Search results for: robotic library
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 930

Search results for: robotic library

90 DNA Hypomethylating Agents Induced Histone Acetylation Changes in Leukemia

Authors: Sridhar A. Malkaram, Tamer E. Fandy

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Purpose: 5-Azacytidine (5AC) and decitabine (DC) are DNA hypomethylating agents. We recently demonstrated that both drugs increase the enzymatic activity of the histone deacetylase enzyme SIRT6. Accordingly, we are comparing the changes H3K9 acetylation changes in the whole genome induced by both drugs using leukemia cells. Description of Methods & Materials: Mononuclear cells from the bone marrow of six de-identified naive acute myeloid leukemia (AML) patients were cultured with either 500 nM of DC or 5AC for 72 h followed by ChIP-Seq analysis using a ChIP-validated acetylated-H3K9 (H3K9ac) antibody. Chip-Seq libraries were prepared from treated and untreated cells using SMARTer ThruPLEX DNA- seq kit (Takara Bio, USA) according to the manufacturer’s instructions. Libraries were purified and size-selected with AMPure XP beads at 1:1 (v/v) ratio. All libraries were pooled prior to sequencing on an Illumina HiSeq 1500. The dual-indexed single-read Rapid Run was performed with 1x120 cycles at 5 pM final concentration of the library pool. Sequence reads with average Phred quality < 20, with length < 35bp, PCR duplicates, and those aligning to blacklisted regions of the genome were filtered out using Trim Galore v0.4.4 and cutadapt v1.18. Reads were aligned to the reference human genome (hg38) using Bowtie v2.3.4.1 in end-to-end alignment mode. H3K9ac enriched (peak) regions were identified using diffReps v1.55.4 software using input samples for background correction. The statistical significance of differential peak counts was assessed using a negative binomial test using all individuals as replicates. Data & Results: The data from the six patients showed significant (Padj<0.05) acetylation changes at 925 loci after 5AC treatment versus 182 loci after DC treatment. Both drugs induced H3K9 acetylation changes at different chromosomal regions, including promoters, coding exons, introns, and distal intergenic regions. Ten common genes showed H3K9 acetylation changes by both drugs. Approximately 84% of the genes showed an H3K9 acetylation decrease by 5AC versus 54% only by DC. Figures 1 and 2 show the heatmaps for the top 100 genes and the 99 genes showing H3K9 acetylation decrease after 5AC treatment and DC treatment, respectively. Conclusion: Despite the similarity in hypomethylating activity and chemical structure, the effect of both drugs on H3K9 acetylation change was significantly different. More changes in H3K9 acetylation were observed after 5 AC treatments compared to DC. The impact of these changes on gene expression and the clinical efficacy of these drugs requires further investigation.

Keywords: DNA methylation, leukemia, decitabine, 5-Azacytidine, epigenetics

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89 The Influence of Human Movement on the Formation of Adaptive Architecture

Authors: Rania Raouf Sedky

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Adaptive architecture relates to buildings specifically designed to adapt to their residents and their environments. To design a biologically adaptive system, we can observe how living creatures in nature constantly adapt to different external and internal stimuli to be a great inspiration. The issue is not just how to create a system that is capable of change but also how to find the quality of change and determine the incentive to adapt. The research examines the possibilities of transforming spaces using the human body as an active tool. The research also aims to design and build an effective dynamic structural system that can be applied on an architectural scale and integrate them all into the creation of a new adaptive system that allows us to conceive a new way to design, build and experience architecture in a dynamic manner. The main objective was to address the possibility of a reciprocal transformation between the user and the architectural element so that the architecture can adapt to the user, as the user adapts to architecture. The motivation is the desire to deal with the psychological benefits of an environment that can respond and thus empathize with human emotions through its ability to adapt to the user. Adaptive affiliations of kinematic structures have been discussed in architectural research for more than a decade, and these issues have proven their effectiveness in developing kinematic structures, responsive and adaptive, and their contribution to 'smart architecture'. A wide range of strategies have been used in building complex kinetic and robotic systems mechanisms to achieve convertibility and adaptability in engineering and architecture. One of the main contributions of this research is to explore how the physical environment can change its shape to accommodate different spatial displays based on the movement of the user’s body. The main focus is on the relationship between materials, shape, and interactive control systems. The intention is to develop a scenario where the user can move, and the structure interacts without any physical contact. The soft form of shifting language and interaction control technology will provide new possibilities for enriching human-environmental interactions. How can we imagine a space in which to construct and understand its users through physical gestures, visual expressions, and response accordingly? How can we imagine a space whose interaction depends not only on preprogrammed operations but on real-time feedback from its users? The research also raises some important questions for the future. What would be the appropriate structure to show physical interaction with the dynamic world? This study concludes with a strong belief in the future of responsive motor structures. We imagine that they are developing the current structure and that they will radically change the way spaces are tested. These structures have obvious advantages in terms of energy performance and the ability to adapt to the needs of users. The research highlights the interface between remote sensing and a responsive environment to explore the possibility of an interactive architecture that adapts to and responds to user movements. This study ends with a strong belief in the future of responsive motor structures. We envision that it will improve the current structure and that it will bring a fundamental change to the way in which spaces are tested.

Keywords: adaptive architecture, interactive architecture, responsive architecture, tensegrity

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88 Examining the Concept of Sustainability in the Scenery Architecture of Naqsh-e-Jahan Square

Authors: Mahmood Naghizadeh, Maryam Memarian, Hourshad Irvash

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Following the rise in the world population and the upward growth of urbanization, the design, planning, and management of the site scenery for the purpose of presentation and expansion of sustainable site scenery has turned to be the greatest concern to experts. Since the fundamental principles of the site scenery change more and less haphazardly over time, sustainable site scenery can be viewed as an ideal goal because both sustainability and dynamism come into view in urban site scenery and it wouldn’t be designed according to a set of pre-determined principles. Sustainable site scenery, as the ongoing interaction between idealism and pragmatism with sustainability factors, is a dynamic phenomenon created by bringing cultural, historical, social and natural scenery together. Such an interaction is not to subdue other factors but to reinforce the aforementioned factors. The sustainable site scenery is a persistently occurring event not only has attenuated over time but has gained strength. The sustainability of a site scenery or an event over time depends on its site identity which grows out of its continuous association with the past. The sustainability of a site scene or an event in a time frame intertwined with the identity of the place from past to present. This past history supports the present and future of the scene. The result of such a supportive role is the sustainability of site scenery. Isfahan Naqsh-e-Jahan Square is one of the most outstanding squares in the world and the best embodiment of Iranian site scenery architecture. This square is an arena that brings people together and a dynamic city center comprising various urban and religious complexes, spaces and facilities and is considered as one of the most favorable traditional urban space of Iran. Such a place can illustrate many factors related to sustainable site scenery. One the other hand, there are still no specific principles concerning sustainability in the architecture of site scenery. Meanwhile, sustainability is recognized as a rather modern view in architecture. The purpose of this research is to identify factors involved in sustainability in general and to examine their effects on site scenery architecture in particular. Finally, these factors will be studied with taking Naqsh-e-Jahan Square into account. This research adopts an analytic-descriptive approach that has benefited from the review of literature available in library studies and the documents related to sustainability and site scenery architecture. The statistical population used for the purpose of this research includes square constructed during the Safavid dynasty and Naqsh-e-Jahan Square was picked out as the case study. The purpose of this paper is to come up with a rough definition of sustainable site scenery and demonstrate this concept by analyzing it and recognizing the social, economic and ecological aspects of this project.

Keywords: Naqsh-e-Jahan Square, site scenery architecture, sustainability, sustainable site scenery

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87 Data Mining in Healthcare for Predictive Analytics

Authors: Ruzanna Muradyan

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Medical data mining is a crucial field in contemporary healthcare that offers cutting-edge tactics with enormous potential to transform patient care. This abstract examines how sophisticated data mining techniques could transform the healthcare industry, with a special focus on how they might improve patient outcomes. Healthcare data repositories have dynamically evolved, producing a rich tapestry of different, multi-dimensional information that includes genetic profiles, lifestyle markers, electronic health records, and more. By utilizing data mining techniques inside this vast library, a variety of prospects for precision medicine, predictive analytics, and insight production become visible. Predictive modeling for illness prediction, risk stratification, and therapy efficacy evaluations are important points of focus. Healthcare providers may use this abundance of data to tailor treatment plans, identify high-risk patient populations, and forecast disease trajectories by applying machine learning algorithms and predictive analytics. Better patient outcomes, more efficient use of resources, and early treatments are made possible by this proactive strategy. Furthermore, data mining techniques act as catalysts to reveal complex relationships between apparently unrelated data pieces, providing enhanced insights into the cause of disease, genetic susceptibilities, and environmental factors. Healthcare practitioners can get practical insights that guide disease prevention, customized patient counseling, and focused therapies by analyzing these associations. The abstract explores the problems and ethical issues that come with using data mining techniques in the healthcare industry. In order to properly use these approaches, it is essential to find a balance between data privacy, security issues, and the interpretability of complex models. Finally, this abstract demonstrates the revolutionary power of modern data mining methodologies in transforming the healthcare sector. Healthcare practitioners and researchers can uncover unique insights, enhance clinical decision-making, and ultimately elevate patient care to unprecedented levels of precision and efficacy by employing cutting-edge methodologies.

Keywords: data mining, healthcare, patient care, predictive analytics, precision medicine, electronic health records, machine learning, predictive modeling, disease prognosis, risk stratification, treatment efficacy, genetic profiles, precision health

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86 Epigastric Pain in Emergency Room: Median Arcuate Ligament Syndrome

Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

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Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

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85 Development of Earthquake and Typhoon Loss Models for Japan, Specifically Designed for Underwriting and Enterprise Risk Management Cycles

Authors: Nozar Kishi, Babak Kamrani, Filmon Habte

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Natural hazards such as earthquakes and tropical storms, are very frequent and highly destructive in Japan. Japan experiences, every year on average, more than 10 tropical cyclones that come within damaging reach, and earthquakes of moment magnitude 6 or greater. We have developed stochastic catastrophe models to address the risk associated with the entire suite of damaging events in Japan, for use by insurance, reinsurance, NGOs and governmental institutions. KCC’s (Karen Clark and Company) catastrophe models are procedures constituted of four modular segments: 1) stochastic events sets that would represent the statistics of the past events, hazard attenuation functions that could model the local intensity, vulnerability functions that would address the repair need for local buildings exposed to the hazard, and financial module addressing policy conditions that could estimates the losses incurring as result of. The events module is comprised of events (faults or tracks) with different intensities with corresponding probabilities. They are based on the same statistics as observed through the historical catalog. The hazard module delivers the hazard intensity (ground motion or wind speed) at location of each building. The vulnerability module provides library of damage functions that would relate the hazard intensity to repair need as percentage of the replacement value. The financial module reports the expected loss, given the payoff policies and regulations. We have divided Japan into regions with similar typhoon climatology, and earthquake micro-zones, within each the characteristics of events are similar enough for stochastic modeling. For each region, then, a set of stochastic events is developed that results in events with intensities corresponding to annual occurrence probabilities that are of interest to financial communities; such as 0.01, 0.004, etc. The intensities, corresponding to these probabilities (called CE, Characteristics Events) are selected through a superstratified sampling approach that is based on the primary uncertainty. Region specific hazard intensity attenuation functions followed by vulnerability models leads to estimation of repair costs. Extensive economic exposure model addresses all local construction and occupancy types, such as post-linter Shinand Okabe wood, as well as concrete confined in steel, SRC (Steel-Reinforced Concrete), high-rise.

Keywords: typhoon, earthquake, Japan, catastrophe modelling, stochastic modeling, stratified sampling, loss model, ERM

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84 The Relationship of Depression Risk and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Authors: Yu Chen Su

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Introduction: Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance in pregnant women, impacting both the mother and newborn with short and long-term effects. It increases risks of preeclampsia, hypertension, type 2 diabetes, cesarean section, and preterm birth. GDM is associated with fetal macrosomia, shoulder dystocia, neonatal hypoglycemia, and future type 2 diabetes risk. A study on 6,421 pregnant women found 12% experienced high stress, linked to maladaptive coping and depressive emotions. Women with high-risk pregnancies may experience greater stress and depression. Research suggests GDM increases depression prevalence. A study on 632 Hispanic women with GDM showed severe stress and depression tendencies. Involving 95 women with GDM, 33.4% exhibited depression symptoms. Another study compared 180 GDM women to 186 with normal glucose levels, revealing higher depression levels in GDM women. They found GDM women were 1.85 times more likely to receive antidepressants during pregnancy and 1.69 times more likely to experience postpartum depression. Maternal stress and depressive symptoms during pregnancy are significant factors. Early identification by healthcare professionals can greatly benefit GDM women, their infants, and their families. Objectives: The purpose of this study was to investigate the association between gestational diabetes mellitus (GDM) and the risk of depression. Methods: This study reviewed and analyzed relevant literature on gestational diabetes mellitus (GDM) and depression in 6,876 patients. The literature search followed PRISMA guidelines and included databases like Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library. Prospective or retrospective studies with relevant risk ratios and estimates were included, using a random-effects model for the analysis of depression risk correlation. Studies without depression data or relevant risks were excluded. The search period extended until October 2022. Results: Systematic review of 7 studies (6,876 participants) found a significant association (OR = 8.77, CI: 7.98-9.64, p < 0.05) between gestational diabetes mellitus (GDM) and higher depression risk compared to healthy pregnant women. Conclusions: Pregnancy is a significant life transition involving physiological, psychological, and social changes. Gestational diabetes poses challenges to women's physical and mental well-being. Sensitive healthcare professionals identifying issues early can greatly benefit women, babies, and the family.

Keywords: gestational diabetes, depression, systematic review, neta-analysis

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83 Magnitude of Transactional Sex and Its Determinant Factors Among Women in Sub-Saharan Africa: Systematic Review and Meat Analysis

Authors: Gedefaye Nibret Mihretie

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Background: Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. Many primary studies in Sub-Saharan Africa have been conducted to assess the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. Method: Cross-sectional studies were systematically searched from March 6, 2022, to April 24, 2022, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of transactional sex and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies' heterogeneity. A funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years, source of data, sample sizes and geographical location. Results: Four thousand one hundred thirty articles were extracted from various databases. The final thirty-two studies were included in this systematic review, including 108,075 participants. The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55%, with a confidence interval of 9.59% to 15.52%. Educational status (OR = .48, 95%CI, 0.27, 0.69) was the protective factors of transactional sex whereas, alcohol use (OR = 1.85, 95% CI: 1.19, 2.52), early sex debut (OR = 2.57, 95%CI, 1.17, 3.98), substance abuse (OR = 4.21, 95% CI: 2.05, 6.37), having history of sexual experience abuse (OR = 4.08, 95% CI: 1.38, 6.78), physical violence abuse (OR = 6.59, 95% CI: 1.17, 12.02), and sexual violence abuse (OR = 3.56, 95% CI: 1.15, 8.27) were the risk factors of transactional sex. Conclusion: The prevalence of transactional sex among women in Sub-Saharan Africa was high. Educational status, alcohol use, substance abuse, early sex debut, having a history of sexual experiences, physical violence, and sexual violence were predictors of transaction sex. Governmental and other stakeholders are designed to reduce alcohol utilization, provide health information about the negative consequences of early sex debut, substance abuse, and reduce sexual violence, ensuring gender equality through mass media, which should be included in state policy.

Keywords: women’s health, child health, reproductive health, midwifery

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82 Effectiveness of N-Acetylcysteine in the Treatment of Adults with Trichotillomania: An Evidenced Based Review

Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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81 Interventions to Improve the Performance of Community Based Health Insurance in Low- and Lower Middle-Income-Countries: a Systematic Review

Authors: Scarlet Tabot Enanga Longsti

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Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

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80 The Use of Information and Communication Technology within and between Emergency Medical Teams during a Disaster: A Qualitative study

Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospital Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre- EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors that are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality, and the data were analyzed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system that can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analyzed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospital staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: emergency medical teams, communication, information and communication technologies, disaster

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79 The Historical Background of Physical Changing Towards Ancient Mosques in Aceh, Indonesia

Authors: Karima Adilla

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Aceh province, into which Islam convinced to have entered Indonesia in the 12th Century before spreading throughout the archipelago and the rest of Southeast Asia, has several early Islamic mosques that still exist until today. However, due to some circumstances, the restoration and rehabilitation towards those mosques have been made in some periods, while the background was diverse. Concerning this, the research will examine the physical changing aspects of 3 prominent historical mosques in Aceh Besar and Banda Aceh; those are, Indrapuri Mosque, Baiturrahman Grand Mosque, and Baiturrahim Mosque built coincided with the beginning of Islam’s development in Aceh and regarded as eventful mosques. The existence of Indrapuri Mosque built on the remains of the Lamuri Kingdom’s temple is a historical trace that there was Hindu-Buddhist civilization in Aceh before Islam entered and became the majority religion about 98% from Aceh total population. Also, there was the Dutch who colonialized Aceh behind the existence of two famous mosques in Aceh, namely Baiturrahman Grand Mosque and Baiturrahim Mosque, as the colonizer also assisted to rebuild those 2 sacred Mosques to quell the anger of the Acehnese people because their mosque was burnt by the Dutch. Interestingly, despite underwent a long history successively since the rise of Islam after the Hindu-Buddhist kingdom had collapsed, colonialization, conflict, in Aceh, and even experienced the earthquake and tsunami disaster in 2004, those mosques still exist. Therefore, those mosques have been considered as historical silent witnesses. However, it was not merely those reasons that led the mosques underwent several physical changes, otherwise economic, political, social, cultural and religious factors were also highly influential. Instead of directly illustrating the physical changing of those three mosques, this research intends to identify under what condition the physical appearance continuously changing during the sultanate era, the colonial period until post-independent in terms of the architectural style, detail elements, design philosophy, and how the remnants buildings act as medium to bridge the history. A framework will use qualitative research methods by collecting actual data of the mosque's physical change figures through field studies, investigations, library studies and interviews. This research aims to define every trace of historical issues embedded in the physical changing of those mosques as they are intertwined in collecting historical proof. Thus, the result will reveal the characteristic interrelation between history, the mosque architectural style in a certain period, the physical changes background and its impact. Eventually, this research will also explicate a clear inference of each mosque’s role in representing history in Aceh Besar and Banda Aceh specifically, as well as Aceh generally through architectural design concepts.

Keywords: Aceh ancient mosques, Aceh history, Islamic architecture, physical changing

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78 Mapping Context, Roles, and Relations for Adjudicating Robot Ethics

Authors: Adam J. Bowen

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Abstract— Should robots have rights or legal protections. Often debates concerning whether robots and AI should be afforded rights focus on conditions of personhood and the possibility of future advanced forms of AI satisfying particular intrinsic cognitive and moral attributes of rights-holding persons. Such discussions raise compelling questions about machine consciousness, autonomy, and value alignment with human interests. Although these are important theoretical concerns, especially from a future design perspective, they provide limited guidance for addressing the moral and legal standing of current and near-term AI that operate well below the cognitive and moral agency of human persons. Robots and AI are already being pressed into service in a wide range of roles, especially in healthcare and biomedical contexts. The design and large-scale implementation of robots in the context of core societal institutions like healthcare systems continues to rapidly develop. For example, we bring them into our homes, hospitals, and other care facilities to assist in care for the sick, disabled, elderly, children, or otherwise vulnerable persons. We enlist surgical robotic systems in precision tasks, albeit still human-in-the-loop technology controlled by surgeons. We also entrust them with social roles involving companionship and even assisting in intimate caregiving tasks (e.g., bathing, feeding, turning, medicine administration, monitoring, transporting). There have been advances to enable severely disabled persons to use robots to feed themselves or pilot robot avatars to work in service industries. As the applications for near-term AI increase and the roles of robots in restructuring our biomedical practices expand, we face pressing questions about the normative implications of human-robot interactions and collaborations in our collective worldmaking, as well as the moral and legal status of robots. This paper argues that robots operating in public and private spaces be afforded some protections as either moral patients or legal agents to establish prohibitions on robot abuse, misuse, and mistreatment. We already implement robots and embed them in our practices and institutions, which generates a host of human-to-machine and machine-to-machine relationships. As we interact with machines, whether in service contexts, medical assistance, or home health companions, these robots are first encountered in relationship to us and our respective roles in the encounter (e.g., surgeon, physical or occupational therapist, recipient of care, patient’s family, healthcare professional, stakeholder). This proposal aims to outline a framework for establishing limiting factors and determining the extent of moral or legal protections for robots. In doing so, it advocates for a relational approach that emphasizes the priority of mapping the complex contextually sensitive roles played and the relations in which humans and robots stand to guide policy determinations by relevant institutions and authorities. The relational approach must also be technically informed by the intended uses of the biomedical technologies in question, Design History Files, extensive risk assessments and hazard analyses, as well as use case social impact assessments.

Keywords: biomedical robots, robot ethics, robot laws, human-robot interaction

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77 Challenges of Strategies for Improving Sustainability in Urban Historical Context in Developing Countries: The Case of Shiraz Bein Al-Haramein

Authors: Amir Hossein Ashari, Sedighe Erfan Manesh

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One of the problems in developing countries is renovating the historical context and inducing behaviors appropriate to modern life to such a context. This study was conducted using field and library methods in 2012. Similar cases carried out in Iran and developing countries were compared to unveil the strengths and weaknesses of these projects. At present, in the historical context of Shiraz, the distance between two religious shrines of Shahcheragh (Ahmad ibn Musa) and Astaneh (Sayed Alaa al-Din Hossein), which are significant places in religious, cultural, social, and economic terms, is an area full of historic places called Bein Al-Haramein. Unfortunately, some of these places have been worn out and are not appropriate for common uses. The basic strategy of Bein Al-Haramein was to improve social development of Shiraz, to enhance the vitality and dynamism of the historical context of Bein Al-Haramein and to create tourist attractions in order to boost the city's economic and social stability. To this end, the project includes the huge Bein Al-Haramein Commercial Complex which is under construction now. To construct the complex, officials have decided to demolish places of historical value which can lead to irreparable consequences. Iranian urban design has always been based on three elements of bazaars, mosques and government facilities with bazaars being the organic connector of the other elements. Therefore, the best strategy in the above case is to provide for a commercial connection between the two poles. Although this strategy is included in the project, lack of attention to renovation principles in this area and complete destruction of the context will lead to its irreversible damage and will destroy its cultural and historical identity. In urban planning of this project, some important issues have been neglected including: preserving valuable buildings and special old features of the city, rebuilding worn buildings and context to attract trust and confidence of the people, developing new models according to changes, improving the structural position of old context with minimal degradation, attracting partnerships of residents and protecting their rights and finally using potential facilities of the old context. The best strategy for achieving sustainability in Bein Al-Haramein can be the one used in the distance between Santa Maria Novella and Santa Maria Del Fiore churches in historical context where while protecting the historic context and constructions, old buildings were renovated and given different commercial and service uses making them sustainable and dynamic places. Similarly, in Bein Al-Haramein, renovating old constructions and monuments and giving different commercial and other uses to them can help improve the economic and social sustainability of the area.

Keywords: Bein Al-Haramein, sustainability, historical context, historical context

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76 Digital Literacy Transformation and Implications in Institutions of Higher Learning in Kenya

Authors: Emily Cherono Sawe, Elisha Ondieki Makori

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Knowledge and digital economies have brought challenges and potential opportunities for universities to innovate and improve the quality of learning. Disruption technologies and information dynamics continue to transform and change the landscape in teaching, scholarship, and research activities across universities. Digital literacy is a fundamental and imperative element in higher education and training, as witnessed during the new norm. COVID-19 caused unprecedented disruption in universities, where teaching and learning depended on digital innovations and applications. Academic services and activities were provided online, including library information services. Information professionals were forced to adopt various digital platforms in order to provide information services to patrons. University libraries’ roles in fulfilling educational responsibilities continue to evolve in response to changes in pedagogy, technology, economy, society, policies, and strategies of parent institutions. Libraries are currently undergoing considerable transformational change as a result of the inclusion of a digital environment. Academic libraries have been at the forefront of providing online learning resources and online information services, as well as supporting students and staff to develop digital literacy skills via online courses, tutorials, and workshops. Digital literacy transformation and information staff are crucial elements reminiscent of the prioritization of skills and knowledge for lifelong learning. The purpose of this baseline research is to assess the implications of digital literacy transformation in institutions of higher learning in Kenya and share appropriate strategies to leverage and sustain teaching and research. Objectives include examining the leverage and preparedness of the digital literacy environment in streamlining learning in the universities, exploring and benchmarking imperative digital competence for information professionals, establishing the perception of information professionals towards digital literacy skills, and determining lessons, best practices, and strategies to accelerate digital literacy transformation for effective research and learning in the universities. The study will adopt a descriptive research design using questionnaires and document analysis as the instruments for data collection. The targeted population is librarians and information professionals, as well as academics in public and private universities teaching information literacy programmes. Data and information are to be collected through an online structured questionnaire and digital face-to-face interviews. Findings and results will provide promising lessons together with best practices and strategies to transform and change digital literacies in university libraries in Kenya.

Keywords: digital literacy, digital innovations, information professionals, librarians, higher education, university libraries, digital information literacy

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75 A Literature Review on the Use of Information and Communication Technology within and between Emergency Medical Teams during a Disaster

Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

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74 Combination Therapies Targeting Apoptosis Pathways in Pediatric Acute Myeloid Leukemia (AML)

Authors: Ahlam Ali, Katrina Lappin, Jaine Blayney, Ken Mills

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Leukaemia is the most frequently (30%) occurring type of paediatric cancer. Of these, approximately 80% are acute lymphoblastic leukaemia (ALL) with acute myeloid leukaemia (AML) cases making up the remaining 20% alongside other leukaemias. Unfortunately, children with AML do not have promising prognosis with only 60% surviving 5 years or longer. It has been highlighted recently the need for age-specific therapies for AML patients, with paediatric AML cases having a different mutational landscape compared with AML diagnosed in adult patients. Drug Repurposing is a recognized strategy in drug discovery and development where an already approved drug is used for diseases other than originally indicated. We aim to identify novel combination therapies with the promise of providing alternative more effective and less toxic induction therapy options. Our in-silico analysis highlighted ‘cell death and survival’ as an aberrant, potentially targetable pathway in paediatric AML patients. On this basis, 83 apoptotic inducing compounds were screened. A preliminary single agent screen was also performed to eliminate potentially toxic chemicals, then drugs were constructed into a pooled library with 10 drugs per well over 160 wells, with 45 possible pairs and 120 triples in each well. Seven cell lines were used during this study to represent the clonality of AML in paediatric patients (Kasumi-1, CMK, CMS, MV11-14, PL21, THP1, MOLM-13). Cytotoxicity was assessed up to 72 hours using CellTox™ Green reagent. Fluorescence readings were normalized to a DMSO control. Z-Score was assigned to each well based on the mean and standard deviation of all the data. Combinations with a Z-Score <2 were eliminated and the remaining wells were taken forward for further analysis. A well was considered ‘successful’ if each drug individually demonstrated a Z-Score <2, while the combination exhibited a Z-Score >2. Each of the ten compounds in one well (155) had minimal or no effect as single agents on cell viability however, a combination of two or more of the compounds resulted in a substantial increase in cell death, therefore the ten compounds were de-convoluted to identify a possible synergistic pair/triple combinations. The screen identified two possible ‘novel’ drug pairing, with BCL2 inhibitor ABT-737, combined with either a CDK inhibitor Purvalanol A, or AKT/ PI3K inhibitor LY294002. (ABT-737- 100 nM+ Purvalanol A- 1 µM) (ABT-737- 100 nM+ LY294002- 2 µM). Three possible triple combinations were identified (LY2409881+Akti-1/2+Purvalanol A, SU9516+Akti-1/2+Purvalanol A, and ABT-737+LY2409881+Purvalanol A), which will be taken forward for examining their efficacy at varying concentrations and dosing schedules, across multiple paediatric AML cell lines for optimisation of maximum synergy. We believe that our combination screening approach has potential for future use with a larger cohort of drugs including FDA approved compounds and patient material.

Keywords: AML, drug repurposing, ABT-737, apoptosis

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73 Eucalyptus camaldulensis Leaves Attacked by the Gall Wasp Leptocybe invasa: A Phyto-Volatile Constituents Study

Authors: Maged El-Sayed Mohamed

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Eucalyptus camaldulensis is one on the most well-known species of the genus Eucalyptus in the Middle east, its importance relay on the high production of its unique volatile constituents which exhibits many medicinal and pharmacological activities. The gall-forming wasp (Leptocybe invasa) has recently come into sight as the main pest attacking E. camaldulensis and causing severe injury. The wasp lays its eggs in the petiole and midrib of leaves and stems of young shoots of E. camaldulensis, which leads to gall formation. Gall formation by L. invasa damages growing shoot and leaves of Eucalyptus, resulting in abscission of leaves and drying. AIM: This study is an attempt to investigate the effect of the gall wasp (Leptocybe invasa) attack on the volatile constitutes of E. camaldulensis. This could help in the control of this wasp through stimulating plant defenses or production of a new allelochemicals or insecticide. The study of volatile constitutes of Eucalyptus before and after attack by the wasp can help the re-use and recycle of the infected Eucalyptus trees for new pharmacological and medicinal activities. Methodology: The fresh gall wasp-attacked and healthy leaves (100 g each) were cut and immediately subjected to hydrodistillation using Clevenger-type apparatus for 3 hours. The volatile fractions isolated were analyzed using Gas chromatography/mass spectrometry (GC/MS). Kovat’s retention indices (RI) were calculated with respect to a set of co-injected standard hydrocarbons (C10-C28). Compounds were identified by comparing their spectral data and retention indices with Wiley Registry of Mass Spectral Data 10th edition (April 2013), NIST 11 Mass Spectral Library (NIST11/2011/EPA/NIH) and literature data. Results: Fifty-nine components representing 89.13 and 88.60% of the total volatile fraction content respectively were quantitatively analyzed. Twenty-six major compounds at an average concentration greater than 0.1 ± 0.02% have been used for the statistical comparison. From those major components, twenty-one were found in both the attacked and healthy Eucalyptus leaves’ fractions in different concentration and five components, mono terpene p-Mentha-2-4(8) diene and the sesquiterpenes δ-elemene, β-elemene, E-caryophyllene and Bicyclogermacrene, were unique and only produced in the attacked-leaves’ fraction. CONCLUSION: Newly produced components or those commonly found in the volatile fraction and changed in concentration could represent a part of the plant defense mechanisms or might be an element of the plant allelopathic and communication mechanisms. Identification of the components of the gall wasp-damaged leaves can help in their recycling for different physiological, pharmacological and medicinal uses.

Keywords: Eucalyptus camaldulensis, eucalyptus recycling, gall wasp, Leptocybe invasa, plant defense mechanisms, Terpene fraction

Procedia PDF Downloads 359
72 Solid Particles Transport and Deposition Prediction in a Turbulent Impinging Jet Using the Lattice Boltzmann Method and a Probabilistic Model on GPU

Authors: Ali Abdul Kadhim, Fue Lien

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Solid particle distribution on an impingement surface has been simulated utilizing a graphical processing unit (GPU). In-house computational fluid dynamics (CFD) code has been developed to investigate a 3D turbulent impinging jet using the lattice Boltzmann method (LBM) in conjunction with large eddy simulation (LES) and the multiple relaxation time (MRT) models. This paper proposed an improvement in the LBM-cellular automata (LBM-CA) probabilistic method. In the current model, the fluid flow utilizes the D3Q19 lattice, while the particle model employs the D3Q27 lattice. The particle numbers are defined at the same regular LBM nodes, and transport of particles from one node to its neighboring nodes are determined in accordance with the particle bulk density and velocity by considering all the external forces. The previous models distribute particles at each time step without considering the local velocity and the number of particles at each node. The present model overcomes the deficiencies of the previous LBM-CA models and, therefore, can better capture the dynamic interaction between particles and the surrounding turbulent flow field. Despite the increasing popularity of LBM-MRT-CA model in simulating complex multiphase fluid flows, this approach is still expensive in term of memory size and computational time required to perform 3D simulations. To improve the throughput of each simulation, a single GeForce GTX TITAN X GPU is used in the present work. The CUDA parallel programming platform and the CuRAND library are utilized to form an efficient LBM-CA algorithm. The methodology was first validated against a benchmark test case involving particle deposition on a square cylinder confined in a duct. The flow was unsteady and laminar at Re=200 (Re is the Reynolds number), and simulations were conducted for different Stokes numbers. The present LBM solutions agree well with other results available in the open literature. The GPU code was then used to simulate the particle transport and deposition in a turbulent impinging jet at Re=10,000. The simulations were conducted for L/D=2,4 and 6, where L is the nozzle-to-surface distance and D is the jet diameter. The effect of changing the Stokes number on the particle deposition profile was studied at different L/D ratios. For comparative studies, another in-house serial CPU code was also developed, coupling LBM with the classical Lagrangian particle dispersion model. Agreement between results obtained with LBM-CA and LBM-Lagrangian models and the experimental data is generally good. The present GPU approach achieves a speedup ratio of about 350 against the serial code running on a single CPU.

Keywords: CUDA, GPU parallel programming, LES, lattice Boltzmann method, MRT, multi-phase flow, probabilistic model

Procedia PDF Downloads 207
71 Effects of Drying and Extraction Techniques on the Profile of Volatile Compounds in Banana Pseudostem

Authors: Pantea Salehizadeh, Martin P. Bucknall, Robert Driscoll, Jayashree Arcot, George Srzednicki

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Banana is one of the most important crops produced in large quantities in tropical and sub-tropical countries. Of the total plant material grown, approximately 40% is considered waste and left in the field to decay. This practice allows fungal diseases such as Sigatoka Leaf Spot to develop, limiting plant growth and spreading spores in the air that can cause respiratory problems in the surrounding population. The pseudostem is considered a waste residue of production (60 to 80 tonnes/ha/year), although it is a good source of dietary fiber and volatile organic compounds (VOC’s). Strategies to process banana pseudostem into palatable, nutritious and marketable food materials could provide significant social and economic benefits. Extraction of VOC’s with desirable odor from dried and fresh pseudostem could improve the smell of products from the confectionary and bakery industries. Incorporation of banana pseudostem flour into bakery products could provide cost savings and improve nutritional value. The aim of this study was to determine the effects of drying methods and different banana species on the profile of volatile aroma compounds in dried banana pseudostem. The banana species analyzed were Musa acuminata and Musa balbisiana. Fresh banana pseudostem samples were processed by either freeze-drying (FD) or heat pump drying (HPD). The extraction of VOC’s was performed at ambient temperature using vacuum distillation and the resulting, mostly aqueous, distillates were analyzed using headspace solid phase microextraction (SPME) gas chromatography – mass spectrometry (GC-MS). Optimal SPME adsorption conditions were 50 °C for 60 min using a Supelco 65 μm PDMS/DVB Stableflex fiber1. Compounds were identified by comparison of their electron impact mass spectra with those from the Wiley 9 / NIST 2011 combined mass spectral library. The results showed that the two species have notably different VOC profiles. Both species contained VOC’s that have been established in literature to have pleasant appetizing aromas. These included l-Menthone, D-Limonene, trans-linlool oxide, 1-Nonanol, CIS 6 Nonen-1ol, 2,6 Nonadien-1-ol, Benzenemethanol, 4-methyl, 1-Butanol, 3-methyl, hexanal, 1-Propanol, 2-methyl- acid، 2-Methyl-2-butanol. Results show banana pseudostem VOC’s are better preserved by FD than by HPD. This study is still in progress and should lead to the optimization of processing techniques that would promote the utilization of banana pseudostem in the food industry.

Keywords: heat pump drying, freeze drying, SPME, vacuum distillation, VOC analysis

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70 The Impacts of New Digital Technology Transformation on Singapore Healthcare Sector: Case Study of a Public Hospital in Singapore from a Management Accounting Perspective

Authors: Junqi Zou

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As one of the world’s most tech-ready countries, Singapore has initiated the Smart Nation plan to harness the full power and potential of digital technologies to transform the way people live and work, through the more efficient government and business processes, to make the economy more productive. The key evolutions of digital technology transformation in healthcare and the increasing deployment of Internet of Things (IoTs), Big Data, AI/cognitive, Robotic Process Automation (RPA), Electronic Health Record Systems (EHR), Electronic Medical Record Systems (EMR), Warehouse Management System (WMS in the most recent decade have significantly stepped up the move towards an information-driven healthcare ecosystem. The advances in information technology not only bring benefits to patients but also act as a key force in changing management accounting in healthcare sector. The aim of this study is to investigate the impacts of digital technology transformation on Singapore’s healthcare sector from a management accounting perspective. Adopting a Balanced Scorecard (BSC) analysis approach, this paper conducted an exploratory case study of a newly launched Singapore public hospital, which has been recognized as amongst the most digitally advanced healthcare facilities in Asia-Pacific region. Specifically, this study gains insights on how the new technology is changing healthcare organizations’ management accounting from four perspectives under the Balanced Scorecard approach, 1) Financial Perspective, 2) Customer (Patient) Perspective, 3) Internal Processes Perspective, and 4) Learning and Growth Perspective. Based on a thorough review of archival records from the government and public, and the interview reports with the hospital’s CIO, this study finds the improvements from all the four perspectives under the Balanced Scorecard framework as follows: 1) Learning and Growth Perspective: The Government (Ministry of Health) works with the hospital to open up multiple training pathways to health professionals that upgrade and develops new IT skills among the healthcare workforce to support the transformation of healthcare services. 2) Internal Process Perspective: The hospital achieved digital transformation through Project OneCare to integrate clinical, operational, and administrative information systems (e.g., EHR, EMR, WMS, EPIB, RTLS) that enable the seamless flow of data and the implementation of JIT system to help the hospital operate more effectively and efficiently. 3) Customer Perspective: The fully integrated EMR suite enhances the patient’s experiences by achieving the 5 Rights (Right Patient, Right Data, Right Device, Right Entry and Right Time). 4) Financial Perspective: Cost savings are achieved from improved inventory management and effective supply chain management. The use of process automation also results in a reduction of manpower costs and logistics cost. To summarize, these improvements identified under the Balanced Scorecard framework confirm the success of utilizing the integration of advanced ICT to enhance healthcare organization’s customer service, productivity efficiency, and cost savings. Moreover, the Big Data generated from this integrated EMR system can be particularly useful in aiding management control system to optimize decision making and strategic planning. To conclude, the new digital technology transformation has moved the usefulness of management accounting to both financial and non-financial dimensions with new heights in the area of healthcare management.

Keywords: balanced scorecard, digital technology transformation, healthcare ecosystem, integrated information system

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69 Towards a Strategic Framework for State-Level Epistemological Functions

Authors: Mark Darius Juszczak

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While epistemology, as a sub-field of philosophy, is generally concerned with theoretical questions about the nature of knowledge, the explosion in digital media technologies has resulted in an exponential increase in the storage and transmission of human information. That increase has resulted in a particular non-linear dynamic – digital epistemological functions are radically altering how and what we know. Neither the rate of that change nor the consequences of it have been well studied or taken into account in developing state-level strategies for epistemological functions. At the current time, US Federal policy, like that of virtually all other countries, maintains, at the national state level, clearly defined boundaries between various epistemological agencies - agencies that, in one way or another, mediate the functional use of knowledge. These agencies can take the form of patent and trademark offices, national library and archive systems, departments of education, departments such as the FTC, university systems and regulations, military research systems such as DARPA, federal scientific research agencies, medical and pharmaceutical accreditation agencies, federal funding for scientific research and legislative committees and subcommittees that attempt to alter the laws that govern epistemological functions. All of these agencies are in the constant process of creating, analyzing, and regulating knowledge. Those processes are, at the most general level, epistemological functions – they act upon and define what knowledge is. At the same time, however, there are no high-level strategic epistemological directives or frameworks that define those functions. The only time in US history where a proxy state-level epistemological strategy existed was between 1961 and 1969 when the Kennedy Administration committed the United States to the Apollo program. While that program had a singular technical objective as its outcome, that objective was so technologically advanced for its day and so complex so that it required a massive redirection of state-level epistemological functions – in essence, a broad and diverse set of state-level agencies suddenly found themselves working together towards a common epistemological goal. This paper does not call for a repeat of the Apollo program. Rather, its purpose is to investigate the minimum structural requirements for a national state-level epistemological strategy in the United States. In addition, this paper also seeks to analyze how the epistemological work of the multitude of national agencies within the United States would be affected by such a high-level framework. This paper is an exploratory study of this type of framework. The primary hypothesis of the author is that such a function is possible but would require extensive re-framing and reclassification of traditional epistemological functions at the respective agency level. In much the same way that, for example, DHS (Department of Homeland Security) evolved to respond to a new type of security threat in the world for the United States, it is theorized that a lack of coordination and alignment in epistemological functions will equally result in a strategic threat to the United States.

Keywords: strategic security, epistemological functions, epistemological agencies, Apollo program

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68 Predictive Pathogen Biology: Genome-Based Prediction of Pathogenic Potential and Countermeasures Targets

Authors: Debjit Ray

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Horizontal gene transfer (HGT) and recombination leads to the emergence of bacterial antibiotic resistance and pathogenic traits. HGT events can be identified by comparing a large number of fully sequenced genomes across a species or genus, define the phylogenetic range of HGT, and find potential sources of new resistance genes. In-depth comparative phylogenomics can also identify subtle genome or plasmid structural changes or mutations associated with phenotypic changes. Comparative phylogenomics requires that accurately sequenced, complete and properly annotated genomes of the organism. Assembling closed genomes requires additional mate-pair reads or “long read” sequencing data to accompany short-read paired-end data. To bring down the cost and time required of producing assembled genomes and annotating genome features that inform drug resistance and pathogenicity, we are analyzing the performance for genome assembly of data from the Illumina NextSeq, which has faster throughput than the Illumina HiSeq (~1-2 days versus ~1 week), and shorter reads (150bp paired-end versus 300bp paired end) but higher capacity (150-400M reads per run versus ~5-15M) compared to the Illumina MiSeq. Bioinformatics improvements are also needed to make rapid, routine production of complete genomes a reality. Modern assemblers such as SPAdes 3.6.0 running on a standard Linux blade are capable in a few hours of converting mixes of reads from different library preps into high-quality assemblies with only a few gaps. Remaining breaks in scaffolds are generally due to repeats (e.g., rRNA genes) are addressed by our software for gap closure techniques, that avoid custom PCR or targeted sequencing. Our goal is to improve the understanding of emergence of pathogenesis using sequencing, comparative genomics, and machine learning analysis of ~1000 pathogen genomes. Machine learning algorithms will be used to digest the diverse features (change in virulence genes, recombination, horizontal gene transfer, patient diagnostics). Temporal data and evolutionary models can thus determine whether the origin of a particular isolate is likely to have been from the environment (could it have evolved from previous isolates). It can be useful for comparing differences in virulence along or across the tree. More intriguing, it can test whether there is a direction to virulence strength. This would open new avenues in the prediction of uncharacterized clinical bugs and multidrug resistance evolution and pathogen emergence.

Keywords: genomics, pathogens, genome assembly, superbugs

Procedia PDF Downloads 198
67 BIM Modeling of Site and Existing Buildings: Case Study of ESTP Paris Campus

Authors: Rita Sassine, Yassine Hassani, Mohamad Al Omari, Stéphanie Guibert

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Building Information Modelling (BIM) is the process of creating, managing, and centralizing information during the building lifecycle. BIM can be used all over a construction project, from the initiation phase to the planning and execution phases to the maintenance and lifecycle management phase. For existing buildings, BIM can be used for specific applications such as lifecycle management. However, most of the existing buildings don’t have a BIM model. Creating a compatible BIM for existing buildings is very challenging. It requires special equipment for data capturing and efforts to convert these data into a BIM model. The main difficulties for such projects are to define the data needed, the level of development (LOD), and the methodology to be adopted. In addition to managing information for an existing building, studying the impact of the built environment is a challenging topic. So, integrating the existing terrain that surrounds buildings into the digital model is essential to be able to make several simulations as flood simulation, energy simulation, etc. Making a replication of the physical model and updating its information in real-time to make its Digital Twin (DT) is very important. The Digital Terrain Model (DTM) represents the ground surface of the terrain by a set of discrete points with unique height values over 2D points based on reference surface (e.g., mean sea level, geoid, and ellipsoid). In addition, information related to the type of pavement materials, types of vegetation and heights and damaged surfaces can be integrated. Our aim in this study is to define the methodology to be used in order to provide a 3D BIM model for the site and the existing building based on the case study of “Ecole Spéciale des Travaux Publiques (ESTP Paris)” school of engineering campus. The property is located on a hilly site of 5 hectares and is composed of more than 20 buildings with a total area of 32 000 square meters and a height between 50 and 68 meters. In this work, the campus precise levelling grid according to the NGF-IGN69 altimetric system and the grid control points are computed according to (Réseau Gédésique Français) RGF93 – Lambert 93 french system with different methods: (i) Land topographic surveying methods using robotic total station, (ii) GNSS (Global Network Satellite sytem) levelling grid with NRTK (Network Real Time Kinematic) mode, (iii) Point clouds generated by laser scanning. These technologies allow the computation of multiple building parameters such as boundary limits, the number of floors, the floors georeferencing, the georeferencing of the 4 base corners of each building, etc. Once the entry data are identified, the digital model of each building is done. The DTM is also modeled. The process of altimetric determination is complex and requires efforts in order to collect and analyze multiple data formats. Since many technologies can be used to produce digital models, different file formats such as DraWinG (DWG), LASer (LAS), Comma-separated values (CSV), Industry Foundation Classes (IFC) and ReViT (RVT) will be generated. Checking the interoperability between BIM models is very important. In this work, all models are linked together and shared on 3DEXPERIENCE collaborative platform.

Keywords: building information modeling, digital terrain model, existing buildings, interoperability

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66 The Effects of Exercise Training on LDL Mediated Blood Flow in Coronary Artery Disease: A Systematic Review

Authors: Aziza Barnawi

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Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.

Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease

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65 Symphony of Healing: Exploring Music and Art Therapy’s Impact on Chemotherapy Patients with Cancer

Authors: Sunidhi Sood, Drashti Narendrakumar Shah, Aakarsh Sharma, Nirali Harsh Panchal, Maria Karizhenskaia

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Cancer is a global health concern, causing a significant number of deaths, with chemotherapy being a standard treatment method. However, chemotherapy often induces side effects that profoundly impact the physical and emotional well-being of patients, lowering their overall quality of life (QoL). This research aims to investigate the potential of music and art therapy as holistic adjunctive therapy for cancer patients undergoing chemotherapy, offering non-pharmacological support. This is achieved through a comprehensive review of existing literature with a focus on the following themes, including stress and anxiety alleviation, emotional expression and coping skill development, transformative changes, and pain management with mood upliftment. A systematic search was conducted using Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 2014 to 2023. The review solely incorporated studies focusing on the impact of music and art therapy on the health and overall well-being of cancer patients undergoing chemotherapy in North America. The findings from 16 studies involving pediatric oncology patients, females affected by breast cancer, and general oncology patients show that music and art therapies significantly reduce anxiety (standardized mean difference: -1.10) and improve perceived stress (median change: -4.0) and overall quality of life in cancer patients undergoing chemotherapy. Furthermore, music therapy has demonstrated the potential to decrease anxiety, depression, and pain during infusion treatments (average changes in resilience scale: 3.4 and 4.83 for instrumental and vocal music therapy, respectively). This data calls for consideration of the integration of music and art therapy into supportive care programs for cancer patients undergoing chemotherapy. Moreover, it provides guidance to healthcare professionals and policymakers, facilitating the development of patient-centered strategies for cancer care in Canada. Further research is needed in collaboration with qualified therapists to examine its applicability and explore and evaluate patients' perceptions and expectations in order to optimize the therapeutic benefits and overall patient experience. In conclusion, integrating music and art therapy in cancer care promises to substantially enhance the well-being and psychosocial state of patients undergoing chemotherapy. However, due to the small population size considered in existing studies, further research is needed to bridge the knowledge gap and ensure a comprehensive, patient-centered approach, ultimately enhancing the quality of life (QoL) for individuals facing the challenges of cancer treatment.

Keywords: anxiety, cancer, chemotherapy, depression, music and art therapy, pain management, quality of life

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64 The Four Elements of Zoroastrianism and Sustainable Ecosystems with an Ecological Approach

Authors: Esmat Momeni, Shabnam Basari, Mohammad Beheshtinia

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The purpose of this study is to provide a symbolic explanation of the four elements in Zoroastrianism and sustainable ecosystems with an ecological approach. The research method is fundamental and deductive content analysis. Data collection has been done through library and documentary methods and through reading books and related articles. The population and sample of the present study are Yazd city and Iran country after discovering symbolic concepts derived from the theoretical foundations of Zoroastrianism in four elements of water, air, soil, fire and conformity with Iranian architecture with the ecological approach in Yazd city, the sustainable ecosystem it is explained by the system of nature. The validity and reliability of the results are based on the trust and confidence of the research literature. Research findings show that Yazd was one of the bases of Zoroastrianism in Iran. Many believe that the first person to discuss the elements of nature and respect Zoroastrians is the Prophet of this religion. Keeping the environment clean and pure by paying attention to and respecting these four elements. The water element is a symbol of existence in Zoroastrianism, so the people of Yazd used the aqueduct and designed a pool in front of the building. The soil element is a symbol of the raw material of human creation in the Zoroastrian religion, the most readily available material in the desert areas of Yazd, used as bricks and adobes, creating one of the most magnificent roof coverings is the dome. The wind element represents the invisible force of the soul in Creation in Zoroastrianism, the most important application of wind in the windy, which is a highly efficient cooling system. The element of fire, which is always a symbol of purity in Zoroastrianism, is located in a special place in Yazd's Ataskadeh (altar/ temple), where the most important religious prayers are held in and against the fire. Consequently, indigenous knowledge and attention to indigenous architecture is a part of the national capital of each nation that encompasses their beliefs, values, methods, and knowledge. According to studies on the four elements of Zoroastrianism, the link between these four elements are that due to the hot and dry fire at the beginning, it is the fire that begins to follow the nature of the movement in the stillness of the earth, and arises from the heat of the fire and because of vigor and its decreases, cold (wind) emerges, and from cold, humidity and wetness. And by examining books and resources on Yazd's architectural design with an ecological approach to the values of the four elements Zoroastrianism has been inspired, it can be concluded that in order to have environmentally friendly architecture, it is essential to use sustainable architectural principles, to link religious and sacrament culture and ecology through architecture.

Keywords: ecology, architecture, quadruple elements of air, soil, water, fire, Zoroastrian religion, sustainable ecosystem, Iran, Yazd city

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63 Evaluation of Monoterpenes Induction in Ugni molinae Ecotypes Subjected to a Red Grape Caterpillar (Lepidoptera: Arctiidae) Herbivory

Authors: Manuel Chacon-Fuentes, Leonardo Bardehle, Marcelo Lizama, Claudio Reyes, Andres Quiroz

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The insect-plant interaction is a complex process in which the plant is able to release chemical signaling that modifies the behavior of insects. Insect herbivory can trigger mechanisms that allow the increase in the production of secondary metabolites that allow coping against the herbivores. Monoterpenes are a kind of secondary metabolites involved in direct defense acting as repellents of herbivorous or even in indirect defense acting as attractants for insect predators. In addition, an increase of the monoterpenes concentration is an effect commonly associated with the herbivory. Hence, plants subjected to damage by herbivory increase the monoterpenes production in comparison to plants without herbivory. In this framework, co-evolutionary aspects play a fundamental role in the adaptation of the herbivorous to their host and in the counter-adaptive strategies of the plants to avoid the herbivorous. In this context, Ugni molinae 'murtilla' is a native shrub from Chile characterized by its antioxidant activity mainly related to the phenolic compounds presents in its fruits. The larval stage of the red grape caterpillar Chilesia rudis Butler (Lepidoptera: Arctiidae) has been reported as an important defoliator of U. molinae. This insect is native from Chile and probably has been involved in a co-evolutionary process with murtilla. Therefore, we hypothesized that herbivory by the red grape caterpillar increases the emission of monoterpenes in Ugni molinae. Ecotypes 19-1 and 22-1 of murtilla were established and maintained at 25° C in the Laboratorio de Química Ecológica at Universidad de La Frontera. Red grape caterpillars of ⁓40 mm were collected near to Temuco (Chile) from grasses, and they were deprived of food for 24 h before performing the assays. Ten caterpillars were placed on the foliage of the ecotypes 19-1 and 22-1 and allowed to feed during 48 h. After this time, caterpillars were removed from the ecotypes and monoterpenes were collected. A glass chamber was used to enclose the ecotypes and a Porapak-Q column was used to trap the monoterpenes. After 24 h of capturing, columns were desorbed with hexane. Then, samples were injected in a gas chromatograph coupled to mass spectrometer and monoterpenes were determined according to the NIST library. All the experiments were performed in triplicate. Results showed that α-pinene, β-phellandrene, limonene, and 1,8 cineole were the main monoterpenes released by murtilla ecotypes. For the ecotype 19-1, the abundance of α-pinene was significantly higher in plants subjected to herbivory (100%) in relation to control plants (54.58%). Moreover, β-phellandrene and 1,8 cineole were observed only in control plants. For ecotype 22-1, there was no significant difference in monoterpenes abundance. In conclusion, the results suggest a trade-off of β-phellandrene and 1,8 cineole in response to herbivory damage by red grape caterpillar generating an increase in α-pinene abundance.

Keywords: Chilesia rudis, gas chromatography, monoterpenes, Ugni molinae

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62 The Impact of Physical Exercise on Gestational Diabetes and Maternal Weight Management: A Meta-Analysis

Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Physiological changes during pregnancy, such as alterations in the circulatory, respiratory, and musculoskeletal systems, can negatively impact daily physical activity. This reduced activity is often associated with an increased risk of adverse maternal health outcomes, particularly gestational diabetes mellitus (GDM) and excessive weight gain. This meta-analysis aims to evaluate the effectiveness of structured physical exercise interventions during pregnancy in reducing the risk of GDM and managing maternal weight gain. A comprehensive search was conducted across six major databases: PubMed, Cochrane Library, EMBASE, Web of Science, ScienceDirect, and ClinicalTrials.gov, covering the period from database inception until 2023. Randomized controlled trials (RCTs) that explored the effects of physical exercise programs on pregnant women with low physical activity levels were included. The search was performed using EndNote and results were managed using RevMan (Review Manager) for meta-analysis. RCTs involving healthy pregnant women with low levels of physical activity or sedentary lifestyles were selected. These RCTs must have incorporated structured exercise programs during pregnancy and reported on outcomes related to GDM and maternal weight gain. From an initial pool of 5,112 articles, 65 RCTs (involving 11,400 pregnant women) met the inclusion criteria. Data extraction was performed, followed by a quality assessment of the selected studies using the Cochrane Risk of Bias tool. The meta-analysis was conducted using RevMan software, where pooled relative risks (RR) and weighted mean differences (WMD) were calculated using a random-effects model to address heterogeneity across studies. Sensitivity analyses, subgroup analyses (based on factors such as exercise intensity, duration, and pregnancy stage), and publication bias assessments were also conducted. Structured physical exercise during pregnancy led to a significant reduction in the risk of developing GDM (RR = 0.68; P < 0.001), particularly when the exercise program was performed throughout the pregnancy (RR = 0.62; P = 0.035). In addition, maternal weight gain was significantly reduced (WMD = −1.18 kg; 95% CI −1.54 to −0.85; P < 0.001). There were no significant adverse effects reported for either the mother or the neonate, confirming that exercise interventions are safe for both. This meta-analysis highlights the positive impact of regular moderate physical activity during pregnancy in reducing the risk of GDM and managing maternal weight gain. These findings suggest that physical exercise should be encouraged as a routine part of prenatal care. However, more research is required to refine exercise recommendations and determine the most effective interventions based on individual risk factors and pregnancy stages.

Keywords: gestational diabetes, maternal weight management, meta-analysis, randomized controlled trials

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61 Applying Miniaturized near Infrared Technology for Commingled and Microplastic Waste Analysis

Authors: Monika Rani, Claudio Marchesi, Stefania Federici, Laura E. Depero

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Degradation of the aquatic environment by plastic litter, especially microplastics (MPs), i.e., any water-insoluble solid plastic particle with the longest dimension in the range 1µm and 1000 µm (=1 mm) size, is an unfortunate indication of the advancement of the Anthropocene age on Earth. Microplastics formed due to natural weathering processes are termed as secondary microplastics, while when these are synthesized in industries, they are called primary microplastics. Their presence from the highest peaks to the deepest points in oceans explored and their resistance to biological and chemical decay has adversely affected the environment, especially marine life. Even though the presence of MPs in the marine environment is well-reported, a legitimate and authentic analytical technique to sample, analyze, and quantify the MPs is still under progress and testing stages. Among the characterization techniques, vibrational spectroscopic techniques are largely adopted in the field of polymers. And the ongoing miniaturization of these methods is on the way to revolutionize the plastic recycling industry. In this scenario, the capability and the feasibility of a miniaturized near-infrared (MicroNIR) spectroscopy combined with chemometrics tools for qualitative and quantitative analysis of urban plastic waste collected from a recycling plant and microplastic mixture fragmented in the lab were investigated. Based on the Resin Identification Code, 250 plastic samples were used for macroplastic analysis and to set up a library of polymers. Subsequently, MicroNIR spectra were analysed through the application of multivariate modelling. Principal Components Analysis (PCA) was used as an unsupervised tool to find trends within the data. After the exploratory PCA analysis, a supervised classification tool was applied in order to distinguish the different plastic classes, and a database containing the NIR spectra of polymers was made. For the microplastic analysis, the three most abundant polymers in the plastic litter, PE, PP, PS, were mechanically fragmented in the laboratory to micron size. The distinctive arrangement of blends of these three microplastics was prepared in line with a designed ternary composition plot. After the PCA exploratory analysis, a quantitative model Partial Least Squares Regression (PLSR) allowed to predict the percentage of microplastics in the mixtures. With a complete dataset of 63 compositions, PLS was calibrated with 42 data-points. The model was used to predict the composition of 21 unknown mixtures of the test set. The advantage of the consolidated NIR Chemometric approach lies in the quick evaluation of whether the sample is macro or micro, contaminated, coloured or not, and with no sample pre-treatment. The technique can be utilized with bigger example volumes and even considers an on-site evaluation and in this manner satisfies the need for a high-throughput strategy.

Keywords: chemometrics, microNIR, microplastics, urban plastic waste

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