uropathy. They often enlarge and compress the urinary bladder, urethra and lower end of the ureters. The effectiveness of UAE as a fertility preserving option is described.

Keywords: Uterine leiomyomas and urological complications, uterine artery embolisation for fibroids, Uterine fibroids and complications, Management of uterine fibroids

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