Search results for: Oliver C. Saavedra Valeriano
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 85

Search results for: Oliver C. Saavedra Valeriano

25 Nutrition, Dental Status and Post-Traumatic Stress Disorder among Underage Refugees in Germany

Authors: Marios Loucas, Rafael Loucas, Oliver Muensterer

Abstract:

Aim of the Study: Over the last two years, there has been a substantial rise of refugees entering Germany, of which approximately one-third are underage. Little is known about the general state of health such as nutrition, dental status and post-traumatic stress disorder among underage refugees. Our study assesses the general health status of underage refugees based on a large sample cohort. Methods: After ethics board approval, we used a structured questionnaire to collect demographic information and health-related elements in 3 large refugee accommodation centers, focusing on nutritional and dental status, as well as symptoms of posttraumatic stress disorder. Main results: A total of 461 minor refugees were included. The majority were boys (54.5%), average age was 8 years. Out of the 8 recorded countries of origin, most children came from Syria (33.6%), followed by Afghanistan (23.2%). Of the participants, 50.3% reported DSM-5 criteria of Posttraumatic stress disorder and presented mental health-related problems. The most frequently reported mental abnormalities were concentration disturbances (15.2%), sleep disorders (6.9%), unclear headaches (5.4%). The majority of the participants showed an unfavorable nutritional and dental status. According to the family, the majority of the children rarely eat healthy foods such as fruits, vegetables and fish. However, the majority of these children (over 90%) consume a large quantity of sugary foods and sweetened drinks such as soft drinks and confectionery at least daily. Caries was found in 63% of the minor children included in the study. A large proportion (47%) reported never brushing their teeth. According to the family, 78.3% of refugee children have never been evaluated by a dentist in Germany. The remainder visited a dentist mainly because of unbearable toothache. Conclusions: Minor refugees have specific psychological, nutritional and dental problems that must be considered in order to ensure appropriate medical care. Posttraumatic stress disorder is mainly caused by physical and emotional trauma suffered either during the flight or in the refugee camp in Germany. These data call for widespread screening of psychological, dental and nutritional problems in underage refugees. Dental care of this cohort is completely inadequate. Nutritional programs should focus on educating the families and providing the means to obtain healthy foods for these children.

Keywords: children, nutrition, posttraumatic stress disorder, refugee

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24 The Role of the Renal Specialist Podiatrist

Authors: Clara Luwe, Oliver Harness, Helena Meally, Kim Martin, Alexandra Harrington

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Background: The role of ‘Renal Specialist Podiatrist’ originated in 2022 due to prevailing evidence of patients with diabetes and end-stage renal disease (ESRD) on haemodialysis (HD) and active ulcerations that were at higher risk of rapid deterioration, foot-related hospital admissions, and lower limb amputations. This role started in April 2022 with the aim of screening all patients on haemodialysis and instigating preventative measures to reduce serious foot related complications. Methods: A comprehensive neurovascular foot assessment was completed to establish baseline vascular status and identify those with peripheral arterial disease (PAD) for all patients on HD. Individual’s foot risk was stratified, advice and education tailored and issued. Identifying all diabetes patients on HD as high-risk for diabetic foot complications. Major Findings: All patients screened revealed over half of the caseload had diabetes, and more than half had a clinical presentation of PAD. All those presenting with ulcerations had a diagnosis of diabetes. Of the presenting ulcerations, the majority of these ulcers predated the renal specialist post and were classified as severe >3 SINBAD Score. Since April’22, complications have been identified quicker, reducing the severity (SINBAD<3 or below), and have improved healing times, in line with the national average. During the eight months of the role being in place, we have seen a reduction in minor amputations and no major amputations. Conclusion: By screening all patients on haemodialysis and focusing on education, early recognition of complications, appropriate treatment, and timely onward referral, we can reduce the risk of foot Diabetic foot ulcerations and lower limb amputations. Having regular podiatry input to stratify and facilitate high-risk, active wound patients across different services has helped to keep these patients stable, prevent amputations, and reduce foot-related hospital admissions and mortality from foot-related disease. By improving the accessibility to a specialist podiatrist, patients felt able to raise concerns sooner. This has helped to implement treatment at the earliest possible opportunity, enabling the identification and healing of ulcers at an earlier and less complex stage (SINBAD <3), thus, preventing potential limb-threatening complications.

Keywords: renal, podiatry, haemodialysis, prevention, early detection

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23 Investigations of the Service Life of Different Material Configurations at Solid-lubricated Rolling Bearings

Authors: Bernd Sauer, Michel Werner, Stefan Emrich, Michael Kopnarski, Oliver Koch

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Friction reduction is an important aspect in the context of sustainability and energy transition. Rolling bearings are therefore used in many applications in which components move relative to each other. Conventionally lubricated rolling bearings are used in a wide range of applications, but are not suitable under certain conditions. Conventional lubricants such as grease or oil cannot be used at very high or very low temperatures. In addition, these lubricants evaporate at very low ambient pressure, e.g. in a high vacuum environment, making the use of solid lubricated bearings unavoidable. With the use of solid-lubricated bearings, predicting the service life becomes more complex. While the end of the service life of bearings with conventional lubrication is mainly caused by the failure of the bearing components due to material fatigue, solid-lubricated bearings fail at the moment when the lubrication layer is worn and the rolling elements come into direct contact with the raceway during operation. In order to extend the service life of these bearings beyond the service life of the initial coating, the use of transfer lubrication is recommended, in which pockets or sacrificial cages are used in which the balls run and can thus absorb the lubricant, which is then available for lubrication in tribological contact. This contribution presents the results of wear and service life tests on solid-lubricated rolling bearings with sacrificial cage pockets. The cage of the bearing consists of a polyimide (PI) matrix with 15% molybdenum disulfide (MoS2) and serves as a lubrication depot alongside the silver-coated balls. The bearings are tested under high vacuum (pE < 10-2 Pa) at a temperature of 300 °C on a four-bearing test rig. First, investigations of the bearing system within the bearing service life are presented and the torque curve, the wear mass and surface analyses are discussed. With regard to wear, it can be seen that the bearing rings tend to increase in mass over the service life of the bearing, while the balls and the cage tend to lose mass. With regard to the elementary surface properties, the surfaces of the bearing rings and balls are examined in terms of the mass of the elements on them. Furthermore, service life investigations with different material pairings are presented, whereby the focus here is on the service life achieved in addition to the torque curve, wear development and surface analysis. It was shown that MoS2 in the cage leads to a longer service life, while a silver (Ag) coating on the balls has no positive influence on the service life and even appears to reduce it in combination with MoS2.

Keywords: ball bearings, molybdenum disulfide, solid lubricated bearings, solid lubrication mechanisms

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22 Obstacles and Ways-Forward to Upgrading Nigeria Basic Nursing Schools: A Survey of Perception of Teaching Hospitals’ Nurse Trainers and Stakeholders

Authors: Chijioke Oliver Nwodoh, Jonah Ikechukwu Eze, Loretta Chika Ukwuaba, Ifeoma Ndubuisi, Ada Carol Nwaneri, Ijeoma Lewechi Okoronkwo

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Presence of nursing workforce with unequal qualification and status in Nigeria has undermined the growth of nursing profession in the country. Upgrading of the existing basic and post-basic nursing schools to degree-awarding institutions in Nigeria is a way-forward to solving this inequality problem and Nigeria teaching hospitals are in vantage position for this project due to the already existing supportive structure and manpower in those hospitals. What the nurse trainers and the stakeholders of the teaching hospitals may hold for or against the upgrading is a determining factor for the upgrading project, but that is not clear and has not been investigated in Nigeria. The study investigated the perception of nurse trainers and stakeholders of teaching hospitals in Enugu State of Nigeria on the obstacles and ways-forward to upgrading nursing schools to degree-awarding institutions in Nigeria. The study specifically elicited what the subjects may view as obstacles to upgrading basic and post-basic nursing schools to degree-awarding institutions in Nigeria and ascertained their suggestions on the possible ways of overcoming the obstacles. By utilizing cross-sectional descriptive design and a purposive sampling procedure, 78 accessible subjects out of a total population of 87 were used for the study. The generated data from the subjects were analyzed using frequencies, percentages and mean for the research questions and Pearson’s chi-square for the hypotheses, with the aid of Statistical Package for Social Sciences Version 20.0. The result showed that lack of extant policy, fund, and disunity among policy makers and stakeholders of nursing profession are the main obstacles to the upgrading. However, the respondents did not see items like: stakeholders and nurse trainers of basic and post-basic schools of nursing; fear of admitting and producing poor quality nurses; and so forth, as obstacles to the upgrading project. Institution of the upgrading policy by Nursing and Midwifery Council of Nigeria, funding, awareness creation for the upgrading and unison among policy makers and stakeholders of nursing profession are the major possible ways to overcome the obstacles. The difference in the subjects’ perceptions between the two hospitals was found to be statistically insignificant (p > 0.05). It is recommended that the policy makers and stakeholders of nursing in Nigeria should unite and liaise with Federal Ministries of Health and Education for modalities and actualization of upgrading nursing schools to degree-awarding institutions in Nigeria.

Keywords: nurse trainers, obstacles, perception, stakeholders, teaching hospital, upgrading basic nursing schools, ways-forward

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21 Optimized Renewable Energy Mix for Energy Saving in Waste Water Treatment Plants

Authors: J. D. García Espinel, Paula Pérez Sánchez, Carlos Egea Ruiz, Carlos Lardín Mifsut, Andrés López-Aranguren Oliver

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This paper shortly describes three main actuations over a Waste Water Treatment Plant (WWTP) for reducing its energy consumption: Optimization of the biological reactor in the aeration stage by including new control algorithms and introducing new efficient equipment, the installation of an innovative hybrid system with zero Grid injection (formed by 100kW of PV energy and 5 kW of mini-wind energy generation) and an intelligent management system for load consumption and energy generation control in the most optimum way. This project called RENEWAT, involved in the European Commission call LIFE 2013, has the main objective of reducing the energy consumptions through different actions on the processes which take place in a WWTP and introducing renewable energies on these treatment plants, with the purpose of promoting the usage of treated waste water for irrigation and decreasing the C02 gas emissions. WWTP is always required before waste water can be reused for irrigation or discharged in water bodies. However, the energetic demand of the treatment process is high enough for making the price of treated water to exceed the one for drinkable water. This makes any policy very difficult to encourage the re-use of treated water, with a great impact on the water cycle, particularly in those areas suffering hydric stress or deficiency. The cost of treating waste water involves another climate-change related burden: the energy necessary for the process is obtained mainly from the electric network, which is, in most of the cases in Europe, energy obtained from the burning of fossil fuels. The innovative part of this project is based on the implementation, adaptation and integration of solutions for this problem, together with a new concept of the integration of energy input and operative energy demand. Moreover, there is an important qualitative jump between the technologies used and the alleged technologies to use in the project which give it an innovative character, due to the fact that there are no similar previous experiences of a WWTP including an intelligent discrimination of energy sources, integrating renewable ones (PV and Wind) and the grid.

Keywords: aeration system, biological reactor, CO2 emissions, energy efficiency, hybrid systems, LIFE 2013 call, process optimization, renewable energy sources, wasted water treatment plants

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20 Electronic Waste Analysis And Characterization Study: Management Input For Highly Urbanized Cities

Authors: Jilbert Novelero, Oliver Mariano

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In a world where technological evolution and competition to create innovative products are at its peak, problems on Electronic Waste (E-Waste) are now becoming a global concern. E-waste is said to be any electrical or electronic devices that have reached the terminal of its useful life. The major issue are the volume and the raw materials used in crafting E-waste which is non-biodegradable and contains hazardous substances that are toxic to human health and the environment. The objective of this study is to gather baseline data in terms of the composition of E-waste in the solid waste stream and to determine the top 5 E-waste categories in a highly urbanized city. Recommendations in managing these wastes for its reduction were provided which may serve as a guide for acceptance and implementation in the locality. Pasig City was the chosen beneficiary of the research output and through the collaboration of the City Government of Pasig and its Solid Waste Management Office (SWMO); the researcher successfully conducted the Electronic Waste Analysis and Characterization Study (E-WACS) to achieve the objectives. E-WACS that was conducted on April 2019 showed that E-waste ranked 4th which comprises the 10.39% of the overall solid waste volume. Out of 345, 127.24kg which is the total daily domestic waste generation in the city, E-waste covers 35,858.72kg. Moreover, an average of 40 grams was determined to be the E-waste generation per person per day. The top 5 E-waste categories were then classified after the analysis. The category which ranked first is the office and telecommunications equipment that contained the 63.18% of the total generated E-waste. Second in ranking was the household appliances category with 21.13% composition. Third was the lighting devices category with 8.17%. Fourth on ranking was the consumer electronics and batteries category which was composed of 5.97% and fifth was the wires and cables category where it comprised the 1.41% of the average generated E-waste samples. One of the recommendations provided in this research is the implementation of the Pasig City Waste Advantage Card. The card can be used as a privilege card and earned points can be converted to avail of and enjoy services such as haircut, massage, dental services, medical check-up, and etc. Another recommendation raised is for the LGU to encourage a communication or dialogue with the technology and electronics manufacturers and distributors and international and local companies to plan the retrieval and disposal of the E-wastes in accordance with the Extended Producer Responsibility (EPR) policy where producers are given significant responsibilities for the treatment and disposal of post-consumer products.

Keywords: E-waste, E-WACS, E-waste characterization, electronic waste, electronic waste analysis

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19 3d Gis Participatory Mapping And Conflict Ladm: Comparative Analysis Of Land Policies And Survey Procedures Applied By The Igorots, Ncip, And Denr To Itogon Ancestral Domain Boundaries

Authors: Deniz A. Apostol, Denyl A. Apostol, Oliver T. Macapinlac, George S. Katigbak

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Ang lupa ay buhay at ang buhay ay lupa (land is life and life is land). Based on the 2015 census, the Indigenous Peoples (IPs) population in the Philippines is estimated to be 11.3-20.2 million. They hail from various regions, possess distinct cultures, but encounter shared struggles in territorial disputes. Itogon, the largest Benguet municipality, is home to the Ibaloi, Kankanaey, and other Igorot tribes. Despite having three (3) Ancestral Domains (ADs), Itogon is predominantly labeled as timberland or forest. These overlapping land classifications highlight the presence of inconsistencies in national laws and jurisdictions. This study aims to analyze surveying procedures used by the Igorots, NCIP, and DENR in mapping the Itogon AD Boundaries, show land boundary delineation conflicts, propose surveying guidelines, and recommend 3D Participatory Mapping as geomatics solution for updated AD reference maps. Interpretative Phenomenological Analysis (IPA), Comparative Legal Analysis (CLA), and Map Overlay Analysis (MOA) were utilized to examine the interviews, compare land policies and surveying procedures, and identify differences and overlaps in conflicting land boundaries. In the IPA, master themes identified were AD Definition (rights, responsibilities, restrictions), AD Overlaps (land classifications, political boundaries, ancestral domains, land laws/policies), and Other Conflicts (with other agencies, misinterpretations, suggestions), as considerations for mapping ADs. CLA focused on conflicting surveying procedures: AD Definitions, Surveying Equipment, Surveying Methods, Map Projections, Order of Accuracy, Monuments, Survey Parties, Pre-survey, Survey Proper, and Post-survey procedures. MOA emphasized the land area percentage of conflicting areas, showcasing the impact of misaligned surveying procedures. The findings are summarized through a Land Administration Domain Model (LADM) Conflict, for AD versus AD and Political Boundaries. The products of this study are identification of land conflict factors, survey guidelines recommendations, and contested land area computations. These can serve as references for revising survey manuals, updating AD Sustainable Development and Protection Plans, and making amendments to laws.

Keywords: ancestral domain, gis, indigenous people, land policies, participatory mapping, surveying, survey procedures

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18 Effectiveness of Traditional Chinese Medicine in the Treatment of Eczema: A Systematic Review and Meta-Analysis Based on Eczema Area and Severity Index Score

Authors: Oliver Chunho Ma, Tszying Chang

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Background: Traditional Chinese Medicine (TCM) has been widely used in the treatment of eczema. However, there is currently a lack of comprehensive research on the overall effectiveness of TCM in treating eczema, particularly using the Eczema Area and Severity Index (EASI) score as an evaluation tool. Meta-analysis can integrate the results of multiple studies to provide more convincing evidence. Objective: To conduct a systematic review and meta-analysis based on the EASI score to evaluate the overall effectiveness of TCM in the treatment of eczema. Specifically, the study will review and analyze published clinical studies that investigate TCM treatments for eczema and use the EASI score as an outcome measure, comparing the differences in improving the severity of eczema between TCM and other treatment modalities, such as conventional Western medicine treatments. Methods: Relevant studies, including randomized controlled trials (RCTs) and non-randomized controlled trials, that involve TCM treatment for eczema and use the EASI score as an outcome measure will be searched in medical literature databases such as PubMed, CNKI, etc. Relevant data will be extracted from the selected studies, including study design, sample size, treatment methods, improvement in EASI score, etc. The methodological quality and risk of bias of the included studies will be assessed using appropriate evaluation tools (such as the Cochrane Handbook). The results of the selected studies will be statistically analyzed, including pooling effect sizes (such as standardized mean differences, relative risks, etc.), subgroup analysis (e.g., different TCM syndromes, different treatment modalities), and sensitivity analysis (e.g., excluding low-quality studies). Based on the results of the statistical analysis and quality assessment, the overall effectiveness of TCM in improving the severity of eczema will be interpreted. Expected outcomes: By integrating the results of multiple studies, we expect to provide more convincing evidence regarding the specific effects of TCM in improving the severity of eczema. Additionally, subgroup analysis and sensitivity analysis can further elucidate whether the effectiveness of TCM treatment is influenced by different factors. Besides, we will compare the results of the meta-analysis with the clinical data from our clinic. For both the clinical data and the meta-analysis results, we will perform descriptive statistics such as means, standard deviations, percentages, etc. and compare the differences between the two using statistical tests such as independent samples t-test or non-parametric tests to assess the statistical differences between them.

Keywords: Eczema, traditional Chinese medicine, EASI, systematic review, meta-analysis

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17 Static Charge Control Plan for High-Density Electronics Centers

Authors: Clara Oliver, Oibar Martinez, Jose Miguel Miranda

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Ensuring a safe environment for sensitive electronics boards in places with high limitations in size poses two major difficulties: the control of charge accumulation in floating floors and the prevention of excess charge generation due to air cooling flows. In this paper, we discuss these mechanisms and possible solutions to prevent them. An experiment was made in the control room of a Cherenkov Telescope, where six racks of 2x1x1 m size and independent cooling units are located. The room is 10x4x2.5 m, and the electronics include high-speed digitizers, trigger circuits, etc. The floor used in this room was antistatic, but it was a raised floor mounted in floating design to facilitate the handling of the cables and maintenance. The tests were made by measuring the contact voltage acquired by a person who was walking along the room with different footwear qualities. In addition, we took some measurements of the voltage accumulated in a person in other situations like running or sitting up and down on an office chair. The voltages were taken in real time with an electrostatic voltage meter and dedicated control software. It is shown that peak voltages as high as 5 kV were measured with ambient humidity of more than 30%, which are within the range of a class 3A according to the HBM standard. In order to complete the results, we have made the same experiment in different spaces with alternative types of the floor like synthetic floor and earthenware floor obtaining peak voltages much lower than the ones measured with the floating synthetic floor. The grounding quality one achieves with this kind of floors can hardly beat the one typically encountered in standard floors glued directly on a solid substrate. On the other hand, the air ventilation used to prevent the overheating of the boards probably contributed in a significant way to the charge accumulated in the room. During the assessment of the quality of the static charge control, it is necessary to guarantee that the tests are made under repeatable conditions. One of the major difficulties which one encounters during these assessments is the fact the electrostatic voltmeters might provide different values depending on the humidity conditions and ground resistance quality. In addition, the use of certified antistatic footwear might mask deficiencies in the charge control. In this paper, we show how we defined protocols to guarantee that electrostatic readings are reliable. We believe that this can be helpful not only to qualify the static charge control in a laboratory but also to asses any procedure oriented to minimize the risk of electrostatic discharge events.

Keywords: electrostatics, ESD protocols, HBM, static charge control

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16 Implementation of an Accessible State-Wide Trauma Education Program

Authors: Christine Lassen, Elizabeth Leonard, Matthew Oliver

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The management of trauma is often complex and outcomes dependent on clinical expertise, effective teamwork, and a supported trauma system. The implementation of a statewide trauma education program should be accessible to all clinicians who manage trauma, but this can be challenging due to diverse individual needs, trauma service needs and geography. The NSW Institute of Trauma and Injury Management (ITIM) is a government funded body, responsible for coordinating and supporting the NSW Trauma System. The aim of this presentation is to describe how education initiatives have been implemented across the state. Simulation: In 2006, ITIM developed a Trauma Team Training Course - aimed to educate clinicians on the technical and non-technical skills required to manage trauma. The course is now independently coordinated by trauma services across the state at major trauma centres as well as in regional and rural hospitals. ITIM is currently in the process of re-evaluating and updating the Trauma Team Training Course to allow for the development of new resources and simulation scenarios. Trauma Education Evenings: In 2013, ITIM supported major trauma services to develop trauma education evenings which allowed the provision of free education to staff within the area health service and local area. The success of these local events expanded to regional hospitals. A total of 75 trauma education evenings have been conducted within NSW, with over 10,000 attendees. Wed-Based Resources: Recently, ITIM commenced free live streaming of the trauma education evenings which have now had over 3000 live views. The Trauma App developed in 2015 provides trauma clinicians with a centralised portal for trauma information and works on smartphones and tablets that integrate with the ITIM website. This supports pre-hospital and bedside clinical decisions and allows for trauma care to be more standardised, evidence-based, timely, and appropriate. Online e-Learning modules have been developed to assist clinicians, reduce unwarranted clinical variation and provide up to date evidence based education. The modules incorporate clinically focused education content with summative and formative assessments. Conclusion: Since 2005, ITIM has helped to facilitate the development of trauma education programs for doctors, nurses, pre-hospital and allied health clinicians. ITIM has been actively involved in more than 100 specialized trauma education programs, seminars and clinical workshops - attended by over 12,000 staff. The provision of state-wide trauma education is a challenging task requiring collaboration amongst numerous agencies working towards a common goal – to provide easily accessible trauma education.

Keywords: education, simulation, team-training, trauma

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15 Sterilization Effects of Low Concentration of Hydrogen Peroxide Solution on 3D Printed Biodegradable Polyurethane Nanocomposite Scaffold for Heart Valve Regeneration

Authors: S. E. Mohmad-Saberi, W. Song, N. Oliver, M. Adrian, T.C. Hsu, A. Darbyshire

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Biodegradable polyurethane (PU) has emerged as a potential material to promote repair and regeneration of damaged/diseased tissues in heart valve regeneration due to its excellent biomechanical profile. Understanding the effects of sterilization on their properties is vital since they are more sensitive and more critical of porous structures compared to bulk ones. In this study, the effects of low concentration of hydrogen peroxide (H₂O₂) solution sterilization has been investigated to determine whether the procedure would be efficient and non-destructive to porous three-dimensional (3D) elastomeric nanocomposite, polyhedral oligomeric silsesquioxane-terminated poly (ethylene-diethylene glycol succinate-sebacate) urea-urethane (POSS-EDSS-PU) scaffold. All the samples were tested for sterility following sterilization using phosphate buffer saline (PBS) as control and 5 % v/v H₂O₂ solution. The samples were incubated in tryptic soy broth for the cultivation of microorganisms under agitation at 37˚C for 72 hours. The effects of the 5 % v/v H₂O₂ solution sterilization were evaluated in terms of morphology, chemical and mechanical properties using scanning electron microscopy (SEM), Fourier transform infrared (FTIR) and tensile tester apparatus. Toxicity effects of the 5 % v/v H₂O₂ solution decontamination were studied by in vitro cytotoxicity test, where the cellular responses of human dermal fibroblast (HDF) were examined. A clear, uncontaminated broth using 5 % v/v H₂O₂ solution method indicated efficient sterilization after 3 days, while the non-sterilized control shows clouding broth indicated contamination. The morphology of 3D POSS-EDSS-PU scaffold appeared to have similar morphology after sterilization with 5 % v/v H₂O₂ solution regarding of pore size and surface. FTIR results show that the sterilized samples and non-sterilized control share the same spectra pattern, confirming no significant alterations over the surface chemistry. For the mechanical properties of the H₂O₂ solution-treated scaffolds, the tensile strain was not significantly decreased, however, become significantly stiffer after the sterilization. No cytotoxic effects were observed after the 5 % v/v H₂O₂ solution sterilization as confirmed by cell viability assessed by Alamar Blue assay. The results suggest that low concentration of 5 % v/v hydrogen peroxide solution can be used as an alternative method for sterilizing biodegradable 3D porous scaffold with micro/nano-architecture without structural deformation. This study provides the understanding of the sterilization effects on biomechanical profile and cell proliferation of 3D POSS-EDSS-PU scaffolds.

Keywords: biodegradable, hydrogen peroxide solution, POSS-EDSS-PU, sterilization

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14 Participatory Budgeting in South African Local Government: A Right or Illusion

Authors: Oliver Fuo

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One of the central features of post-apartheid constitutional reform was the establishment of local government as a distinct sphere of government in the Constitution of the Republic of South Africa, 1996. Local government, constituted by about 279 wall-to-wall municipalities, have legislative and executive powers vested in democratically elected municipal councils to govern areas within their jurisdiction subject only to limits imposed by the Constitution. In addition, unlike the past where municipalities merely played a service delivery role, they are now mandated to realise an expanded developmental mandate – pursue social justice and sustainable development; contribute, together with national and provincial government, to the realisation of socio-economic rights entrenched in the Bill of Rights; and facilitate public participation in local governance. In order to finance their developmental programmes, municipalities receive equitable allocations from national government and have legal powers to generate additional finances by charging rates on property and imposing surcharges on services provided. In addition to its general obligation to foster public participation in local governance, the law requires municipalities to facilitate public participation in their budgeting processes. This requirement is generally consistent with recent trends in local government democratic reforms which call for inclusive budget planning and implementation whereby citizens, civil society and NGOs participate in the allocation of resources. This trend is best captured in the concept of participatory budgeting. This paper specifically analyses the legal and policy framework for participatory budgeting at the local government level in South Africa. Using Borbet South Africa (Pty) Ltd and Others v Nelson Mandela Bay Municipality 2014 (5) SA 256 (ECP) as an example, this paper argues that the legal framework for participatory budgeting creates an illusory right for citizens to participate in municipal budgeting processes. This challenge is further compounded by the barrenness of the jurisprudence of courts that interpret the obligation of municipalities in this regard. It is submitted that the wording of s 27(4) of the Municipal Finance Management Act (MFMA) 53 of 2003 - which expressly stipulates that non-compliance by a municipality with a provision relating to the budget process or a provision in any legislation relating to the approval of a budget-related policy, does not affect the validity of an annual or adjustments budget – is problematic as it seems to trivialise the obligation to facilitate public participation in budgeting processes. It is submitted that where this provision is abused by municipal officials, this could lead to the sidelining of the real interests of communities in local budgets. This research is based on a critical and integrated review of primary and secondary sources of law.

Keywords: courts and jurisprudence, local government law, participatory budgeting, South Africa

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13 Qualitative Narrative Framework as Tool for Reduction of Stigma and Prejudice

Authors: Anastasia Schnitzer, Oliver Rehren

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Mental health has become an increasingly important topic in society in recent years, not least due to the challenges posed by the corona pandemic. Along with this, the public has become more and more aware that a lack of enlightenment and proper coping mechanisms may result in a notable risk to develop mental disorders. Yet, there are still many biases against those affected, which are further connected to issues of stigmatization and societal exclusion. One of the main strategies to combat these forms of prejudice and stigma is to induce intergroup contact. More specifically, the Intergroup Contact Theory states engaging in certain types of contact with members of marginalized groups may be an effective way to improve attitudes towards these groups. However, due to the persistent prejudice and stigmatization, affected individuals often do not dare to speak openly about their mental disorders, so that intergroup contact often goes unnoticed. As a result, many people only experience conscious contact with individuals with a mental disorder through media. As an analogy to the Intergroup Contact Theory, the Parasocial Contact Hypothesis proposes that repeatedly being exposed to positive media representations of outgroup members can lead to a reduction of negative prejudices and attitudes towards this outgroup. While there is a growing body of research on the merit of this mechanism, measurements often only consist of 'positive' or 'negative' parasocial contact conditions (or examine the valence or quality of the previous contact with the outgroup); meanwhile, more specific conditions are often neglected. The current study aims to tackle this shortcoming. By scrutinizing the potential of contemporary series as a narrative framework of high quality, we strive to elucidate more detailed aspects of beneficial parasocial contact -for the sake of reducing prejudice and stigma towards individuals with mental disorders. Thus, a two-factorial between-subject online panel study with three measurement points was conducted (N = 95). Participants were randomly assigned to one of two groups, having to watch episodes of either a series with a narrative framework of high (Quality-TV) or low quality (Continental-TV), with one-week interval in-between the episodes. Suitable series were determined with the help of a pretest. Prejudice and stigma towards people with mental disorders were measured at the beginning of the study, before and after each episode, and in a final follow-up one week after the last two episodes. Additionally, parasocial interaction (PSI), quality of contact (QoC), and transportation were measured several times. Based on these data, multivariate multilevel analyses were performed in R using the lavaan package. Latent growth models showed moderate to high increases in QoC and PSI as well as small to moderate decreases in stigma and prejudice over time. Multilevel path analysis with individual and group levels further revealed that a qualitative narrative framework leads to a higher quality of contact experience, which then leads to lower prejudice and stigma, with effects ranging from moderate to high.

Keywords: prejudice, quality of contact, parasocial contact, narrative framework

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12 System-Driven Design Process for Integrated Multifunctional Movable Concepts

Authors: Oliver Bertram, Leonel Akoto Chama

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In today's civil transport aircraft, the design of flight control systems is based on the experience gained from previous aircraft configurations with a clear distinction between primary and secondary flight control functions for controlling the aircraft altitude and trajectory. Significant system improvements are now seen particularly in multifunctional moveable concepts where the flight control functions are no longer considered separate but integral. This allows new functions to be implemented in order to improve the overall aircraft performance. However, the classical design process of flight controls is sequential and insufficiently interdisciplinary. In particular, the systems discipline is involved only rudimentarily in the early phase. In many cases, the task of systems design is limited to meeting the requirements of the upstream disciplines, which may lead to integration problems later. For this reason, approaching design with an incremental development is required to reduce the risk of a complete redesign. Although the potential and the path to multifunctional moveable concepts are shown, the complete re-engineering of aircraft concepts with less classic moveable concepts is associated with a considerable risk for the design due to the lack of design methods. This represents an obstacle to major leaps in technology. This gap in state of the art is even further increased if, in the future, unconventional aircraft configurations shall be considered, where no reference data or architectures are available. This means that the use of the above-mentioned experience-based approach used for conventional configurations is limited and not applicable to the next generation of aircraft. In particular, there is a need for methods and tools for a rapid trade-off between new multifunctional flight control systems architectures. To close this gap in the state of the art, an integrated system-driven design process for multifunctional flight control systems of non-classical aircraft configurations will be presented. The overall goal of the design process is to find optimal solutions for single or combined target criteria in a fast process from the very large solution space for the flight control system. In contrast to the state of the art, all disciplines are involved for a holistic design in an integrated rather than a sequential process. To emphasize the systems discipline, this paper focuses on the methodology for designing moveable actuation systems in the context of this integrated design process of multifunctional moveables. The methodology includes different approaches for creating system architectures, component design methods as well as the necessary process outputs to evaluate the systems. An application example of a reference configuration is used to demonstrate the process and validate the results. For this, new unconventional hydraulic and electrical flight control system architectures are calculated which result from the higher requirements for multifunctional moveable concept. In addition to typical key performance indicators such as mass and required power requirements, the results regarding the feasibility and wing integration aspects of the system components are examined and discussed here. This is intended to show how the systems design can influence and drive the wing and overall aircraft design.

Keywords: actuation systems, flight control surfaces, multi-functional movables, wing design process

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11 Identification of Hub Genes in the Development of Atherosclerosis

Authors: Jie Lin, Yiwen Pan, Li Zhang, Zhangyong Xia

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Atherosclerosis is a chronic inflammatory disease characterized by the accumulation of lipids, immune cells, and extracellular matrix in the arterial walls. This pathological process can lead to the formation of plaques that can obstruct blood flow and trigger various cardiovascular diseases such as heart attack and stroke. The underlying molecular mechanisms still remain unclear, although many studies revealed the dysfunction of endothelial cells, recruitment and activation of monocytes and macrophages, and the production of pro-inflammatory cytokines and chemokines in atherosclerosis. This study aimed to identify hub genes involved in the progression of atherosclerosis and to analyze their biological function in silico, thereby enhancing our understanding of the disease’s molecular mechanisms. Through the analysis of microarray data, we examined the gene expression in media and neo-intima from plaques, as well as distant macroscopically intact tissue, across a cohort of 32 hypertensive patients. Initially, 112 differentially expressed genes (DEGs) were identified. Subsequent immune infiltration analysis indicated a predominant presence of 27 immune cell types in the atherosclerosis group, particularly noting an increase in monocytes and macrophages. In the Weighted gene co-expression network analysis (WGCNA), 10 modules with a minimum of 30 genes were defined as key modules, with blue, dark, Oliver green and sky-blue modules being the most significant. These modules corresponded respectively to monocyte, activated B cell, and activated CD4 T cell gene patterns, revealing a strong morphological-genetic correlation. From these three gene patterns (modules morphology), a total of 2509 key genes (Gene Significance >0.2, module membership>0.8) were extracted. Six hub genes (CD36, DPP4, HMOX1, PLA2G7, PLN2, and ACADL) were then identified by intersecting 2509 key genes, 102 DEGs with lipid-related genes from the Genecard database. The bio-functional analysis of six hub genes was estimated by a robust classifier with an area under the curve (AUC) of 0.873 in the ROC plot, indicating excellent efficacy in differentiating between the disease and control group. Moreover, PCA visualization demonstrated clear separation between the groups based on these six hub genes, suggesting their potential utility as classification features in predictive models. Protein-protein interaction (PPI) analysis highlighted DPP4 as the most interconnected gene. Within the constructed key gene-drug network, 462 drugs were predicted, with ursodeoxycholic acid (UDCA) being identified as a potential therapeutic agent for modulating DPP4 expression. In summary, our study identified critical hub genes implicated in the progression of atherosclerosis through comprehensive bioinformatic analyses. These findings not only advance our understanding of the disease but also pave the way for applying similar analytical frameworks and predictive models to other diseases, thereby broadening the potential for clinical applications and therapeutic discoveries.

Keywords: atherosclerosis, hub genes, drug prediction, bioinformatics

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10 Empowering Indigenous Epistemologies in Geothermal Development

Authors: Te Kīpa Kēpa B. Morgan, Oliver W. Mcmillan, Dylan N. Taute, Tumanako N. Fa'aui

Abstract:

Epistemologies are ways of knowing. Indigenous Peoples are aware that they do not perceive and experience the world in the same way as others. So it is important when empowering Indigenous epistemologies, such as that of the New Zealand Māori, to also be able to represent a scientific understanding within the same analysis. A geothermal development assessment tool has been developed by adapting the Mauri Model Decision Making Framework. Mauri is a metric that is capable of representing the change in the life-supporting capacity of things and collections of things. The Mauri Model is a method of grouping mauri indicators as dimension averages in order to allow holistic assessment and also to conduct sensitivity analyses for the effect of worldview bias. R-shiny is the coding platform used for this Vision Mātauranga research which has created an expert decision support tool (DST) that combines a stakeholder assessment of worldview bias with an impact assessment of mauri-based indicators to determine the sustainability of proposed geothermal development. The initial intention was to develop guidelines for quantifying mātauranga Māori impacts related to geothermal resources. To do this, three typical scenarios were considered: a resource owner wishing to assess the potential for new geothermal development; another party wishing to assess the environmental and cultural impacts of the proposed development; an assessment that focuses on the holistic sustainability of the resource, including its surface features. Indicator sets and measurement thresholds were developed that are considered necessary considerations for each assessment context and these have been grouped to represent four mauri dimensions that mirror the four well-being criteria used for resource management in Aotearoa, New Zealand. Two case studies have been conducted to test the DST suitability for quantifying mātauranga Māori and other biophysical factors related to a geothermal system. This involved estimating mauri0meter values for physical features such as temperature, flow rate, frequency, colour, and developing indicators to also quantify qualitative observations about the geothermal system made by Māori. A retrospective analysis has then been conducted to verify different understandings of the geothermal system. The case studies found that the expert DST is useful for geothermal development assessment, especially where hapū (indigenous sub-tribal grouping) are conflicted regarding the benefits and disadvantages of their’ and others’ geothermal developments. These results have been supplemented with evaluations for the cumulative impacts of geothermal developments experienced by different parties using integration techniques applied to the time history curve of the expert DST worldview bias weighted plotted against the mauri0meter score. Cumulative impacts represent the change in resilience or potential of geothermal systems, which directly assists with the holistic interpretation of change from an Indigenous Peoples’ perspective.

Keywords: decision support tool, holistic geothermal assessment, indigenous knowledge, mauri model decision-making framework

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9 The Development of Quality Standards for the Qualification of Community Interpreters in Germany: A Needs Assessment

Authors: Jessica Terese Mueller, Christoph Breitsprecher, Mike Oliver Mosko

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Due to an unusually high number of asylum seekers entering Germany over the course of the past few years, the need for community interpreters has increased dramatically, in order to make the communication between asylum seekers and various actors in social and governmental agencies possible. In the field of social work in particular, there are community interpreters who possess a wide spectrum of qualifications spanning from state-certified professional interpreters with graduate degrees to lay or ad-hoc interpreters with little to no formal training. To the best of our knowledge, Germany has no official national quality standards for the training of community interpreters at present, which would serve to professionalise this field as well as to assure a certain degree of quality in the training programmes offered. Given the current demand for trained community interpreters, there is a growing number of training programmes geared toward qualifying community interpreters who work with asylum seekers in Germany. These training programmes range from short one-day workshops to graduate programmes with specialisations in Community Interpreting. As part of a larger project to develop quality standards for the qualification of community interpreters working with asylum seekers in the field of social work, a needs assessment was performed in the city-state of Hamburg and the state of North Rhine Westphalia in the form of focus groups and individual interviews with relevant actors in the field in order to determine the content and practical knowledge needed for community interpreters from the perspectives of those who work in and rely on this field. More specifically, social workers, volunteers, certified language and cultural mediators, paid and volunteer community interpreters and asylum seekers were invited to take part in focus groups in both locations, and asylum seekers, training providers, researchers, linguists and other national and international experts were individually interviewed. The responses collected in these focus groups and interviews have been analysed using Mayring’s concept of content analysis. In general, the responses indicate a high degree of overlap related to certain categories as well as some categories which seemed to be of particular importance to certain groups individually, while showing little to no relevance for other groups. For example, the topics of accuracy and transparency of the interpretations, as well as professionalism and ethical concerns were touched on in some form in most groups. Some group-specific topics which are the focus of experts were topics related to interpreting techniques and more concretely described theoretical and practical knowledge which should be covered in training programmes. Social workers and volunteers generally concentrated on issues regarding the role of the community interpreters and the importance of setting and clarifying professional boundaries. From the perspective of service receivers, asylum seekers tended to focus on the importance of having access to interpreters who are from their home region or country and who speak the same regiolect, dialect or variety as they do in order to prevent misunderstandings or misinterpretations which might negatively affect their asylum status. These results indicate a certain degree of consensus with trainings offered internationally for community interpreters.

Keywords: asylum seekers, community interpreting, needs assessment, quality standards, training

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8 Strategies for the Optimization of Ground Resistance in Large Scale Foundations for Optimum Lightning Protection

Authors: Oibar Martinez, Clara Oliver, Jose Miguel Miranda

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In this paper, we discuss the standard improvements which can be made to reduce the earth resistance in difficult terrains for optimum lightning protection, what are the practical limitations, and how the modeling can be refined for accurate diagnostics and ground resistance minimization. Ground resistance minimization can be made via three different approaches: burying vertical electrodes connected in parallel, burying horizontal conductive plates or meshes, or modifying the own terrain, either by changing the entire terrain material in a large volume or by adding earth-enhancing compounds. The use of vertical electrodes connected in parallel pose several practical limitations. In order to prevent loss of effectiveness, it is necessary to keep a minimum distance between each electrode, which is typically around five times larger than the electrode length. Otherwise, the overlapping of the local equipotential lines around each electrode reduces the efficiency of the configuration. The addition of parallel electrodes reduces the resistance and facilitates the measurement, but the basic parallel resistor formula of circuit theory will always underestimate the final resistance. Numerical simulation of equipotential lines around the electrodes overcomes this limitation. The resistance of a single electrode will always be proportional to the soil resistivity. The electrodes are usually installed with a backfilling material of high conductivity, which increases the effective diameter. However, the improvement is marginal, since the electrode diameter counts in the estimation of the ground resistance via a logarithmic function. Substances that are used for efficient chemical treatment must be environmentally friendly and must feature stability, high hygroscopicity, low corrosivity, and high electrical conductivity. A number of earth enhancement materials are commercially available. Many are comprised of carbon-based materials or clays like bentonite. These materials can also be used as backfilling materials to reduce the resistance of an electrode. Chemical treatment of soil has environmental issues. Some products contain copper sulfate or other copper-based compounds, which may not be environmentally friendly. Carbon-based compounds are relatively inexpensive and they do have very low resistivities, but they also feature corrosion issues. Typically, the carbon can corrode and destroy a copper electrode in around five years. These compounds also have potential environmental concerns. Some earthing enhancement materials contain cement, which, after installation acquire properties that are very close to concrete. This prevents the earthing enhancement material from leaching into the soil. After analyzing different configurations, we conclude that a buried conductive ring with vertical electrodes connected periodically should be the optimum baseline solution for the grounding of a large size structure installed on a large resistivity terrain. In order to show this, a practical example is explained here where we simulate the ground resistance of a conductive ring buried in a terrain with a resistivity in the range of 1 kOhm·m.

Keywords: grounding improvements, large scale scientific instrument, lightning risk assessment, lightning standards

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7 European Electromagnetic Compatibility Directive Applied to Astronomical Observatories

Authors: Oibar Martinez, Clara Oliver

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The Cherenkov Telescope Array Project (CTA) aims to build two different observatories of Cherenkov Telescopes, located in Cerro del Paranal, Chile, and La Palma, Spain. These facilities are used in this paper as a case study to investigate how to apply standard Directives on Electromagnetic Compatibility to astronomical observatories. Cherenkov Telescopes are able to provide valuable information from both Galactic and Extragalactic sources by measuring Cherenkov radiation, which is produced by particles which travel faster than light in the atmosphere. The construction requirements demand compliance with the European Electromagnetic Compatibility Directive. The largest telescopes of these observatories, called Large Scale Telescopes (LSTs), are high precision instruments with advanced photomultipliers able to detect the faint sub-nanosecond blue light pulses produced by Cherenkov Radiation. They have a 23-meter parabolic reflective surface. This surface focuses the radiation on a camera composed of an array of high-speed photosensors which are highly sensitive to the radio spectrum pollution. The camera has a field of view of about 4.5 degrees and has been designed for maximum compactness and lowest weight, cost and power consumption. Each pixel incorporates a photo-sensor able to discriminate single photons and the corresponding readout electronics. The first LST is already commissioned and intends to be operated as a service to Scientific Community. Because of this, it must comply with a series of reliability and functional requirements and must have a Conformité Européen (CE) marking. This demands compliance with Directive 2014/30/EU on electromagnetic compatibility. The main difficulty of accomplishing this goal resides on the fact that Conformité Européen marking setups and procedures were implemented for industrial products, whereas no clear protocols have been defined for scientific installations. In this paper, we aim to give an answer to the question on how the directive should be applied to our installation to guarantee the fulfillment of all the requirements and the proper functioning of the telescope itself. Experts in Optics and Electromagnetism were both needed to make these kinds of decisions and match tests which were designed to be made over the equipment of limited dimensions on large scientific plants. An analysis of the elements and configurations most likely to be affected by external interferences and those that are most likely to cause the maximum disturbances was also performed. Obtaining the Conformité Européen mark requires knowing what the harmonized standards are and how the elaboration of the specific requirement is defined. For this type of large installations, one needs to adapt and develop the tests to be carried out. In addition, throughout this process, certification entities and notified bodies play a key role in preparing and agreeing the required technical documentation. We have focused our attention mostly on the technical aspects of each point. We believe that this contribution will be of interest for other scientists involved in applying industrial quality assurance standards to large scientific plant.

Keywords: CE marking, electromagnetic compatibility, european directive, scientific installations

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6 Evaluating a Peer-To-Peer Health Education Program in Public Housing Communities during the COVID-19 Pandemic

Authors: Jane Oliver, Angeline Ferdinand, Jessica Kaufman, Peta Edler, Nicole Allard, Margie Danchin, Katherine B. Gibney

Abstract:

Background: The cohealth Health Concierge program operated in Melbourne, Australia, from July 2020 to 30 June 2022. The program was designed to provide place-based peer-to-peer COVID-19 education and support to culturally and linguistically diverse residents of high-rise public housing estates. During this time, the COVID-19 public health response changed frequently. We conducted a mixed-methods evaluation to determine the program’s impact on residents’ trust, engagement and communication with health services and public health activities. Methods: The RE-AIM model was used to assess program reach, effectiveness, adoption, implementation and maintenance and the evaluation was informed by a Project Reference Group including end-users. Data were collected between March and May 2022 in four estates where the program operated. We surveyed 301 residents, conducted qualitative interviews with 32 stakeholders and analyzed data from 20,901 forms reporting interactions between Health Concierges and residents collected from August 2021 to May 2022. These forms outlined the support provided by Health Concierges during each interaction. Results: Overall, the program was effective in guiding residents to testing and vaccination services and facilitating COVID-19 safe practices. Nearly two-thirds (191; 63.5%) of the 301 surveyed participants reported speaking with a Health Concierge in the previous six months, and some described having meaningful conversations with them. Despite this, many of the interactions residents described having with Health Concierges were superficial. When considering surveyed participants’ responses to the adapted Public Health Disaster Trust Scale, the mean score across all estates was 2.3 (or slightly more than ‘somewhat confident’) in public health authorities’ ability to respond to a localized infectious disease outbreak. While the program was valued during the rapidly changing public health response, many felt it had failed to evolve in the ‘living with COVID’ phase. Some residents expressed frustration with Health Concierges’ having perceived inactive, passive roles - although other residents felt Health Concierges were helpful and appreciated them. A perception that the true impact of Health Concierges’ work was underrecognized was widely voiced by health staff. All 20,901 Interaction Forms identified COVID-19-related supports provided to residents; almost all included provision of facemasks and/or hand sanitiser and 78% identified additional supports that were also provided, most frequently provision of other health information. Conclusions: The program disseminated up-to-date information to a diverse population within a rapidly changing public health setting. Health Concierges were able promote COVID-19-safe behaviours, including vaccine uptake, and link residents with support services. We recommend the program be revised and continued. New programs that draw on the Health Concierge model may be valuable in supporting future pandemic responses and should be considered in preparedness planning.

Keywords: community health, COVID-19 pandemic, infectious diseases, public health, community health workers

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5 PolyScan: Comprehending Human Polymicrobial Infections for Vector-Borne Disease Diagnostic Purposes

Authors: Kunal Garg, Louise Theusen Hermansan, Kanoktip Puttaraska, Oliver Hendricks, Heidi Pirttinen, Leona Gilbert

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The Germ Theory (one infectious determinant is equal to one disease) has unarguably evolved our capability to diagnose and treat infectious diseases over the years. Nevertheless, the advent of technology, climate change, and volatile human behavior has brought about drastic changes in our environment, leading us to question the relevance of the Germ Theory in our day, i.e. will vector-borne disease (VBD) sufferers produce multiple immune responses when tested for multiple microbes? Vector diseased patients producing multiple immune responses to different microbes would evidently suggest human polymicrobial infections (HPI). Ongoing diagnostic tools are exceedingly unequipped with the current research findings that would aid in diagnosing patients for polymicrobial infections. This shortcoming has caused misdiagnosis at very high rates, consequently diminishing the patient’s quality of life due to inadequate treatment. Equipped with the state-of-art scientific knowledge, PolyScan intends to address the pitfalls in current VBD diagnostics. PolyScan is a multiplex and multifunctional enzyme linked Immunosorbent assay (ELISA) platform that can test for numerous VBD microbes and allow simultaneous screening for multiple types of antibodies. To validate PolyScan, Lyme Borreliosis (LB) and spondyloarthritis (SpA) patient groups (n = 54 each) were tested for Borrelia burgdorferi, Borrelia burgdorferi Round Body (RB), Borrelia afzelii, Borrelia garinii, and Ehrlichia chaffeensis against IgM and IgG antibodies. LB serum samples were obtained from Germany and SpA serum samples were obtained from Denmark under relevant ethical approvals. The SpA group represented chronic LB stage because reactive arthritis (SpA subtype) in the form of Lyme arthritis links to LB. It was hypothesized that patients from both the groups will produce multiple immune responses that as a consequence would evidently suggest HPI. It was also hypothesized that the multiple immune response proportion in SpA patient group would be significantly larger when compared to the LB patient group across both antibodies. It was observed that 26% LB patients and 57% SpA patients produced multiple immune responses in contrast to 33% LB patients and 30% SpA patients that produced solitary immune responses when tested against IgM. Similarly, 52% LB patients and an astounding 73% SpA patients produced multiple immune responses in contrast to 30% LB patients and 8% SpA patients that produced solitary immune responses when tested against IgG. Interestingly, IgM immune dysfunction in both the patient groups was also recorded. Atypically, 6% of the unresponsive 18% LB with IgG antibody was recorded producing multiple immune responses with the IgM antibody. Similarly, 12% of the unresponsive 19% SpA with IgG antibody was recorded producing multiple immune responses with the IgM antibody. Thus, results not only supported hypothesis but also suggested that IgM may atypically prevail longer than IgG. The PolyScan concept will aid clinicians to detect patients for early, persistent, late, polymicrobial, & immune dysfunction conditions linked to different VBD. PolyScan provides a paradigm shift for the VBD diagnostic industry to follow that will drastically shorten patient’s time to receive adequate treatment.

Keywords: diagnostics, immune dysfunction, polymicrobial, TICK-TAG

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4 Evaluation of Forensic Pathology Practice Outside Germany – Experiences From 20 Years of Second Look Autopsies in Cooperation with the Institute of Legal Medicine Munich

Authors: Michael Josef Schwerer, Oliver Peschel

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Background: The sense and purpose of forensic postmortem examinations are undoubtedly the same in Institutes of Legal Medicine all over the world. Cause and manner of death must be determined, persons responsible for unnatural death must be brought to justice, and accidents demand changes in the respective scenarios to avoid future mishaps. The latter particularly concerns aircraft accidents, not only regarding consequences from criminal or civil law but also in pursuance of the International Civil Aviation Authority’s regulations, which demand lessons from mishap investigations to improve flight safety. Irrespective of the distinct circumstances of a given casualty or the respective questions in subsequent death investigations, a forensic autopsy is the basis for all further casework, the clue to otherwise hidden solutions, and the crucial limitation for final success when not all possible findings have been properly collected. This also implies that the targeted work of police forces and expert witnesses strongly depends on the quality of forensic pathology practice. Deadly events in foreign countries, which lead to investigations not only abroad but also in Germany, can be challenging in this context. Frequently, second-look autopsies after the repatriation of the deceased to Germany are requested by the legal authorities to ensure proper and profound documentation of all relevant findings. Aims and Methods: To validate forensic postmortem practice abroad, a retrospective study using the findings in the corresponding second-look autopsies in the Institute of Legal Medicine Munich over the last 20 years was carried out. New findings unreported in the previous autopsy were recorded and judged for their relevance to solving the respective case. Further, the condition of the corpse at the time of the second autopsy was rated to discuss artifacts mimicking evidence or the possibility of lost findings resulting from, e.g., decomposition. Recommendations for future handling of death cases abroad and efficient autopsy practice were pursued. Results and Discussion: Our re-evaluation confirmed a high quality of autopsy practice abroad in the vast majority of cases. However, in some casework, incomplete documentation of pathology findings was revealed along with either insufficient or misconducted dissection of organs. Further, some of the bodies showed missing parts of some organs, most probably resulting from sampling for histology studies during the first postmortem. For the aeromedical evaluation of a decedent’s health status prior to an aviation mishap, particularly lost or obscured findings in the heart, lungs, and brain impeded expert testimony. Moreover, incomplete fixation of the body or body parts for repatriation was seen in several cases. This particularly involved previously dissected organs deposited back into the body cavities at the end of the first autopsy. Conclusions and Recommendations: Detailed preparation in the first forensic autopsy avoids the necessity of a second-look postmortem in the majority of cases. To limit decomposition changes during repatriation from abroad, special care must be taken to include pre-dissected organs in the chemical fixation process, particularly when they are separated from the blood vessels and just deposited back into the body cavities.

Keywords: autopsy practice, second-look autopsy, retrospective study, quality standards, decomposition changes, repatriation

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3 European Food Safety Authority (EFSA) Safety Assessment of Food Additives: Data and Methodology Used for the Assessment of Dietary Exposure for Different European Countries and Population Groups

Authors: Petra Gergelova, Sofia Ioannidou, Davide Arcella, Alexandra Tard, Polly E. Boon, Oliver Lindtner, Christina Tlustos, Jean-Charles Leblanc

Abstract:

Objectives: To assess chronic dietary exposure to food additives in different European countries and population groups. Method and Design: The European Food Safety Authority’s (EFSA) Panel on Food Additives and Nutrient Sources added to Food (ANS) estimates chronic dietary exposure to food additives with the purpose of re-evaluating food additives that were previously authorized in Europe. For this, EFSA uses concentration values (usage and/or analytical occurrence data) reported through regular public calls for data by food industry and European countries. These are combined, at individual level, with national food consumption data from the EFSA Comprehensive European Food Consumption Database including data from 33 dietary surveys from 19 European countries and considering six different population groups (infants, toddlers, children, adolescents, adults and the elderly). EFSA ANS Panel estimates dietary exposure for each individual in the EFSA Comprehensive Database by combining the occurrence levels per food group with their corresponding consumption amount per kg body weight. An individual average exposure per day is calculated, resulting in distributions of individual exposures per survey and population group. Based on these distributions, the average and 95th percentile of exposure is calculated per survey and per population group. Dietary exposure is assessed based on two different sets of data: (a) Maximum permitted levels (MPLs) of use set down in the EU legislation (defined as regulatory maximum level exposure assessment scenario) and (b) usage levels and/or analytical occurrence data (defined as refined exposure assessment scenario). The refined exposure assessment scenario is sub-divided into the brand-loyal consumer scenario and the non-brand-loyal consumer scenario. For the brand-loyal consumer scenario, the consumer is considered to be exposed on long-term basis to the highest reported usage/analytical level for one food group, and at the mean level for the remaining food groups. For the non-brand-loyal consumer scenario, the consumer is considered to be exposed on long-term basis to the mean reported usage/analytical level for all food groups. An additional exposure from sources other than direct addition of food additives (i.e. natural presence, contaminants, and carriers of food additives) is also estimated, as appropriate. Results: Since 2014, this methodology has been applied in about 30 food additive exposure assessments conducted as part of scientific opinions of the EFSA ANS Panel. For example, under the non-brand-loyal scenario, the highest 95th percentile of exposure to α-tocopherol (E 307) and ammonium phosphatides (E 442) was estimated in toddlers up to 5.9 and 8.7 mg/kg body weight/day, respectively. The same estimates under the brand-loyal scenario in toddlers resulted in exposures of 8.1 and 20.7 mg/kg body weight/day, respectively. For the regulatory maximum level exposure assessment scenario, the highest 95th percentile of exposure to α-tocopherol (E 307) and ammonium phosphatides (E 442) was estimated in toddlers up to 11.9 and 30.3 mg/kg body weight/day, respectively. Conclusions: Detailed and up-to-date information on food additive concentration values (usage and/or analytical occurrence data) and food consumption data enable the assessment of chronic dietary exposure to food additives to more realistic levels.

Keywords: α-tocopherol, ammonium phosphatides, dietary exposure assessment, European Food Safety Authority, food additives, food consumption data

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2 Cluster Randomized Trial of 'Ready to Learn': An After-School Literacy Program for Children Starting School

Authors: Geraldine Macdonald, Oliver Perra, Nina O’Neill, Laura Neeson, Kathryn Higgins

Abstract:

Background: Despite improvements in recent years, almost one in six children in Northern Ireland (NI) leaves primary school without achieving the expected level in English and Maths. By early adolescence, this ratio is one in five. In 2010-11, around 9000 pupils in NI had failed to achieve the required standard in literacy and numeracy by the time they left full-time education. This paper reports the findings of an experimental evaluation of a programmed designed to improve educational outcomes of a cohort of children starting primary school in areas of high social disadvantage in Northern Ireland. The intervention: ‘Ready to Learn’ comprised two key components: a literacy-rich After School programme (one hour after school, three days per week), and a range of activities and support to promote the engagement of parents with their children’s learning, in school and at home. The intervention was delivered between September 2010 and August 2013. Study aims and objectives: The primary aim was to assess whether, and to what extent, ‘Ready to Learn’ improved the literacy of socially disadvantaged children entering primary schools compared with children in schools without access to the programme. Secondary aims included assessing the programme’s impact on children’s social, emotional and behavioural regulation, and parents’ engagement with their children’s learning. In total, 505 children (almost all) participated in the baseline assessment for the study, with good retention over seven sweeps of data collection. Study design: The intervention was evaluated by means of a cluster randomized trial, with schools as the unit of randomization and analysis. It included a qualitative component designed to examine process and implementation, and to explore the concept of parental engagement. Sixteen schools participated, with nine randomized to the experimental group. As well as outcome data relating to children, 134 semi-structured interviews were conducted with parents over the three years of the study, together with 88 interviews with school staff. Results: Given the children’s ages, not all measures used were direct measures of reading. Findings point to a positive impact of “Ready to Learn” on children’s reading achievement (comprehension and fluency), as assessed by the York Assessment of Reading Comprehension (YARC) and decoding, assessed using the Word Recognition and Phonic Skills (WRaPS3). Effects were not large, but evidence suggests that it is unusual for an after school programme to clearly to demonstrate effects on reading skills. No differences were found on three other measures of literacy-related skills: British Picture Vocabulary Scale (BPVS-II), Naming Speed and Non-word Reading Tests from the Phonological Assessment Battery (PhAB) or Concepts about Print (CAP) – the last due to an age-related ceiling effect). No differences were found between the two groups on measures of social, emotional and behavioural regulation, and due to low levels of participation, it was not possible directly to assess the contribution of the parent component to children’s outcomes. The qualitative data highlighted conflicting concepts of engagement between parents and school staff. Ready to Learn is a promising intervention that merits further support and evaluation.

Keywords: after-school, education, literacy, parental engagement

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1 Effectiveness of a Physical Activity Loyalty Scheme to Maintain Behaviour Change: A Cluster Randomised Controlled Trial

Authors: Aisling Gough, Ruth F. Hunter, Jianjun Tang, Sarah F. Brennan, Oliver Smith, Mark A. Tully, Chris Patterson, Alberto Longo, George Hutchinson, Lindsay Prior, David French, Jean Adams, Emma McIntosh, Frank Kee

Abstract:

Background: As a large proportion of the UK workforce is employed in sedentary occupations, worksite interventions have the potential to contribute significantly to the health of the population. The UK Government is currently encouraging the use of financial incentives to promote healthier lifestyles but there is a dearth of evidence regarding the effectiveness and sustainability of incentive schemes to promote physical activity in the workplace. Methods: A large cluster RCT is currently underway, incorporating nested behavioural economic field experiments and process evaluation, to evaluate the effectiveness of a Physical Activity Loyalty Scheme. Office-based employees were recruited from large public sector organisations in Lisburn and Belfast (Northern Ireland) and randomised to an Intervention or Control group. Participants in the Intervention Group were encouraged to take part in 150 minutes of physical activity per week through provision of financial incentives (retailer vouchers) to those who met physical activity targets throughout the course of the 6 month intervention. Minutes of physical activity were monitored when participants passed by sensors (holding a keyfob) placed along main walking routes, parks and public transport stops nearby their workplace. Participants in the Control Group will complete the same outcome assessments (waiting-list control). The primary outcome is steps per day measured via pedometers (7 days). Secondary outcomes include health and wellbeing (Short Form-8, EuroQol-5D-5L, Warwick Edinburgh Mental Well Being Scale), and work absenteeism and presenteeism. Data will be collected at baseline, 6, 12 and 18 months. Information on PAL card & website usage, voucher downloads and redemption of vouchers will also be collected as part of a comprehensive process evaluation. Results: In total, 853 participants have been recruited from 9 workplaces in Lisburn, 12 buildings within the Stormont Estate, Queen’s University Belfast and Belfast City Hospital. Participants have been randomised to intervention and control groups. Baseline and 6-month data for the Physical Activity Loyalty Scheme has been collected. Findings regarding the effectiveness of the intervention from the 6-month follow-up data will be presented. Discussion: This study will address the gap in knowledge regarding the effectiveness and cost-effectiveness of a workplace-based financial incentive scheme to promote a healthier lifestyle. As the UK workforce is increasingly sedentary, workplace-based physical activity interventions have significant potential in terms of encouraging employees to partake in physical activity during the working day which could lead to substantial improvements in physical activity levels overall. Implications: If a workplace based physical activity intervention such as this proves to be both effective and cost-effective, there is great potential to contribute significantly to the health and wellbeing of the workforce in the future. Workplace-based physical activity interventions have the potential to improve the physical and mental health of employees which may in turn lead to economic benefits for the employer, such as reduction in rates of absenteeism and increased productivity.

Keywords: behaviour change, cluster randomised controlled trial, loyalty scheme, physical activity

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