Search results for: Emma J. Dale

Authors: Jianhua Zhang, Weiping Chen, Guanjie Chen, Jason Flannick, Emma Fikse, Glenda Smerin, Yanqin Yang, Yulong Li, John A. Hanover, William F. Simonds

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Ethnic disparities in many diseases are well recognized and reflect the consequences of genetic, behavior, and environmental factors. However, direct scientific evidence connecting the ethnic genetic variations and the disease disparities has been elusive, which may have led to the ethnic inequalities in large scale genetic studies. Through the genome-wide analysis of data representing 185,934 subjects, including 14,955 from our own studies of the African America Diabetes Mellitus, we discovered sets of genetic variants either unique to or conserved in all ethnicities. We further developed a quantitative gene function-based high-risk variant index (hrVI) of 20,428 genes to establish profiles that strongly correlate with the subjects' self-identified ethnicities. With respect to the ability to detect human essential and pathogenic genes, the hrVI analysis method is both comparable with and complementary to the well-known genetic analysis methods, pLI and VIRlof. Application of the ethnicity-specific hrVI analysis to the type 2 diabetes mellitus (T2DM) national repository, containing 20,791 cases and 24,440 controls, identified 114 candidate T2DM-associated genes, 8.8-fold greater than that of ethnicity-blind analysis. All the genes identified are defined as either pathogenic or likely-pathogenic in ClinVar database, with 33.3% diabetes-associated and 54.4% obesity-associated genes. These results demonstrate the utility of hrVI analysis and provide the first genetic evidence by clustering patterns of how genetic variations among ethnicities may impede the discovery of diabetes and foreseeably other disease-associated genes.

Keywords: diabetes-associated genes, ethnic health disparities, high-risk variant index, hrVI, T2DM

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Authors: Xingdu Wang, Charlie Gere, Emma Rose, Yuxuan Zhao

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The study introduces a fresh perspective on the digital realm through an examination of the Chinese concept of Xiang, elucidating how it can build an understanding of pixels and textures on screens as digital trigrams. This concept attempts to offer an outlook on the intersection of digital technology and the natural world, thereby contributing to discussions about the harmonious relationship between humans and technology. The study looks for the ancient Chinese theory of Xiang as a key to establishing the theories and practices to respond to the problem of Contemporary Chinese technics. Xiang is a Chinese method of understanding the essentials of things through appearances, which differs from the method of science in the Westen. Xiang, the basement of Chinese visual art, is rooted in ancient Chinese philosophy and connected to the eight trigrams. The discussion of Xiang connects art, philosophy, and technology. This paper connects the meaning of Xiang with the 'truth appearing' philosophically through the analysis of the concepts of phenomenon and noumenon and the unique Chinese way of observing. Hereafter, the historical interconnection between ancient painting and writing in China emphasizes their relationship between technical craftsmanship and artistic expression. In digital, the paper blurs the traditional boundaries between images and text on digital screens in theory. Lastly, this study identified an ensemble concept relating to pixels and textures in computer vision, drawing inspiration from AI image recognition in Chinese paintings. In art practice, by presenting a fluid visual experience in the form of pixels, which mimics the flow of lines in traditional calligraphy and painting, it is hoped that the viewer will be brought back to the process of the truth appearing as defined by the 'Xiang’.

Keywords: Chinese cosmotechnics, computer vision, contemporary Neo-Confucianism, texture and pixel, Xiang

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Authors: Annika Stechemesser, Rachel Pounds, Emma Lucas, Chris Dawson, Julia Lipecki, Pavle Vrljicak, Jan Brosens, Sean Kehoe, Jason Yap, Lawrence Young, Sascha Ott

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Advances in technology make it now possible to retrieve the genetic information of thousands of single cancerous cells. One of the key challenges in single cell analysis of cancerous tissue is to determine the number of different cell types and their characteristic genes within the sample to better understand the tumors and their reaction to different treatments. For this analysis to be possible, it is crucial to filter out background noise as it can severely blur the downstream analysis and give misleading results. In-depth analysis of the state-of-the-art filtering methods for single cell data showed that they do, in some cases, not separate noisy and normal cells sufficiently. We introduced an algorithm that filters and clusters single cell data simultaneously without relying on certain genes or thresholds chosen by eye. It detects communities in a Shared Nearest Neighbor similarity network, which captures the similarities and dissimilarities of the cells by optimizing the modularity and then identifies and removes vertices with a weak clustering belonging. This strategy is based on the fact that noisy data instances are very likely to be similar to true cell types but do not match any of these wells. Once the clustering is complete, we apply a set of evaluation metrics on the cluster level and accept or reject clusters based on the outcome. The performance of our algorithm was tested on three datasets and led to convincing results. We were able to replicate the results on a Peripheral Blood Mononuclear Cells dataset. Furthermore, we applied the algorithm to two samples of ovarian cancer from the same patient before and after chemotherapy. Comparing the standard approach to our algorithm, we found a hidden cell type in the ovarian postchemotherapy data with interesting marker genes that are potentially relevant for medical research.

Keywords: cancer research, graph theory, machine learning, single cell analysis

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Authors: Ahmad Shukri Mohd Noor, Emma Ahmad Sirajudin, Rabiei Mamat

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Pertaining to a particular Marine interest, the process of data sampling could take years before a study can be concluded. Therefore, the need for a robust backup system for the data is invariably implicit. In recent advancement of Marine applications, more functionalities and tools are integrated to assist the work of the researchers. It is anticipated that this modality will continue as research scope widens and intensifies and at the same to follow suit with current technologies and lifestyles. The convenience to collect and share information these days also applies to the work in Marine research. Therefore, Marine system designers should be aware that high availability is a necessary attribute in Marine repository applications as well as a robust backup system for the data. In this paper, the approach to high availability is related both to hardware and software but the focus is more on software. We consider a NABTIC repository system that is primitively built on a single server and does not have replicated components. First, the system is decomposed into separate modules. The modules are placed on multiple servers to create a distributed system. Redundancy is added by placing the copies of the modules on different servers using Neighbor Caring Environment System(NCES) technique. NCER is utilizing parallel replication components mechanism. A background monitoring is established to check servers’ heartbeats to confirm their aliveness. At the same time, a critical adaptive threshold is maintained to make sure a failure is timely detected using Adaptive Fault Detection (AFD). A confirmed failure will set the recovery mode where a selection process will be done before a fail-over server is instructed. In effect, the Marine repository service is continued as the fail-over masks a recent failure. The performance of the new prototype is tested and is confirmed to be more highly available. Furthermore, the downtime is not noticeable as service is immediately restored automatically. The Marine repository system is said to have achieved fault tolerance.

Keywords: availability, fault detection, replication, fault tolerance, marine application

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Authors: Ismahane Emma Karima Bessi

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Military sociology is largely avoided. Discussing the military as a societal phenomenon and the social dimensions of war and peace is now considered a disgraceful and neglected province of social science that has a major impact on global populations. The first official press war began with William Howard Russell in the mid-19th century. The media are crucial to war and peace. Even Gaius Julius Caesar, with his "commentarii bello gallico", was a media tool to influence his warfare. Napoleon Bonaparte also knew how important the press was for his actions. This shows how important history is for crisis and war journalism. The one-sided media coverage that every country is confronted with ultimately prevents people from having a certain interest in the truth and from gross knowledge gaps in order to get an accurate picture of reality. There is a need to examine the relationship between the military, war, and the media to look at the modality in which the media is involved in military conflicts, in this case, as an adjunct, i.e., war because of the media. These are promoted or initiated by the following factors: photos intended for the visual manipulation of the population, the pressure from politicians and parties who are urging and exerting their influence on the global media to share the same pattern of opinion, and, most importantly, the media profiting from the war by listening to popular reactions and passing them on promoting with new visuals. These influence political elections. The media occupies a huge and ubiquitous part of the population. These have the ability to make a country that is in constant crisis and war mode appear in a brilliant light of peace. An article or photograph taken by one journalist has a tremendous impact as it can control the minds of millions of people. Most wars currently have state-political reasons. The parties, therefore, want to have their (potential) voters on their side, who are inflated by the media. The military is loathed or loved. Thinking must be created that a well-trained military in the instances of natural sciences, history, and sociology can save or protect the lives of many people. Theoretical methods for this are defined and evaluated in more detail in this paper.

Keywords: war, history, military, science, journalism, crisis

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Authors: Tamara Roma, Emma Capulli

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Pregnancy and fertility, in other words, reproduction, has become, in the last half of the century, increasingly and globally controlled, medicalized, and regulated. The reflection proposed starts from the consequences of the inscription of reproduction into the neoliberal economic paradigm. The new biotechnologies developments have raised a new patriarchal justification for State’s control of uterus bodies and a new construction of knowledge about reproductive health. Moral discussion and juridification remove reproduction and non-reproduction from their personal and intimate context and frame them under words like “duties”, “rights”, “family planning”, “demography”, and “population policy”, reinvent them as “States business” and ultimately help to re/confirm a specific construct of fertility, motherhood, and family. Moreover, the interaction between the neoliberal economy and medical biotechnologies brought about a new formulation of the connection between feminine generative potential and value production. The widespread and contemporary debates on Medically Assisted Reproduction (MAR), surrogacy and abortion suggest the need for a “feminist/queer global bioethical discourse” capable of inserting itself into the official bioethical debate characterized by the traditional dichotomy of laic bioethics/Catholic bioethics. The contribution moves from a feminist bioethics perspective on reproductive technologies to introduce a feminist/queer global bioethics point of view on reproductive health. The comparison between reproduction and non-reproduction debates is useful to analyze and demonstrate how restrictive legislations, dichotomic bioethical discussion and medical control confirm and strengthens gender injustice in reproductive life. In fact, MAR, surrogacy, and abortion restrictions stem from a shared social and legal paradigm that depends on traditional gender roles revealing how the stratification of reproduction is based on multiple discrimination along the lines of gender, race, and class. In conclusion, the perspective of feminist/queer global bioethics tries to read the concept of universal reproductive justice, introducing an original point of view on reproductive health access.

Keywords: queer bioethics, reproductive health, reproductive justice, reproductive technologies

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Authors: Emma Roberts

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The Rome II Regulation has established a uniform regime of conflict of law rules across the European Union (except for Denmark) which determines the law applicable in non-contractual obligations disputes. It marks a significant development towards the Europeanization of private international law and aims to provide the most appropriate connecting factors to achieve both legal certainty and justice in individual cases. Many non-contractual obligations are recognised to present such distinct factors that, to achieve these aims, a special rule is provided for determining the applicable law in cases in respect of product liability and environmental torts, for example. Throughout the legislative process, the European Parliament sought to establish a separate rule for road traffic accidents, recognising that these cases too present such novel situations that a blanket application of a lex loci damni approach would not provide an appropriate answer. Such attempts were rejected and, as a result, cases arising out of road traffic accidents are subject to the Regulation’s general lex loci damni rule along with its escape clause and limited exception. This paper offers a critique of the Regulation’s response to cross-border road traffic accident cases. In England and Wales, there have been few cases that have applied the Regulation’s provisions to date, but significantly the majority of such cases are in respect of road traffic accidents. This paper examines the decisions in those cases and challenges the legislators’ decision not to provide a special rule for such incidences. Owing to the diversity in compensation systems globally, applying the Regulation’s general rule to cases of road traffic accidents – given the breadth of matters that are to be subject to the lex cause – cannot ensure an outcome that provides ‘justice in individual cases’ as is assured by the Regulation's recitals. Not only does this paper suggest that the absence of a special rule for road traffic accidents means that the Regulation fails to achieve one of its principal aims, but it further makes out a compelling case for the legislative body of the European Union to implement a corrective instrument.

Keywords: accidents abroad, applicable law, cross-border torts, non-contractual obligations, road traffic accidents

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Authors: Catherine Wheatley, Emma L. Davies, Helen Dawes

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The health benefits of exercise are widely recognised, but numerous interventions have failed to halt a sharp decline in physical activity during early adolescence. Many such projects are underpinned by the Theory of Planned Behaviour, yet this model of rational decision-making leaves variance in behavior unexplained. This study investigated whether the Prototype Willingness Model, which proposes a second, reactive decision-making path to account for spontaneous responses to the social environment, has potential to improve understanding of adolescent exercise behaviour in school by exploring constructs in the model with young people. PE teachers in 4 Oxfordshire schools each nominated 6 pupils who were active in school, and 6 who were inactive, to participate in the study. Of these, 45 (22 male) aged 12-13 took part in 8 focus group discussions. These were transcribed and subjected to deductive thematic analysis to search for themes relating to the prototype willingness model. Participants appeared to make rational decisions about commuting to school or attending sports clubs, but spontaneous choices to be inactive during both break and PE. These reactive decisions seemed influenced by a social context described as more ‘judgmental’ than primary school, characterised by anxiety about physical competence, negative peer evaluation and inactive playground norms. Participants described their images of typical active and inactive adolescents: active images included negative social characteristics including ‘show-off’. There was little concern about the long-term risks of inactivity, although participants seemed to recognise that physical activity is healthy. The Prototype Willingness Model might more fully explain young adolescents’ physical activity in school than rational behavioural models, indicating potential for physical activity interventions that target social anxieties in response to the changing playground environment. Images of active types could be more complex than earlier research has suggested, and their negative characteristics might influence willingness to be active.

Keywords: adolescence, physical activity, prototype willingness model, school

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Authors: Emma O’ Keeffe, Helen Hughes, Peter McLoughlin, Shiau Pin Tan, Nick McCarthy

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Biosecurity is emerging as one of the most important issues facing the agricultural and forestry community. This is as a result of increased invasion from new pests and diseases with the main protocol for dealing with these species being the use of synthetic pesticides. However, these chemicals have been shown to exhibit negative effects on the environment. Seaweeds represent a vast untapped resource of bio-molecules with a broad range of biological activities including pesticidal. This project investigated both the antifungal and antibacterial activity of seaweed species against two problematic root rot fungi, Armillaria mellea and Heterobasidion annosum and ten quarantine bacterial plant pathogens including Xanthomonas arboricola, Xanthomonas fragariae, and Erwinia amylovora. Four seaweed species were harvested from the South-East coast of Ireland including brown, red and green varieties. The powdered seaweeds were extracted using four different solvents by liquid extraction. The poisoned food technique was employed to establish the antifungal efficacy, and the standard disc diffusion assay was used to assess the antibacterial properties of the seaweed extracts. It was found that extracts of the green seaweed exhibited antifungal activity against H. annosum, with approximately 50% inhibition compared to the negative control. The protectant activities of the active extracts were evaluated on disks of Picea sitchensis, a plant species sensitive to infection from H. annosum and compared to the standard chemical control product urea. The crude extracts exhibited very similar activity to the 10% and 20% w/v concentrations of urea, demonstrating the ability of seaweed extracts to compete with commercially available products. Antibacterial activity was exhibited by a number of seaweed extracts with the red seaweed illustrating the strongest activity, with a zone of inhibition of 15.83 ± 0.41 mm exhibited against X. arboricola whilst the positive control (10 μg/disk of chloramphenicol) had a zone of 26.5 ± 0.71 mm. These results highlight the potential application of seaweed extracts in the forestry and agricultural industries for use as biopesticides. Further work is now required to identify the bioactive molecules that are responsible for this antifungal and antibacterial activity in the seaweed extracts, including toxicity studies to ensure the extracts are non-toxic to plants and humans.

Keywords: antibacterial, antifungal, biopesticides, seaweeds

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Authors: Jocelyn Jones, Louise Southalan, Lindey Andrews, Mandy Wilson, Emma Vieira, Jackie Oakley, Dorothy Bagshaw, Alice V. Brown, Patrick Egan, Duc Dau, Lucy Spanswick

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Working with people experiencing homelessness requires careful use of methods that support them to comfortably share their experiences. This is particularly important for Aboriginal and Torres Strait Islander peoples, the traditional owners of Australia, who have experienced intergenerational and compounding trauma since colonisation. Aboriginal cultures regularly experience research fatigue and distrust in research’s potential for impact. They often view research as an extraction -a process of taking the knowledge that empowers the research team and its institution, rather than benefiting those being researched. Through a partnership between an Aboriginal Community Controlled Organisation and a university research institute, we conducted a community-driven research project with 70-90 Aboriginal people experiencing homelessness in Perth, Western Australia. The project aimed to listen to and advocate for the voices of those who are experiencing homelessness, guided by the Aboriginal community. In consultation with Aboriginal Elders, we selected methods that are considered culturally safe, including those who would prefer to express their experiences creatively. This led us to run a series of Photovoice workshops -an established method that supports people to share their experiences through photography. This method treats participants as experts and is regularly used with marginalised groups across the world. We detail our experience and lessons in using Photovoice with Aboriginal community members experiencing homelessness. This includes the ways the method needed to be moulded to community needs and driven by their individual choices, such as being dynamic in the length of time participants would spend with us, how we would introduce the method to them, and providing support workers for participants when taking photos. We also discuss lessons in establishing and retaining engagement and how the method was successful in supporting participants to comfortably share their stories. Finally, we outline the insights into homelessness that the method offered, including highlighting the difficulty experienced by participants in transitioning from homelessness to accommodation and the diversity of hopes people who have experienced homelessness have for the future.

Keywords: Aboriginal and Torres Strait Islander peoples, photovoice, homelessness, community-led research

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Authors: Alice V. Brown, Patrick Egan, Dorothy Bagshaw, Jackie Oakley, Emma Vieira, Louise Southalan, Duc Dau, Lucy Spanswick, Lindey Andrews, Mandy Wilson, Jocelyn Jones

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Western Australia has recently adopted a 10-year plan to end homelessness across its State, with sections of the plan focused particularly on the Aboriginal and Torres Strait Islander population. In 2022, we engaged with 70-90 Aboriginal people experiencing homelessness in Perth, Western Australia, through qualitative interviews and creative methods, listening to their experiences of homelessness and their views on how services, State plans, and policies could better support them. This research was driven by the Aboriginal community through a Community Ownership Group of 16 Aboriginal Elders, elected by Elders’ groups, from across the Perth metropolitan area. The Community Ownership Group met every six weeks across the 15-month project timeline to guide the research team, endorse methods chosen, and provide richer context to research findings to ensure they adequately represent the experiences of Aboriginal people. These meetings were audio-recorded when possible and documented through meeting notes, verbal and visual minutes, and film, providing insights into homelessness from the perspective of Aboriginal Elders. In this paper, we compare the views of those experiencing homelessness with the views of the Aboriginal Elders -many of whom have experienced homelessness firsthand- and literature regarding how those experiencing homelessness can be better supported. We detail the ‘survival-directed thinking’ of those we engaged with who was in the throes of homelessness, leading them to focus more on immediate solutions such as food and housing. We then compare these narratives to Elders’ views that have been more regularly focused on connection to culture and long-term plans for healing homelessness, alongside immediate outreach -views also reflected in the literature. Through these comparisons, we highlight the importance of engaging both with those currently experiencing homelessness as well as with Aboriginal Elders as important cultural caretakers and authorities. We demonstrate how these varied voices uncover both long and short-term perspectives on how homelessness can be better managed in policy and service provision. We also highlight the potential role Aboriginal Elders can play in supporting the Aboriginal homeless community and their transition into housing.

Keywords: Aboriginal and Torres strait islander peoples, aboriginal elders, homelessness, community-led research

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Authors: Emma R. Arakelova, Stepan G. Grigoryan, Flora G. Arsenyan, Nelli S. Babayan, Ruzanna M. Grigoryan, Natalia K. Sarkisyan

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Novel nanosize zinc oxide composites of doxorubicin obtained by deposition of 180 nm thick zinc oxide film on the drug surface using DC-magnetron sputtering of a zinc target in the form of gels (PEO+Dox+ZnO and Starch+NaCMC+Dox+ZnO) were studied for drug delivery applications. The cancer specificity was revealed both in in vitro and in vivo models. The cytotoxicity of the test compounds was analyzed against human cancer (HeLa) and normal (MRC5) cell lines using MTT colorimetric cell viability assay. IC50 values were determined and compared to reveal the cancer specificity of the test samples. The mechanistic study of the most active compound was investigated using Flow cytometry analyzing of the DNA content after PI (propidium iodide) staining. Data were analyzed with Tree Star FlowJo software using cell cycle analysis Dean-Jett-Fox module. The in vivo anticancer activity estimation experiments were carried out on mice with inoculated ascitic Ehrlich’s carcinoma at intraperitoneal introduction of doxorubicin and its zinc oxide compositions. It was shown that the nanosize zinc oxide film deposition on the drug surface leads to the selective anticancer activity of composites at the cellular level with the range of selectivity index (SI) from 4 (Starch+NaCMC+Dox+ZnO) to 200 (PEO(gel)+Dox+ZnO) which is higher than that of free Dox (SI = 56). The significant increase in vivo antitumor activity (by a factor of 2-2.5) and decrease of general toxicity of zinc oxide compositions of doxorubicin in the form of the above mentioned gels compared to free doxorubicin were shown on the model of inoculated Ehrlich's ascitic carcinoma. Mechanistic studies of anticancer activity revealed the cytostatic effect based on the high level of DNA biosynthesis inhibition at considerable low concentrations of zinc oxide compositions of doxorubicin. The results of studies in vitro and in vivo behavior of PEO+Dox+ZnO and Starch+NaCMC+Dox+ZnO composites confirm the high potential of the nanosize zinc oxide composites as a vector delivery system for future application in cancer chemotherapy.

Keywords: anticancer activity, cancer specificity, doxorubicin, zinc oxide

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Authors: Emma E. Hellawell, Susan J. Hughes

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BBrownfield sites are currently being redeveloped for residential use. Information on soil contamination on these former industrial sites is collected as part of the planning process by the local government. This research project analyses this untapped resource of environmental data, using site investigation data submitted to a local Borough Council, in Surrey, UK. Over 150 site investigation reports were collected and interrogated to extract relevant information. This study involved three phases. Phase 1 was the development of a database for soil contamination information from local government reports. This database contained information on the source, history, and quality of the data together with the chemical information on the soil that was sampled. Phase 2 involved obtaining site investigation reports for development within the study area and extracting the required information for the database. Phase 3 was the data analysis and interpretation of key contaminants to evaluate typical levels of contaminants, their distribution within the study area, and relating these results to current guideline levels of risk for future site users. Preliminary results for a pilot study using a sample of the dataset have been obtained. This pilot study showed there is some inconsistency in the quality of the reports and measured data, and careful interpretation of the data is required. Analysis of the information has found high levels of lead in shallow soil samples, with mean and median levels exceeding the current guidance for residential use. The data also showed elevated (but below guidance) levels of potentially carcinogenic polyaromatic hydrocarbons. Of particular concern from the data was the high detection rate for asbestos fibers. These were found at low concentrations in 25% of the soil samples tested (however, the sample set was small). Contamination levels of the remaining chemicals tested were all below the guidance level for residential site use. These preliminary pilot study results will be expanded, and results for the whole local government area will be presented at the conference. The pilot study has demonstrated the potential for this extensive dataset to provide greater information on local contamination levels. This can help inform regulators and developers and lead to more targeted site investigations, improving risk assessments, and brownfield development.

Keywords: Brownfield development, contaminated land, local government planning data, site investigation

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Authors: Mandy Wilson, Emma Vieira, Jocelyn Jones, Alice V. Brown, Lindey Andrews, Louise Southalan, Jackie Oakley, Dorothy Bagshaw, Patrick Egan, Laura Dent, Duc Dau, Lucy Spanswick

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Alcohol and drug dependency are pertinent issues for those experiencing homelessness. This includes Aboriginal and Torres Strait Islander people, Australia’s traditional owners, living in Perth, Western Australia (WA). Societal narratives around the drivers behind drug and alcohol dependency in Aboriginal communities, particularly those experiencing homelessness, have been biased and unchanging, with little regard for complexity. This can include the idea that Aboriginal people have ‘chosen’ to use alcohol or other drugs without consideration for intergenerational trauma and the trauma of homelessness that may influence their choices. These narratives have flow-on impacts on policies and services that directly impact Aboriginal people experiencing homelessness. In 2021, we commenced a project which aimed to listen to and elevate the voices of 70-90 Aboriginal people experiencing homelessness in Perth. The project is community-driven, led by an Aboriginal Community Controlled Organisation in partnership with a university research institute. A community-ownership group of Aboriginal Elders endorsed the project’s methods, chosen to ensure their suitability for the Aboriginal community. In this paper, we detail these methods, including semi-structured interviews influenced by an Aboriginal yarning approach – an important style of conversation for Aboriginal people which follows cultural protocols; and photovoice – supporting people to share their stories through photography. Through these engagements, we detail the reasons Aboriginal people in Perth shared for using alcohol or other drugs while experiencing homelessness. These included supporting their survival on the streets, managing their mental health, and coping while on the journey to finding support. We also detail why they sought to discontinue alcohol and other drug use, including wanting to reconnect with family and changing priorities. Finally, we share how Aboriginal people experiencing homelessness have said they are impacted by their family’s alcohol and other drug use, including feeling uncomfortable living with a family who is drug and alcohol-dependent and having to care for grandchildren despite their own homelessness. These findings provide a richer understanding of alcohol and drug use for Aboriginal people experiencing homelessness in Perth, shedding light on potential changes to targeted policy and service approaches.

Keywords: Aboriginal and Torres Strait Islander peoples, alcohol and other drugs, homelessness, community-led research

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Authors: Emma Van Schie

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The purpose of this study is to use mixed methods research to create typologies of the performance of firms in the cotton-to-clothing value chain in Zimbabwe, and to use these typologies to achieve the objective of adding to the small pool of studies on Sub-Saharan African value chains performing in the context of economic liberalisation and achieving development. The uptake of economic liberalisation measures across Sub-Saharan Africa has led to the restructuring of many value chains. While this action has resulted in some African economies positively reintegrating into global commodity chains, it has also been deeply problematic for the development impacts of the majority of others. Over and above this, these nations have been placed at a disadvantage due to the fact that there is little scholarly and policy research on approaches for managing economic liberalisation and value chain development in the unique African context. As such, the central question facing these less successful cases is how they can integrate into the world economy whilst still fostering their development. This paper draws from quantitative questionnaires and qualitative interviews with 28 stakeholders in the cotton-to-clothing value chain in Zimbabwe. This paper examines the performance of firms in the value chain, and the subsequent local socio-economic development impacts that are affected by the revival of the cotton-to-clothing value chain following its collapse in the wake of Zimbabwe’s uptake of economic liberalisation measures. Firstly, the paper finds the relatively undocumented characteristics and structures of firms in the value chain in the post-economic liberalisation era. As well as this, it finds typologies of the status of firms as either being in operation, closed down, or being placed under judicial management and the common characteristics that these typologies hold. The key findings show how a mixture of macro and local level aspects, such as value chain governance and the management structure of a business, leads to the most successful typology that is able to add value to the chain in the context of economic liberalisation, and thus unlock its socioeconomic development potential. These typologies are used in making industry and policy recommendations on achieving this balance between the macro and the local level, as well as recommendations for further academic research for more typologies and models on the case of cotton value chains in Sub-Saharan Africa. In doing so, this study adds to the small collection of academic evidence and policy recommendations for the challenges that African nations face when trying to incorporate into global commodity chains in attempts to benefit from their associated socioeconomic development opportunities.

Keywords: cotton-to-clothing value chain, economic liberalisation, restructuring value chain, typologies of firms, value chain governance, Zimbabwe

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Authors: Emma Plante, Charles Ekwunwa, Diego Illanes

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Introduction: Serum Sickness-Like Reaction (SSLR) is an inflammatory immune response characterized by a rash, polyarthralgias, and fever. SSLR usually occurs in response to a new medication (most commonly antibiotics, anticonvulsants, or antiinflammatory agents) and is believed to involve the formation of drug-specific immune complexes. Here we present a case of a 16-year-old female patient who developed an SSLR in response to the D-mannose-containing over-the-counter supplement, Uqora, used to promote bladder health. Methodology: The methodology for this study included a thorough literature search for other cases of SSLR associated with D-Mannose containing products. Data collection was performed through a review of the patient’s medical record, including history, physical examination, relevant laboratory results, and treatment plan. Findings: A 16-year-old female with a history of overactive bladder and anemia presented with a diffuse urticarial rash, headaches, joint pain, and swelling for three days. Her medications included oral contraceptive pills, iron, mirabegron, UQora, and a probiotic. Physical examination revealed a diffuse urticarial rash, and her musculoskeletal exam revealed swelling and tenderness in her wrists. Her CBC, basic metabolic panel, liver function panel, lyme titers, and urinalysis were all within normal limits. The patient was referred to an allergist, who diagnosed her with SSLR. All medications were discontinued, and she was treated with a 7-day course of prednisone and cetirizine. Her symptoms resolved, and her medications were slowly resumed sequentially over several months. However, UQora triggered a recurrence of her symptoms, and it was identified as the culprit medication. Consequently, UQora was permanently discontinued, and the patient has remained symptom-free. Conclusion: This case report describes the first documented case of SSLR caused by UQora (active ingredient D-mannose). D-Mannose is a monosaccharide found in many plants and fruits, and it is commonly used to prevent urinary tract infections. While the clinical features and timeline, in this case, were typical of SSLR, UQora as the trigger was highly unusual. Clinicians should be aware of the diverse triggers of SSLR and the importance of prompt identification and management to enhance patient safety. It is possible D-mannose was not the trigger, and further research is necessary to better understand the potential therapeutic applications of D-mannose, as well as the potential risks and interactions.

Keywords: serum sickness-like reaction, d-mannose, hypersensitivity reaction, urticaria

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Authors: Emma Avoyan

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The safety standards for flood protection in the Netherlands have been revised recently. It is expected that all major flood-protection structures will have to be reinforced to meet the new standards. The Dutch Flood Protection Programme aims at accomplishing this task through innovative integrated projects such as construction of multi-functional flood defenses. In these projects, flood safety purposes will be combined with spatial planning, nature development, emergency management or other sectoral objectives. Therefore, implementation of dike reinforcement projects requires early involvement and collaboration between public and private sectors, different governmental actors and agencies. The development and implementation of such integrated projects has been an issue in Dutch flood risk management since long. Therefore, this article analyses how cross-sector collaboration within flood risk governance in the Netherlands has evolved over time, and how this development can be explained. The integrative framework for collaborative governance is applied as an analytical tool to map external factors framing possibilities as well as constraints for cross-sector collaboration in Dutch flood risk domain. Supported by an extensive document and literature analysis, the paper offers insights on how the system context and different drivers changing over time either promoted or hindered cross-sector collaboration between flood protection sector, urban development, nature conservation or any other sector involved in flood risk governance. The system context refers to the multi-layered and interrelated suite of conditions that influence the formation and performance of complex governance systems, such as collaborative governance regimes, whereas the drivers initiate and enable the overall process of collaboration. In addition, by applying a method of process tracing we identify a causal and chronological chain of events shaping cross-sectoral interaction in Dutch flood risk management. Our results indicate that in order to evaluate the performance of complex governance systems, it is important to firstly study the system context that shapes it. Clear understanding of the system conditions and drivers for collaboration gives insight into the possibilities of and constraints for effective performance of complex governance systems. The performance of the governance system is affected by the system conditions, while at the same time the governance system can also change the system conditions. Our results show that the sequence of changes within the system conditions and drivers over time affect how cross-sector interaction in Dutch flood risk governance system happens now. Moreover, we have traced the potential of this governance system to shape and change the system context.

Keywords: collaborative governance, cross-sector interaction, flood risk management, the Netherlands

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Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

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Authors: Richard Byrne, Emma Mulliner

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Smart cities are a vision for the future that is increasingly becoming a reality. While a key concept of the smart city is the ability to capture, communicate, and process data that has long been produced through day-to-day activities of the city, much of the assessment models in place neglect this fact to focus on ‘smartness’ concepts. Although it is true technology often provides the opportunity to capture and communicate data in more effective ways, there are also human processes involved that are just as important. The growing importance with regards to the use and ownership of data in society can be seen by all with companies such as Facebook and Google increasingly coming under the microscope, however, why is the same scrutiny not applied to cities? The research area is therefore of great importance to the future of our cities here and now, while the findings will be of just as great importance to our children in the future. This research aims to understand the influence data is having on organisations operating throughout the smart cities sector and employs a mixed-method research approach in order to best answer the following question: Would a data-based evaluation model for smart cities be more appropriate than a smart-based model in assessing the development of the smart city? A fully comprehensive literature review concluded that there was a requirement for a data-driven assessment model for smart cities. This was followed by a documentary analysis to understand the root source of data integration to the smart city. A content analysis of city data platforms enquired as to the alternative approaches employed by cities throughout the UK and draws on best practice from New York to compare and contrast. Grounded in theory, the research findings to this point formulated a qualitative analysis framework comprised of: the changing environment influenced by data, the value of data in the smart city, the data ecosystem of the smart city and organisational response to the data orientated environment. The framework was applied to analyse primary data collected through the form of interviews with both public and private organisations operating throughout the smart cities sector. The work to date represents the first stage of data collection that will be built upon by a quantitative research investigation into the feasibility of data network effects in the smart city. An analysis into the benefits of data interoperability supporting services to the smart city in the areas of health and transport will conclude the research to achieve the aim of inductively forming a framework that can be applied to future smart city policy. To conclude, the research recognises the influence of technological perspectives in the development of smart cities to date and highlights this as a challenge to introduce theory applied with a planning dimension. The primary researcher has utilised their experience working in the public sector throughout the investigation to reflect upon what is perceived as a gap in practice of where we are today, to where we need to be tomorrow.

Keywords: data, planning, policy development, smart cities

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Authors: Zoltan Sebestyen, Eszter Barta-Rajnai, Emma Jakab, Zsuzsanna Czegeny

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Extraction of the energy content of lignocellulosic biomass is one of the possible pathways to reduce the greenhouse gas emission derived from the burning of the fossil fuels. The application of the bioenergy can mitigate the energy dependency of a country from the foreign natural gas and the petroleum. The diversity of the plant materials makes difficult the utilization of the raw biomass in power plants. This problem can be overcome by the application of thermochemical techniques. Pyrolysis is the thermal decomposition of the raw materials under inert atmosphere at high temperatures, which produces pyrolysis gas, biooil and charcoal. The energy content of these products can be exploited by further utilization. The differences in the chemical and physical properties of the raw biomass materials can be reduced by the use of torrefaction. Torrefaction is a promising mild thermal pretreatment method performed at temperatures between 200 and 300 °C in an inert atmosphere. The goal of the pretreatment from a chemical point of view is the removal of water and the acidic groups of hemicelluloses or the whole hemicellulose fraction with minor degradation of cellulose and lignin in the biomass. Thus, the stability of biomass against biodegradation increases, while its energy density increases. The volume of the raw materials decreases so the expenses of the transportation and the storage are reduced as well. Biooil is the major product during pyrolysis and an important by-product during torrefaction of biomass. The composition of biooil mostly depends on the quality of the raw materials and the applied temperature. In this work, thermoanalytical techniques have been used to study the qualitative and quantitative composition of the pyrolysis and torrefaction oils of a woody (black locust) and two herbaceous samples (rape straw and wheat straw). The biooil contains C5 and C6 anhydrosugar molecules, as well as aromatic compounds originating from hemicellulose, cellulose, and lignin, respectively. In this study, special emphasis was placed on the formation of the lignin monomeric products. The structure of the lignin fraction is different in the wood and in the herbaceous plants. According to the thermoanalytical studies the decomposition of lignin starts above 200 °C and ends at about 500 °C. The lignin monomers are present among the components of the torrefaction oil even at relatively low temperatures. We established that the concentration and the composition of the lignin products vary significantly with the applied temperature indicating that different decomposition mechanisms dominate at low and high temperatures. The evolutions of decomposition products as well as the thermal stability of the samples were measured by thermogravimetry/mass spectrometry (TG/MS). The differences in the structure of the lignin products of woody and herbaceous samples were characterized by the method of pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS). As a statistical method, principal component analysis (PCA) has been used to find correlation between the composition of lignin products of the biooil and the applied temperatures.

Keywords: pyrolysis, torrefaction, biooil, lignin

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Authors: Emma S. Bowers

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Perturbations in global environments and temperatures have heightened the urgency of creating cost-efficient, energy-neutral building techniques. Structural responses to this thermal crisis have included designs (including those of the building standard PassivHaus) with airtightness, window placement, insulation, solar orientation, shading, and heat-exchange ventilators as potential solutions or interventions. Limitations in the predictability of the circulation of cooled air through the ambient temperature gradients throughout a structure are one of the major obstacles facing these enhanced building methods. A diverse range of air-cooling devices utilizing varying technologies is implemented around the world. Many of them worsen the problem of climate change by consuming energy. Using natural ventilation principles of air buoyancy and density to circulate fresh air throughout a building with no energy input can combat these obstacles. A unique prototype of an energy-neutral air-circulation system was constructed in order to investigate potential temperature and pressure gradients related to the stack effect (updraft of air through a building due to changes in air pressure). The stack effect principle maintains that since warmer air rises, it will leave an area of low pressure that cooler air will rush in to fill. The result is that warmer air will be expelled from the top of the building as cooler air is directed through the bottom, creating an updraft. Stack effect can be amplified by cooling the air near the bottom of a building and heating the air near the top. Using readily available, mostly recyclable or biodegradable materials, an insulated building module was constructed. A tri-part construction model was utilized: a subterranean earth-tube heat exchanger constructed of PVC pipe and placed in a horizontally oriented trench, an insulated, airtight cube aboveground to represent a building, and a solar chimney (painted black to increase heat in the out-going air). Pressure and temperature sensors were placed at four different heights within the module as well as outside, and data was collected for a period of 21 days. The air pressures and temperatures over the course of the experiment were compared and averaged. The promise of this design is that it represents a novel approach which directly addresses the obstacles of air flow and expense, using the physical principle of stack effect to draw a continuous supply of fresh air through the structure, using low-cost and readily available materials (and zero manufactured energy). This design serves as a model for novel approaches to creating temperature controlled buildings using zero energy and opens the door for future research into the effects of increasing module scale, increasing length and depth of the earth tube, and shading the building. (Model can be provided).

Keywords: air circulation, PassivHaus, stack effect, thermal gradient

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Authors: Bianca Koroschetz, Emma Mäenpää

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The purpose of this paper is to study consumer practices and meanings of different antifouling methods in order to identify the main barriers for sustainable consumption of antifouling products in the Baltic Sea. The Baltic Sea is considered to be an important tourism area. More than 3.5 million leisure boaters use the sea for recreational boating. Most leisure boat owners use toxic antifouling paint to keep barnacles from attaching to the hull. Attached barnacles limit maneuverability and add drag which in turn increases fuel costs. Antifouling paint used to combat barnacles causes particular problems, as the use of these products continuously adds to the distribution of biocides in the coastal ecosystem and leads to the death of marine organisms. To keep the Baltic Sea as an attractive tourism area measures need to be undertaken to stop the pollution coming from toxic antifouling paints. The antifouling market contains a wide range of environment-friendly alternative products such as a brush wash for boats, hand scrubbing devices, hull covers and boat lifts. Unfortunately, not a lot of boat owners use these environment-friendly alternatives and instead prefer the use of the traditional toxic copper paints. We ask “Why is the unsustainable consumption of toxic paints still predominant when there is a big range of environment-friendly alternatives available? What are the barriers for sustainable consumption?” Environmental psychology has concentrated on developing models of human behavior, including the main factors that influence pro-environmental behavior. The main focus of these models was directed to the individual’s attitudes, principals, and beliefs. However, social practice theory emphasizes the importance to study practices, as they have a stronger explanatory power than attitude-behavior to explain unsustainable consumer behavior. Thus, the study focuses on describing the material, meaning and competence of antifouling practice in order to understand the social and cultural embeddedness of the practice. Phenomenological interviews were conducted with boat owners using antifouling products such as paints and alternative methods. This data collection was supplemented with participant observations in marinas. Preliminary results indicate that different factors such as costs, traditions, advertising, frequency of use, marinas and application of method impact on the consumption of antifouling products. The findings have shown that marinas have a big influence on the consumption of antifouling goods. Some marinas are very active in supporting the sustainable consumption of antifouling products as for example in Stockholm area several marinas subsidize costs for using environmental friendly alternatives or even forbid toxic paints. Furthermore the study has revealed that environmental friendly methods are very effective and do not have to be more expensive than painting with toxic paints. This study contributes to a broader understanding why the unsustainable consumption of toxic paints is still predominant when a big range of environment-friendly alternatives exist. Answers to this phenomenon will be gained by studying practices instead of attitudes offering a new perspective on environmental issues.

Keywords: antifouling paint, Baltic Sea, boat tourism, sustainable consumption

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Authors: Emma Castiglioni, Nigel Scrutton, Derren Heyes, Alistair Fielding

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By using light as trigger, it is possible to study many biological processes, such as the activity of genes, proteins, and other molecules, with precise spatiotemporal control. Caged compounds, where biologically active molecules are generated from an inert precursor upon laser photolysis, offer the potential to initiate such biological reactions with high temporal resolution. As light acts as the trigger for cleaving the protecting group, the ‘caging’ technique provides a number of advantages as it can be intracellular, rapid and controlled in a quantitative manner. We are developing caging strategies to study the catalytic cycle of a number of enzyme systems, such as nitric oxide synthase and ethanolamine ammonia lyase. These include the use of caged substrates, caged electrons and the possibility of caging the enzyme itself. In addition, we are developing a novel freeze-quench instrument to study these reactions, which combines rapid mixing and flashing capabilities. Reaction intermediates will be trapped at low temperatures and will be analysed by using electron paramagnetic resonance (EPR) spectroscopy to identify the involvement of any radical species during catalysis. EPR techniques typically require relatively long measurement times and very often, low temperatures to fully characterise these short-lived species. Therefore, common rapid mixing techniques, such as stopped-flow or quench-flow are not directly suitable. However, the combination of rapid freeze-quench (RFQ) followed by EPR analysis provides the ideal approach to kinetically trap and spectroscopically characterise these transient radical species. In a typical RFQ experiment, two reagent solutions are delivered to the mixer via two syringes driven by a pneumatic actuator or stepper motor. The new mixed solution is then sprayed into a cryogenic liquid or surface, and the frozen sample is then collected and packed into an EPR tube for analysis. The earliest RFQ instrument consisted of a hydraulic ram unit as a drive unit with direct spraying of the sample into a cryogenic liquid (nitrogen, isopentane or petroleum). Improvements to the RFQ technique have arisen from the design of new mixers in order to reduce both the volume and the mixing time. In addition, the cryogenic isopentane bath has been coupled to a filtering system or replaced by spraying the solution onto a surface that is frozen via thermal conductivity with a cryogenic liquid. In our work, we are developing a novel RFQ instrument which combines the freeze-quench technology with flashing capabilities to enable the studies of both thermally-activated and light-activated biological reactions. This instrument also uses a new rotating plate design based on magnetic couplings and removes the need for mechanical motorised rotation, which can otherwise be problematic at cryogenic temperatures.

Keywords: caged compounds, freeze-quench apparatus, photolysis, radicals

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Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

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Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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Authors: Fang Bin Guo, Emma Roberts, Haibin Du, Yonggang Wang, Yu Chen, Xiuli Ge

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This paper explores the findings so far from a major externally-funded project which operates internationally in China, Germany and the UK. The research team is working in the context of the redevelopment of post-industrial sites in China and how these might be platforms for creative enterprises and thereby, the economy and welfare to flourish. Results from the project are anticipated to inform urban design policies in China and possibly farther afield. The research has utilised ethnographic studies and participatory design methods to investigate alternative strategies for sustainable urban renewal of China’s post-industrial areas. Additionally, it has undertaken comparative studies of successful examples of European and Chinese urban regeneration cases. The international cross-disciplinary team has been seeking different opportunities for developing relevant creative industries whilst retaining cultural and industrial heritage. This paper will explore the research conducted so far by the team and offer initial findings. Findings point out the development challenges of cities respecting the protection of local culture/heritages, history of the industries and transformation of the local economies. The preliminary results and pilot analysis of the current research have demonstrated that local government policyholders, business investors/developers and creative industry practitioners are the three major stakeholders that will impact city revitalisations. These groups are expected to work together with asynchronous vision in order for redevelopments to be successful. Meanwhile, local geography, history, culture, politics, economy and ethnography have been identified as important factors that impact on project design and development during urban transformations. Data is being processed from the team’s research conducted across the focal Western and Chinese cities. This has provided theoretical guidance and practical support to the development of significant experimental projects. Many were re-examined with a more international perspective, and adjustments have been based on the conclusions of the research. The observations and research are already generating design solutions in terms of ascertaining essential site components, layouts, visual design and practical facilities for regenerated sites. Two significant projects undertaken by this project team have been nominated by the central Chinese government as the most successful exemplars. They have been listed as outstanding national industry heritage projects; in particular, one of them was nominated by ArchDaily as Building of the Year 2019, and so this project outcome has made a substantial contribution to research and innovation. In summary, this paper will outline the funded project, discuss the work conducted so far, and pinpoint the initial discoveries. It will detail the future steps and indicate how these will impact on national and local governments in China, designers, local citizens and building users.

Keywords: cultural & industrial heritages, ethnographic research, participatory design, regeneration of post-industrial sites, sustainable

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Authors: Emma Pope, Demos Parapanos

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Rural tourism has become more obvious and prevalent, with tourists’ increasingly seeking authentic experiences. This movement accelerated post-Covid, putting destinations in danger of reaching levels of saturation called ‘overtourism’. Whereas the phenomenon of overtourism has been frequently discussed in the urban context by academics and practitioners over recent years, it has hardly been referred to in the context of rural tourism, where perhaps it is even more difficult to manage. Rural tourism was historically considered small-scale, marked by its traditional character and by having little impact on nature and rural society. The increasing number of rural areas experiencing overtourism, however, demonstrates the need for new approaches, especially as the impacts and enablers of overtourism are context specific. Cumbria, with approximately 47 million visitors each year, and 23,000 operational enterprises, is one of these rural areas experiencing overtourism in the UK. Using the county of Cumbria as an example, this paper aims to explore better planning and management in rural destinations by clustering the area into rural and ‘urban-rural’ tourism zones. To achieve the aim, this study uses secondary data from a variety of sources to identify variables relating to visitor economy development and demand. These data include census data relating to population and employment, tourism industry-specific data including tourism revenue, visitor activities, and accommodation stock, and big data sources such as Trip Advisor and All Trails. The combination of these data sources provides a breadth of tourism-related variables. The subsequent analysis of this data draws upon various validated models. For example, tourism and hospitality employment density, territorial tourism pressure, and accommodation density. In addition to these statistical calculations, other data are utilized to further understand the context of these zones, for example, tourist services, attractions, and activities. The data was imported into ARCGIS where the density of the different variables is visualized on maps. This study aims to provide an understanding of the geographical context of visitor economy development and tourist behavior in rural areas. The findings contribute to an understanding of the spatial dynamics of tourism within the region of Cumbria through the creation of thematized maps. Different zones of tourism industry clusters are identified, which include elements relating to attractions, enterprises, infrastructure, tourism employment and economic impact. These maps visualize hot and cold spots relating to a variety of tourism contexts. It is believed that the strategy used to provide a visual overview of tourism development and demand in Cumbria could provide a strategic tool for rural areas to better plan marketing opportunities and avoid overtourism. These findings can inform future sustainability policy and destination management strategies within the areas through an understanding of the processes behind the emergence of both hot and cold spots. It may mean that attract and disperse needs to be reviewed in terms of a strategic option. In other words, to use sector or zonal policies for the individual hot or cold areas with transitional zones dependent upon local economic, social and environmental factors.

Keywords: overtourism, rural tourism, sustainable tourism, tourism planning, tourism zones

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Authors: Jean Pierre Kabue, Emma Meader, Afsatou Ndama Traore, Paul R. Hunter, Natasha Potgieter

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Norovirus is now considered the most common cause of outbreaks of nonbacterial gastroenteritis. Limited data are available for Norovirus strains in Africa, especially in rural and peri-urban areas. Despite the excessive burden of diarrhea disease in developing countries, Norovirus infections have been to date mostly reported in developed countries. There is a need to investigate intensively the role of viral agents associated with diarrhea in different settings in Africa continent. To determine the prevalence and genetic diversity of Norovirus strains circulating in the rural communities in the Limpopo Province, South Africa and investigate the genetic relationship between Norovirus strains, a cross-sectional study was performed on human stools collected from rural communities. Between July 2014 and April 2015, outpatient children under 5 years of age from rural communities of Vhembe District, South Africa, were recorded for the study. A total of 303 stool specimens were collected from those with diarrhea (n=253) and without (n=50) diarrhea. NoVs were identified using real-time one-step RT-PCR. Partial Sequence analyses were performed to genotype the strains. Phylogenetic analyses were performed to compare identified NoVs genotypes to the worldwide circulating strains. Norovirus detection rate was 41.1% (104/253) in children with diarrhea. There was no significant difference (OR=1.24; 95% CI 0.66-2.33) in Norovirus detection between symptomatic and asymptomatic children. Comparison of the median CT values for NoV in children with diarrhea and without diarrhea revealed significant statistical difference of estimated GII viral load from both groups, with a much higher viral burden in children with diarrhea. To our knowledge, this is the first study reporting on the differences in estimated viral load of GII and GI NoV positive cases and controls. GII.Pe (n=9) were the predominant genotypes followed by GII.Pe/GII.4 Sydney 2012 (n=8) suspected recombinant and GII.4 Sydney 2012 variants(n=7). Two unassigned GII.4 variants and an unusual RdRp genotype GII.P15 were found. With note, the rare GIIP15 identified in this study has a common ancestor with GIIP15 strain from Japan previously reported as GII/untypeable recombinant strain implicated in a gastroenteritis outbreak. To our knowledge, this is the first report of this unusual genotype in the African continent. Though not confirmed predictive of diarrhea disease in this study, the high detection rate of NoV is an indication of subsequent exposure of children from rural communities to enteric pathogens due to poor sanitation and hygiene practices. The results reveal that the difference between asymptomatic and symptomatic children with NoV may possibly be related to the NoV genogroups involved. The findings emphasize NoV genetic diversity and predominance of GII.Pe/GII.4 Sydney 2012, indicative of increased NoV activity. An uncommon GII.P15 and two unassigned GII.4 variants were also identified from rural settings of the Vhembe District/South Africa. NoV surveillance is required to help to inform investigations into NoV evolution, and to support vaccine development programmes in Africa.

Keywords: asymptomatic, common, outpatients, norovirus genetic diversity, sporadic gastroenteritis, South African rural communities, symptomatic

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Authors: Joy Chiu, Colin Hemez, Emma Ryan, Jia Sun, Robert Dubrow, Michael Pascucilla

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The popularity of recreational boating is on the rise in the United States, which raises numerous national-level challenges in the management of air and water pollution, aquatic habitat destruction, and waterway access. The need to control sewage discharge from recreational vessels underlies all of these challenges. The release of raw human waste into aquatic environments can lead to eutrophication and algal blooms; can increase human exposure to pathogenic viruses, bacteria, and parasites; can financially impact commercial shellfish harvest/fisheries and marine bathing areas; and can negatively affect access to recreational and/or commercial waterways to the detriment of local economies. Because of the damage that unregulated sewage discharge can do to environments and human health/marine life, recreational vessels in the United States are required by law to 'pump-out' sewage from their holding tanks into sewage treatment systems in all designated 'no discharge areas'. Many pump-out boats, which transfer waste out of recreational vessels, are operated and maintained using funds allocated through the Federal Clean Vessel Act (CVA). The East Shore District Health Department of Branford, Connecticut is protecting this estuary by pioneering the design and construction of the first-in-the-nation zero-emissions, the solar-electric pump-out boat of its size to replace one of its older traditional gasoline-powered models through a Connecticut Department of Energy and Environmental Protection CVA Grant. This study, conducted in collaboration with the East Shore District Health Department, the Connecticut Department of Energy and Environmental Protection, States Organization for Boating Access and Connecticut’s CVA program coordinators, had two aims: (1) To perform a national assessment of pump-out boat programs, supplemented by a limited international assessment, to establish best pump-out boat practices (regardless of how the boat is powered); and (2) to estimate the cost, greenhouse gas emissions, and environmental and public health impacts of solar-electric versus traditional gasoline-powered pump-out boats. A national survey was conducted of all CVA-funded pump-out program managers and selected pump-out boat operators to gauge best practices; costs associated with gasoline-powered pump-out boat operation and management; and the regional, cultural, and policy-related issues that might arise from the adoption of solar-electric pump-out boat technology. We also conducted life-cycle analyses of gasoline-powered and solar-electric pump-out boats to compare their greenhouse gas emissions; production of air, soil and water pollution; and impacts on human health. This work comprises the most comprehensive study into pump-out boating practices in the United States to date, in which information obtained at local, state, national, and international levels is synthesized. This study aims to enable CVA programs to make informed recommendations for sustainable pump-out boating practices and identifies the challenges and opportunities that remain for the wide adoption of solar-electric pump-out boat technology.

Keywords: pump-out boat, marine water, solar-electric, zero emissions

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Authors: Paul Licina, Emma M. Johnston, David Lisle, Mark Young, Chris Brady

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Background: Lumbar pars pathology is a common cause of pain in the growing spine. It can be seen in young athletes participating in at-risk sports and can affect sporting performance and long-term health due to its resistance to traditional management. There is a current lack of consensus of classification and treatment for pars injuries. Previous systems used CT to stage pars defects but could not assess early stress reactions. A modified classification is proposed that considers findings on MRI, significantly improving early treatment guidance. The treatment protocol is designed for patients aged 5 to 19 years. Method: Clinical screening identifies patients with a low, medium, or high index of suspicion for lumbar pars injury using patient age, sport participation and pain characteristics. MRI of the at-risk cohort enables augmentation of existing CT-based classification while avoiding ionising radiation. Patients are classified into five categories based on MRI findings. A type 0 lesion (stress reaction) is present when CT is normal and MRI shows high signal change (HSC) in the pars/pedicle on T2 images. A type 1 lesion represents the ‘early defect’ CT classification. The group previously referred to as a 'progressive stage' defect on CT can be split into 2A and 2B categories. 2As have HSC on MRI, whereas 2Bs do not. This distinction is important with regard to healing potential. Type 3 lesions are terminal stage defects on CT, characterised by pseudarthrosis. MRI shows no HSC. Results: Stress reactions (type 0) and acute fractures (1 and 2a) can heal and are treated in a custom-made hard brace for 12 weeks. It is initially worn 23 hours per day. At three weeks, patients commence basic core rehabilitation. At six weeks, in the absence of pain, the brace is removed for sleeping. Exercises are progressed to positions of daily living. Patients with continued pain remain braced 23 hours per day without exercise progression until becoming symptom-free. At nine weeks, patients commence supervised exercises out of the brace for 30 minutes each day. This allows them to re-learn muscular control without rigid support of the brace. At 12 weeks, bracing ceases and MRI is repeated. For patients with near or complete resolution of bony oedema and healing of any cortical defect, rehabilitation is focused on strength and conditioning and sport-specific exercise for the full return to activity. The length of this final stage is approximately nine weeks but depends on factors such as development and level of sports participation. If significant HSC remains on MRI, CT scan is considered to definitively assess cortical defect healing. For these patients, return to high-risk sports is delayed for up to three months. Chronic defects (2b and 3) cannot heal and are not braced, and rehabilitation follows traditional protocols. Conclusion: Appropriate clinical screening and imaging with MRI can identify pars pathology early. In those with potential for healing, we propose hard bracing and appropriate rehabilitation as part of a multidisciplinary management protocol. The validity of this protocol will be tested in future studies.

Keywords: adolescents, MRI classification, pars interticularis, treatment protocol

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Authors: Nicki Mohammadi, Emma Reford, Natalia Romano Spica, Laura Tabacof, Jenna Tosto-Mancuso, David Putrino, Christopher P. Kellner

Abstract:

Introductory Statement: The onset of the COVID-19 pandemic demanded an unprecedented need for the rapid development, dispersal, and application of infection testing. However, despite the impressive mobilization of resources, individuals were incredibly limited in their access to tests, particularly during the initial months of the pandemic (March-April 2020) in New York City (NYC). Access to COVID-19 testing is crucial in understanding patients’ illness experiences and integral to the development of COVID-19 standard-of-care protocols, especially in the context of overall access to healthcare resources. Succinct Description of basic methodologies: 18 Patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery within the Mount Sinai Health System) were interviewed regarding their experience with COVID-19 during the first wave (March-May 2020) of the COVID-19 pandemic in New York City. Patients were asked about their experiences navigating COVID-19 diagnoses, the health care system, and their recovery process. Transcribed interviews were analyzed for thematic codes, using grounded theory to guide the identification of emergent themes and codebook development through an iterative process. Data coding was performed using NVivo12. References for the domain “testing” were then extracted and analyzed for themes and statistical patterns. Clear Indication of Major Findings of the study: 100% of participants (18/18) referenced COVID-19 testing in their interviews, with a total of 79 references across the 18 transcripts (average: 4.4 references/interview; 2.7% interview coverage). 89% of participants (16/18) discussed the difficulty of access to testing, including denial of testing without high severity of symptoms, geographical distance to the testing site, and lack of testing resources at healthcare centers. Participants shared varying perspectives on how the lack of certainty regarding their COVID-19 status affected their course of recovery. One participant shared that because she never tested positive she was shielded from her anxiety and fear, given the death toll in NYC. Another group of participants shared that not having a concrete status to share with family, friends and professionals affected how seriously onlookers took their symptoms. Furthermore, the absence of a positive test barred some individuals from access to treatment programs and employment support. Concluding Statement: Lack of access to COVID-19 testing in the first wave of the pandemic in NYC was a prominent element of patients’ illness experience, particularly during their recovery phase. While for some the lack of concrete results was protective, most emphasized the invalidating effect this had on the perception of illness for both self and others. COVID-19 testing is now widely accessible; however, those who are unable to demonstrate a positive test result but who are still presumed to have had COVID-19 in the first wave must continue to adapt to and live with the effects of this gap in knowledge and care on their recovery. Future efforts are required to ensure that patients do not face barriers to care due to the lack of testing and are reassured regarding their access to healthcare. Affiliations- 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 2Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY

Keywords: accessibility, COVID-19, recovery, testing

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