Search results for: Z score facial landmark standardization

Authors: Buse A. Ataç, Doğan K. Cenan, Arda Çetinkaya, Naz D. Şahin, Köksal Sanlı, Zeynep Koç, Akın Kısa

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With its spatial data reliability, interpretation and questioning capabilities, Geographical Information Systems make significant contributions to scientists, planners and practitioners. Geographic information systems have received great attention in today's digital world, growing rapidly, and increasing the efficiency of use. Access to and use of current and accurate geographical data, which are the most important components of the Geographical Information System, has become a necessity rather than a need for sustainable and economic development. This project aims to enable sharing of data collected by public institutions and organizations on a web-based platform. Within the scope of the project, INSPIRE (Infrastructure for Spatial Information in the European Community) data specifications are considered as a road-map. In this context, Turkey's National Geographic Information System (TUCBS) Integration Project supports sharing spatial data within 61 pilot public institutions as complied with defined national standards. In this paper, which is prepared by the project team members in the TUCBS Integration Project, the technical process with a detailed methodology is explained. In this context, the main technical processes of the Project consist of Geographic Data Analysis, Geographic Data Harmonization (Standardization), Web Service Creation (WMS, WFS) and Metadata Creation-Publication. In this paper, the integration process carried out to provide the data produced by 61 institutions to be shared from the National Geographic Data Portal (GEOPORTAL), have been trying to be conveyed with a detailed methodology.

Keywords: data specification, geoportal, GIS, INSPIRE, Turkish National Geographic Information System, TUCBS, Turkey's national geographic information system

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Authors: Nadeem A. Kizilbash

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The study aimed to compare the histopathological characterization of prostate cancer using the conventional and 2005 ISUP modified Gleason system. It employed samples from 40 prostate cancer patients employing resection, biopsies and RP. The majority of cases (95%) comprised adenocarcinoma of the prostate. The results showed that there is migration or upgrading of scores to higher values on using the 2005 ISUP modified Gleason system and an increase in a score of 7 in more than 45% of the cases.

Keywords: prostate cancer, conventional gleason grading, 2005 ISUP modified gleason system, histopathology

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Authors: Arulselvi Subramanian, Albert Venencia, Sanjeev Bhoi

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Coagulopathy of trauma is an early endogenous coagulation abnormality that occurs shortly resulting in high mortality. In emergency trauma situations, viscoelastic tests may be better in identifying the various phenotypes of coagulopathy and demonstrate the contribution of platelet function to coagulation. We aimed to determine thrombin generation and clot strength, by estimating a ratio of Maximum amplitude and R-time (MA-R ratio) for identifying trauma coagulopathy and predicting subsequent mortality. Methods: We conducted a prospective cohort analysis of acutely injured trauma patients of the adult age groups (18- 50 years), admitted within 24hrs of injury, for one year at a Level I trauma center and followed up on 3rd day and 5th day of injury. Patients with h/o coagulation abnormalities, liver disease, renal impairment, with h/o intake of drugs were excluded. Thromboelastography was done and a ratio was calculated by dividing the MA by the R-time (MA-R). Patients were further stratified into sub groups based on the calculated MA-R quartiles. First sampling was done within 24 hours of injury; follow up on 3rd and 5thday of injury. Mortality was the primary outcome. Results: 100 acutely injured patients [average, 36.6±14.3 years; 94% male; injury severity score 12.2(9-32)] were included in the study. Median (min-max) on admission MA-R ratio was 15.01(0.4-88.4) which declined 11.7(2.2-61.8) on day three and slightly rose on day 5 13.1(0.06-68). There were no significant differences between sub groups in regard to age, or gender. In the lowest MA-R ratios subgroup; MA-R1 (<8.90; n = 27), injury severity score was significantly elevated. MA-R2 (8.91-15.0; n = 23), MA-R3 (15.01-19.30; n = 24) and MA-R4 (>19.3; n = 26) had no difference between their admission laboratory investigations, however slight decline was observed in hemoglobin, red blood cell count and platelet counts compared to the other subgroups. Also significantly prolonged R time, shortened alpha angle and MA were seen in MA-R1. Elevated incidence of mortality also significantly correlated with on admission low MA-R ratios (p 0.003). Temporal changes in the MA-R ratio did not correlated with mortality. Conclusion: The MA-R ratio provides a snapshot of early clot function, focusing specifically on thrombin burst and clot strength. In our observation, patients with the lowest MA-R time ratio (MA-R1) had significantly increased mortality compared with all other groups (45.5% MA-R1 compared with <25% in MA-R2 to MA-R3, and 9.1% in MA-R4; p < 0.003). Maximum amplitude and R-time may prove highly useful to predict at-risk patients early, when other physiologic indicators are absent.

Keywords: coagulopathy, trauma, thromboelastography, mortality

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Authors: Aparna Sengupta

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The paper seeks to find answers to the question as to why India’s disaster management policies have been unable to deliver the desired results. Are the shortcomings in policy formulation, effective policy implementation or timely prevention mechanisms? Or is there a fundamental issue of policy formulation which sparsely takes into account the cultural specificities and uniqueness, technological know-how, educational, religious and attitudinal capacities of the target population into consideration? India was slow in legislating disaster policies but more than that the reason for lesser success of disaster polices seems to be the gap between policy and the people. We not only keep hearing about the failure of governmental efforts but also how the local communities deal far more efficaciously with disasters utilizing their traditional knowledge. The 2004 Indian Ocean tsunami which killed 250,000 people (approx.) could not kill the tribal communities who saved themselves due to their age-old traditional knowledge. This large scale disaster, considered as a landmark event in history of disasters in the twenty-first century, can be attributed in bringing and confirming the importance of Traditional Environmental Knowledge in managing disasters. This brings forth the importance of cultural and traditional know-how in dealing with natural disasters and one is forced to question as to why shouldn’t traditional environmental knowledge (TEK) be taken into consideration while formulating India’s disaster resilience policies? Though at the international level, many scholars have explored the connectedness of disaster to cultural dimensions and several research examined how culture acts as a stimuli in perceiving disasters and their management (Clifford, 1956; Mcluckie, 1970; Koentjaraningrat, 1985; Peacock, 1997; Elliot et.al, 2006; Aruntoi, 2008; Kulatunga, 2010). But in the Indian context, this field of inquiry i.e. linking disaster policies with tradition and generational understanding has seldom received attention of the government, decision- making authorities, disaster managers and even in the academia. The present study attempts to fill this gap in research and scholarship by presenting an historical analysis of disaster and its cognition by cultural communities in India. The paper seeks to interlink the cultural comprehension of Indian tribal communities with scientific-technology towards more constructive disaster policies in India.

Keywords: culture, disasters, local communities, traditional knowledge

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Authors: Mahnaz Seyedoshohadaee

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Background and Aims: Hospitalization of one of the family members in the hospital, especially in the emergency department, causes anxiety and psychological problems in family members and others. The way nurses interact with patients and their companions can play an important role in controlling and managing their anxiety. This study aims to determine the relationship between the anxiety of family members of patients referring to emergency departments and their views on the communication skills of nurses. Materials and Methods: The current research was a descriptive-correlation cross-sectional study on 263 family members of patients referred to the department. The emergency of two selected medical training centers affiliated with Iran University of Medical Sciences was performed. The samples were selected continuously in 2018 based on the inclusion criteria. Information was collected using the Health Communication Questionnaire (HCCQ) and Beck Anxiety Questionnaire (BAI). To analyze the data, Pearson's correlation coefficient, independent t-tests, analysis of variance, and Kruskal-Wallis were used at a significance level of 0.05. The data was analyzed using SPSS version 16 statistical software. Results: The mean score of communication skills of emergency department nurses from the point of view of patients' companions was at a low level (74.36 with a standard deviation of 3.7). 3.75% of patients' companions had anxiety at a mild level. There was no statistically significant correlation between the anxieties of the patient's companions. The anxiety of the patient's companions had a statistically significant relationship with the educational level (P=0.039), economic status (P=0.033), and family relationship with the patient (P=0.001). Also, the average anxiety score in children was significantly higher than that of patients' wives (P=0.008). The triage level of the patient also had a statistically significant relationship with the anxiety of the patient's companions (P>0.001). Conclusion: Most of the family members of the patients referred to the emergency room experienced mild anxiety. Also, from their point of view, the communication skills of emergency nurses were at a weak level. Despite the fact that there was no statistically significant relationship between the patient's family member's anxiety and their opinion about nurses' communication skills in this study, it seems that the weak communication skills of nurses from the patient's family member's point of view need special attention. The results of the present study can provide the necessary grounds for planning to improve the communication skills of nurses and also control the anxiety of patient caregivers through in-service training or other incentive mechanisms.

Keywords: anxiety, family, emergency department, communication skills, nurse

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Authors: Shafaq Rubab

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The primary reason for dropping out of school is associated with students’ lack of motivation in class, especially in mathematics. Digital game-based learning is an approach that is being actively explored; there are very few learning games based on proven instructional design models or frameworks due to which the effectiveness of the learning games suffers. The purpose of this research was twofold: first, developing an appropriate instructional design model and second, evaluating the impact of the instructional design model on students’ motivation. This research contributes significantly to the existing literature in terms of student motivation and the impact of instructional design model in digital game-based learning. The sample size for this study consists of two hundred out-of-school students between the age of 6 and 12 years. The research methodology used for this research was a quasi-experimental approach and data was analyzed by using the instructional material motivational survey questionnaire which is adapted from the Keller Arcs model. Control and experimental groups consisting of two hundred students were analyzed by utilizing instructional material motivational survey (IMMS), and comparison of result from both groups showed the difference in the level of motivation of the students. The result of the research showed that the motivational level of student in the experimental group who were taught by the game was higher than the student in control group (taught by conventional methodology). The mean score of the experimental group against all subscales (attention, relevance, confidence, and satisfaction) of IMMS survey was higher; however, no statistical significance was found between the motivational scores of control and experimental group. The positive impact of game-based learning on students’ level of motivation, as measured in this study, strengthens the case for the use of pedagogically sound instructional design models in the design of interactive learning applications. In addition, the present study suggests learning from interactive, immersive applications as an alternative solution for children, especially in Third World countries, who, for various reasons, do not attend school. The mean score of experimental group against all subscales of IMMS survey was higher; however, no statistical significance was found between motivational scores of control and experimental group.

Keywords: digital game-based learning, students’ motivation, and instructional designing, instructional material motivational survey

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Authors: Rachana Tank, Donald. M. Lyall, Kristin Flegal, Joey Ward, Jonathan Cavanagh

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Alzheimer’s research UK estimates by 2050, 2 million individuals will be living with Late Onset Alzheimer’s disease (LOAD). However, individuals experience considerable cognitive deficits and brain pathology over decades before reaching clinically diagnosable LOAD and studies have utilised gene candidate studies such as genome wide association studies (GWAS) and polygenic risk (PGR) scores to identify high risk individuals and potential pathways. This investigation aims to determine whether high genetic risk of LOAD is associated with worse brain MRI and cognitive performance in healthy older adults within the UK Biobank cohort. Previous studies investigating associations of PGR for LOAD and measures of MRI or cognitive functioning have focused on specific aspects of hippocampal structure, in relatively small sample sizes and with poor ‘controlling’ for confounders such as smoking. Both the sample size of this study and the discovery GWAS sample are bigger than previous studies to our knowledge. Genetic interaction between loci showing largest effects in GWAS have not been extensively studied and it is known that APOE e4 poses the largest genetic risk of LOAD with potential gene-gene and gene-environment interactions of e4, for this reason we  also analyse genetic interactions of PGR with the APOE e4 genotype. High genetic loading based on a polygenic risk score of 21 SNPs for LOAD is associated with worse brain MRI and cognitive outcomes in healthy individuals within the UK Biobank cohort. Summary statistics from Kunkle et al., GWAS meta-analyses (case: n=30,344, control: n=52,427) will be used to create polygenic risk scores based on 21 SNPs and analyses will be carried out in N=37,000 participants in the UK Biobank. This will be the largest study to date investigating PGR of LOAD in relation to MRI. MRI outcome measures include WM tracts, structural volumes. Cognitive function measures include reaction time, pairs matching, trail making, digit symbol substitution and prospective memory. Interaction of the APOE e4 alleles and PGR will be analysed by including APOE status as an interaction term coded as either 0, 1 or 2 e4 alleles. Models will be adjusted partially for adjusted for age, BMI, sex, genotyping chip, smoking, depression and social deprivation. Preliminary results suggest PGR score for LOAD is associated with decreased hippocampal volumes including hippocampal body (standardised beta = -0.04, P = 0.022) and tail (standardised beta = -0.037, P = 0.030), but not with hippocampal head. There were also associations of genetic risk with decreased cognitive performance including fluid intelligence (standardised beta = -0.08, P<0.01) and reaction time (standardised beta = 2.04, P<0.01). No genetic interactions were found between APOE e4 dose and PGR score for MRI or cognitive measures. The generalisability of these results is limited by selection bias within the UK Biobank as participants are less likely to be obese, smoke, be socioeconomically deprived and have fewer self-reported health conditions when compared to the general population. Lack of a unified approach or standardised method for calculating genetic risk scores may also be a limitation of these analyses. Further discussion and results are pending.

Keywords: Alzheimer's dementia, cognition, polygenic risk, MRI

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Authors: A. Shoiynbek, K. Kozhakhmet, P. Menezes, D. Kuanyshbay, D. Bayazitov

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Speech emotion recognition has received increasing research interest all through current years. There was used emotional speech that was collected under controlled conditions in most research work. Actors imitating and artificially producing emotions in front of a microphone noted those records. There are four issues related to that approach, namely, (1) emotions are not natural, and it means that machines are learning to recognize fake emotions. (2) Emotions are very limited by quantity and poor in their variety of speaking. (3) There is language dependency on SER. (4) Consequently, each time when researchers want to start work with SER, they need to find a good emotional database on their language. In this paper, we propose the approach to create an automatic tool for speech emotion extraction based on facial emotion recognition and describe the sequence of actions of the proposed approach. One of the first objectives of the sequence of actions is a speech detection issue. The paper gives a detailed description of the speech detection model based on a fully connected deep neural network for Kazakh and Russian languages. Despite the high results in speech detection for Kazakh and Russian, the described process is suitable for any language. To illustrate the working capacity of the developed model, we have performed an analysis of speech detection and extraction from real tasks.

Keywords: deep neural networks, speech detection, speech emotion recognition, Mel-frequency cepstrum coefficients, collecting speech emotion corpus, collecting speech emotion dataset, Kazakh speech dataset

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Authors: E. Al Daoud

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The purpose of computing the similarity and the diversity in the species is to trace the process of evolution and to find the relationship between the species and discover the unique, the special, the common and the universal proteins. The proteins of the whole genome of 40 species are compared with the cronobacter genome which is used as reference genome. More than 3 billion pairwise alignments are performed using blastp. Several findings are introduced in this study, for example, we found 172 proteins in cronobacter genome which have insignificant hits in other species, 116 significant proteins in the all tested species with very high score value and 129 common proteins in the plants but have insignificant hits in mammals, birds, fishes, and insects.

Keywords: genome, species, blastp, conserved genes, Cronobacter

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Authors: A. Dionísio, L. Roseiro, J. Fonseca, P. Nicolau

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Thermography is a non-radiating and contact-free technology which can be used to monitor skin temperature. The efficiency and safety of thermography technology make it a useful tool for detecting and locating thermal changes in skin surface, characterized by increases or decreases in temperature. This work intends to be a contribution for the use of thermography as a methodology for evaluation of skin temperature in the context of orofacial biomechanics. The study aims to identify the oscillations of skin temperature in the left and right hemiface regions of the masseter muscle, during and after thermal stimulus, and estimate the time required to restore the initial temperature after the application of the stimulus. Using a FLIR T430sc camera, a data acquisition protocol was followed with a group of eight volunteers, aged between 22 and 27 years. The tests were performed in a controlled environment with the volunteers in a comfortably static position. The thermal stimulus involves the use of an ice volume with controlled size and contact surface. The skin surface temperature was recorded in two distinct situations, namely without further stimulus and with the additions of a stimulus obtained by a chewing gum. The data obtained were treated using FLIR Research IR Max software. The time required to recover the initial temperature ranged from 20 to 52 minutes when no stimulus was added and varied between 8 and 26 minutes with the chewing gum stimulus. These results show that recovery is faster with the addition of the stimulus and may guide clinicians regarding the pre and post-operative times with ice therapy, in the presence or absence of mechanical stimulus that increases muscle functions (e.g. phonetics or mastication).

Keywords: thermography, orofacial biomechanics, skin temperature, ice therapy

Procedia PDF Downloads 239

Authors: Nassima Noufail, Sara Bouhali

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In this work, we develop a semi-supervised solution for the purpose of action detection in videos and propose an efficient algorithm for video segmentation. The approach is divided into video segmentation, feature extraction, and classification. In the first part, a video is segmented into clips, and we used the K-means algorithm for this segmentation; our goal is to find groups based on similarity in the video. The application of k-means clustering into all the frames is time-consuming; therefore, we started by the identification of transition frames where the scene in the video changes significantly, and then we applied K-means clustering into these transition frames. We used two image filters, the gaussian filter and the Laplacian of Gaussian. Each filter extracts a set of features from the frames. The Gaussian filter blurs the image and omits the higher frequencies, and the Laplacian of gaussian detects regions of rapid intensity changes; we then used this vector of filter responses as an input to our k-means algorithm. The output is a set of cluster centers. Each video frame pixel is then mapped to the nearest cluster center and painted with a corresponding color to form a visual map. The resulting visual map had similar pixels grouped. We then computed a cluster score indicating how clusters are near each other and plotted a signal representing frame number vs. clustering score. Our hypothesis was that the evolution of the signal would not change if semantically related events were happening in the scene. We marked the breakpoints at which the root mean square level of the signal changes significantly, and each breakpoint is an indication of the beginning of a new video segment. In the second part, for each segment from part 1, we randomly selected a 16-frame clip, then we extracted spatiotemporal features using convolutional 3D network C3D for every 16 frames using a pre-trained model. The C3D final output is a 512-feature vector dimension; hence we used principal component analysis (PCA) for dimensionality reduction. The final part is the classification. The C3D feature vectors are used as input to a multi-class linear support vector machine (SVM) for the training model, and we used a multi-classifier to detect the action. We evaluated our experiment on the UCF101 dataset, which consists of 101 human action categories, and we achieved an accuracy that outperforms the state of art by 1.2%.

Keywords: video segmentation, action detection, classification, Kmeans, C3D

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Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

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Authors: Eglė Bilevičiūtė, Vidmantas Egidijus Kurapka, Snieguolė Matulienė, Sigutė Stankevičiūtė

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The Council of European Union (EU Council) has stressed on several occasions the need for a concerted, comprehensive and effective solution to delinquency problems in EU communities. In the context of establishing a European Forensic Science Area and the development of forensic science infrastructure in Europe, EU Council believes that forensic science can significantly contribute to the efficiency of law enforcement, crime prevention and combating crimes. Lithuanian scientists have consolidated to implement a project named “Conception of the vision for European Forensic Science 2020 implementation in Lithuania” (the project is funded for the period of 1 March 2014 - 31 December 2016) with the objective to create a conception of implementation of the vision for European Forensic Science 2020 in Lithuania by 1) evaluating the current status of Lithuania’s forensic system and opportunities for its improvement; 2) analysing achievements and knowledge in investigation of crimes listed in conclusions of EU Council on the vision for European Forensic Science 2020 including creation of a European Forensic Science Area and the development of forensic science infrastructure in Europe: trafficking in human beings, organised crime and terrorism; 3) analysing conceptions of criminalistics, which differ in different EU member states due to the variety of forensic schools, and finding means for their harmonization. Apart from the conception of implementation of the vision for European Forensic Science 2020 in Lithuania, the project is expected to suggest provisions that will be relevant to other EU countries as well. Consequently, the presented conception of implementation of vision for European Forensic Science 2020 in Lithuania could initiate a project for a common vision of European Forensic Science and contribute to the development of the EU as an area of freedom, security and justice. The article presents main ideas of the project of the conception of the vision for European Forensic Science 2020 of EU Council and analyses its legal background, as well as prospects of and challenges for its implementation in Lithuania and the EU.

Keywords: EUROVIFOR, standardization, vision for European Forensic Science 2020, Lithuania

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Authors: M. A. Askari, M. A. Nazari, P. Perrier, Y. Payan

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Growth and remodeling of biological structures have gained lots of attention over the past decades. Determining the response of living tissues to mechanical loads is necessary for a wide range of developing fields such as prosthetics design or computerassisted surgical interventions. It is a well-known fact that biological structures are never stress-free, even when externally unloaded. The exact origin of these residual stresses is not clear, but theoretically, growth is one of the main sources. Extracting body organ’s shapes from medical imaging does not produce any information regarding the existing residual stresses in that organ. The simplest cause of such stresses is gravity since an organ grows under its influence from birth. Ignoring such residual stresses might cause erroneous results in numerical simulations. Accounting for residual stresses due to tissue growth can improve the accuracy of mechanical analysis results. This paper presents an original computational framework based on gradual growth to determine the residual stresses due to growth. To illustrate the method, we apply it to a finite element model of a healthy human face reconstructed from medical images. The distribution of residual stress in facial tissues is computed, which can overcome the effect of gravity and maintain tissues firmness. Our assumption is that tissue wrinkles caused by aging could be a consequence of decreasing residual stress and thus not counteracting gravity. Taking into account these stresses seems therefore extremely important in maxillofacial surgery. It would indeed help surgeons to estimate tissues changes after surgery.

Keywords: finite element method, growth, residual stress, soft tissue

Procedia PDF Downloads 257

Authors: Maria Sonto Maputle, Rhulani C. Shihundla, Rachel T. Lebese

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Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.

Keywords: documentation, knowledge, patient care, patient’s information, training

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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the country. The elevated death and disease among ex-slaves were attributable to the unavailability of healthcare. To address the paucity of healthcare services, the College, an institution with the mission of educating minority professionals and serving the under served population, was established in 1876. This study was designed to assess if the College has accomplished its mission of serving under served communities and contributed to the elimination of health disparities in the United States. The study objective was to quantify the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities, which, in turn, was significantly associated with a health professional shortage score partly designated by the U.S. Department of Health and Human Services. Various statistical methods were used to analyze the alumni data in years 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates into the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t test was performed to detect the significant mean differences for clustering and criterion variables between Disadvantaged and Non-disadvantaged Communities, which confirms the “content” validity of cluster analysis model. Chi-square test was used to assess if the proportion of cluster groups (Disadvantaged vs Non-disadvantaged Communities) were consistent with that of practicing specialties (primary care vs. non-primary care). Finally, the partial least squares (PLS) path model was constructed to explore the “construct” validity of analytics model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving disadvantaged community. The social ecological theory along with statistical models mentioned was used to establish the relationship between medical and dental graduates (primary care professionals serving disadvantaged communities) and their social environments (socioeconomic status, adverse health outcome, health professional shortage score). Based on social ecological framework, it was hypothesized that the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities could be quantified. Also, primary care professionals serving disadvantaged communities related to a health professional shortage score can be measured. Adverse health outcome (adult obesity rate, age-adjusted premature mortality rate, and percent of people diagnosed with diabetes) could be affected by the latent variable, namely socioeconomic status (unemployment rate, poverty rate, percent of children who were in free lunch programs, and percent of uninsured adults). The study results indicated that approximately 83% (3,192/3,864) of the College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. In addition, the PLS path modeling demonstrated that primary care professionals serving disadvantaged community was significantly associated with socioeconomic status and adverse health outcome (p < .001). In summary, the majority of medical and dental graduates from the College provide primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcomes, which demonstrate that the College has fulfilled its mission.

Keywords: disadvantaged community, K-means cluster analysis, PLS path modeling, primary care

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Authors: Kemal Kehan, Emine Aktas Bajalan

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This study was carried out to determine the burnout levels and related factors of teachers working in primary schools affiliated to the Turkish Republic of Northern Cyprus (TRNC) Ministry of National Education during the COVID-19 pandemic period. The research was conducted in descriptive cross-sectional design. The population of the research consists of 1071 teachers working in 93 primary schools in 6 central districts affiliated to the TRNC Ministry of National Education in the 2021-2022 academic year. When the sample size of the study was calculated by power analysis, it was determined that 202 teachers should be reached with 95% confidence (1-α), 95% test power (1-β) and d=0.5 effect size. Within the scope of the inclusion criteria of the research, the main sample of the study consisted of 300 teachers and the baist random sampling method was used. The data were collected using the Sociodemographic Data Form consisting of 34 questions, including the sociodemographic characteristics of the teachers and the 22-item Maslach Burnout Scale (MBS). The analysis of the data was carried out using descriptive and correlational analyzes in the SPSS 22 package program. In the study, it was determined that 65% of the teachers were women, 68% were married, 84% had a bachelor's degree, 70.33% had children, and 67.67% were dependents. Regarding how teachers evaluate the COVID-19 pandemic period; 90% of them said, “I am worried about my family's health and the risk of infection”, 80% of them, “I feel that my profession does not get the value it deserves”, 75.67% of them mentioned “My hopes for the future have started to wane”, 75.33% of them say “I am worried about my own health”. It was determined that they gave the answer of, “I am worried about the issue”. It was found that the teachers' MBS total score average was 48.63±8.01, the burnout level was moderate, and the average score they got from the sub-dimensions of the scale was also moderate. It has been found that there are negative correlations between the professional satisfaction scores of the teachers during and before the COVID-19 pandemic and the scores they received from the general and sub-dimensions of MBS. It was determined that there was a statistically significant difference (p<0.05) between the scores of teachers diagnosed with COVID-19 from the scale and its sub-dimensions. As a result, it is suggested that social activities should be increased and professional development and promotion opportunities should be offered in order to ensure that teachers are satisfied with their work areas, to reduce their burnout levels or to prevent them completely.

Keywords: teachers, burnout, maslach burnout scale, pandemic, online education

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Authors: Ainura Tursunalieva, Irene Hudson

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Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

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Authors: G. Sandhya Devi, G. Suvarna Kumar, S. Chandini

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This research work aims to develop a system that will analyze and identify students who indulge in malpractices/suspicious activities during the course of an academic offline examination. Automated Video Surveillance provides an optimal solution which helps in monitoring the students and identifying the malpractice event immediately. This work is organized into three modules. The first module deals with performing an impersonation check using a PCA-based face recognition method which is done by cross checking his profile with the database. The presence or absence of the student is even determined in this module by implementing an image registration technique wherein a grid is formed by considering all the images registered using the frontal camera at the determined positions. Second, detecting such facial malpractices in which a student gets involved in conversation with another, trying to obtain unauthorized information etc., based on the threshold range evaluated by considering his/her mouth state whether open or closed. The third module deals with identification of unauthorized material or gadgets used in the examination hall by training the positive samples of the object through various stages. Here, a top view camera feed is analyzed to detect the suspicious activities. The system automatically alerts the administration when any suspicious activities are identified, thereby reducing the error rate caused due to manual monitoring. This work is an improvement over our previous work published in identifying suspicious activities done by examinees in an offline examination.

Keywords: impersonation, image registration, incrimination, object detection, threshold evaluation

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Authors: Fouzia Qamar, Shahida Hasnain

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The objective of the present study was to evaluate the possible role of Agrobacterium tumefaciens as a possible insect biocontrol agent. Pests selected for the present challenge were adult males of Periplaneta americana and last instar larvae of Pieris brassicae and Spodoptera litura. Different ranges of bacterial doses were selected and tested to score the mortalities of the insects after 24 hours, for the lethal dose estimation studies. Mode of application for the inoculation of the bacteria, was the microinjection technique. The evaluation of the possible entomopathogenic carrying attribute of bacterial Ti plasmid, led to the conclusion that the loss of plasmid was associated with the loss of virulence against target insects.

Keywords: agrobacterium tumefaciens, toxicity assessment, biopesticidal attribute, entomopathogenic agent

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Authors: Mohiuddin Ahsanul Kabir Chowdhury, Ahmed Ehsanur Rahman, Nazia Binte Ali, Abdullah Nurus Salam Khan, Afrin Iqbal, Mohammad Mehedi Hasan, Salma Morium, Afsana Bhuiyan, Shams El Arifeen

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Violence against women has been treated as a global epidemic which is as fatal as any serious disease or accidents. Like many other low-income countries it is also common in Bangladesh. In spite of existence of a few documented evidences in some other countries, in Bangladesh, domestic violence against women (DVAW) is not considered as a factor for malnutrition in children yet. Hence, the aim of the study was to investigate the association between DVAW and the nutritional status of their under-5 children in the context of slum areas of Chittagong, Bangladesh. A Cross-sectional survey was conducted among 87 women of reproductive age having at least one child under-5 years of age and staying with husband for at least last 1 year in selected slums under Chittagong City Corporation area. Data collection tools were structured questionnaire for the study participants and mid-upper arm circumference (MUAC) to measure the nutritional status of the under-5 children. The data underwent descriptive and regression analysis. Out of 87 respondents, 50 (57.5%) reported to suffer from domestic violence by their husband during last one year. Physical violence was found to be significantly associated with age (p=0.02), age at marriage (p=0.043), wealth score (p=0.000), and with knowledge regarding law (p=0.017). According to the measurement of mid-upper arm circumference (MUAC) 21% children were suffering from severe acute malnutrition (SAM) and the same percentage of children were suffering from moderate acute malnutrition (MAM). However, unadjusted odds ratio suggested that there was negative association with domestic violence and nutritional status. But, the logistic regression confounding for other variable showed significant association with total family income (p=0.006), wealth score (p=0.031), age at marriage (p=0.029) and number of child (p=0.006). Domestic violence against women and under nutrition of the children, both are highly prevalent in Bangladesh. More extensive research should be performed to identify the factors contributing to the high prevalence of domestic violence and malnutrition in urban slums of Bangladesh. Household-based intervention is needed to limit this burning problem. In a nutshell, effective community participation, education and counseling are essential to create awareness among the community.

Keywords: Bangladesh, cross sectional survey, domestic violence against women, nutritional status, under-5 children, urban slums

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Authors: Ma. Doreen E. Candelaria, Ma. Louise Margaret A. Ramos, Dr. Jaime Y. Hernandez, Jr

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Bamboo has been introduced as a possible alternative to some construction materials nowadays. Its potential use in the field of engineering, however, is still not widely practiced due to insufficient engineering knowledge on the material’s properties and characteristics. Although there are researches and studies proving its advantages, it is still not enough to say that bamboo can sustain and provide the strength and capacity required of common structures. In line with this, a more detailed analysis was made to observe the layered structure of the bamboo, particularly the species of Kawayan Tinik. It is the main intent of this research to provide the necessary experiments to determine the tensile strength of dried bamboo samples. The test includes tensile strength parallel to fibers with samples taken at internodes only. Throughout the experiment, methods suggested by the International Organization for Standardization (ISO) were followed. The specimens were tested using 3366 INSTRON Universal Testing Machine, with a rate of loading set to 0.6 mm/min. It was then observed from the results of these experiments that dried bamboo samples recorded high layered tensile strengths, as high as 600 MPa. Likewise, along the culm’s length and across its cross section, higher tensile strength were observed at the top part and at its outer layers. Overall, the top part recorded the highest tensile strength per layer, with its outer layers having tensile strength as high as 600 MPa. The recorded tensile strength of its middle and inner layers, on the other hand, were approximately 450 MPa and 180 MPa, respectively. From this variation in tensile strength across the cross section, it may be concluded that an increase in tensile strength may be observed towards the outer periphery of the bamboo. With these preliminary investigations on the layered tensile strength of bamboo, it is highly recommended to conduct experimental investigations on the layered compressive strength properties as well. It is also suggested to conduct investigations evaluating perpendicular layered tensile strength of the material.

Keywords: bamboo strength, layered strength tests, strength test, tensile test

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Authors: Hannah Evangeline Sangeetha

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Ageing is an inevitable change in the life span of an individual. India’s old age population has increased from 19 million in 1947 to 100 million in the 21st century. The United Nations World Population ageing reports that the grey population has immensely increased from 9.2% in 1990 to 11.7 % in 2013, and it’s expected to triple by the year 2050 growing from 737 million to over 2 billion persons 60 years of age and older. Ageing is a period of physical, mental and social decline which brings a host of challenges to the individual and the family. Hence it requires attention at the micro, mezzo and the macro levels of the society. The concepts of healthy and successful aging are being used to help people to change their negative attitude towards aging. This perspective is important to make people realize their potentialities to bring about a change in the minds of senior citizens as well as the society. The objective of this study was to understand the level of active ageing among the rural elderly women and its impact on the quality of life. 330 elderly women from 12 villages of Sriperumbudur associated with the Mobile medical care of Help age India were interviewed using census method. The study revealed the following findings; most respondents in this study were young old between the age group of 60 to 75 years. All the three major religious groups were represented, 85.5percent were Hindus. Majority of the respondents 73.3percent had no education. It was interesting to know that majority of the respondents were self reliant (83.94 percent) and 82.73 percent of them very independent and took care of them by themselves (activities of daily living) without any support from their families. 76.9 percent of the senior women worked based on their competencies, 75.5 percent of them were involved in plenty of activities everyday including their occupation and household chores, which enabled them to be physically active. The chi square values that there is a significant association between the overall active ageing score, religion &number of members in the family. The other demographic variables like age, occupation, income marital status, age at marriage, number of children in the family and Socio –Economic Status were not significantly associated with the overall active aging score. The p-value 0.032 showed Social network and being self-reliant are significantly associated. The study surprisingly shows that most women enjoyed freedom and Independence in their family which is a positive indicator of active ageing.

Keywords: active ageing, quality of life, independence, self reliance

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Authors: L. Hoade, O. O. Onafowokan, K. Anderson, G. E. Bartlett, E. D. Fern, M. R. Norton, R. G. Middleton

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Aims: Femoroacetabular impingement (FAI) was first recognised as a potential driver for hip pain at the turn of the last millennium. While there is an increasing trend towards surgical management of FAI by arthroscopic means, open surgical hip dislocation and debridement (SHD) remains the Gold Standard of care in terms of reported outcome measures. (1) Long-term functional and survivorship outcomes of SHD as a treatment for FAI are yet to be sufficiently reported in the literature. This study sets out to help address this imbalance. Methods: We undertook a retrospective review of our institutional database for all patients who underwent SHD for FAI between January 2003 and December 2008. A total of 223 patients (241 hips) were identified and underwent a ten year review with a standardised radiograph and patient-reported outcome measures questionnaire. The primary outcome measure of interest was survivorship, defined as progression to total hip arthroplasty (THA). Negative predictive factors were analysed. Secondary outcome measures of interest were survivorship to further (non-arthroplasty) surgery, functional outcomes as reflected by patient reported outcome measure scores (PROMS) scores, and whether a learning curve could be identified. Results: The final cohort consisted of 131 females and 110 males, with a mean age of 34 years. There was an overall native hip joint survival rate of 85.4% at ten years. Those who underwent a THA were significantly older at initial surgery, had radiographic evidence of preoperative osteoarthritis and pre- and post-operative acetabular undercoverage. In those whom had not progressed to THA, the average Non-arthritic Hip Score and Oxford Hip Score at ten year follow-up were 72.3% and 36/48, respectively, and 84% still deemed their surgery worthwhile. A learning curve was found to exist that was predicated on case selection rather than surgical technique. Conclusion: This is only the second study to evaluate the long-term outcomes (beyond ten years) of SHD for FAI and the first outside the originating centre. Our results suggest that, with correct patient selection, this remains an operation with worthwhile outcomes at ten years. How the results of open surgery compared to those of arthroscopy remains to be answered. While these results precede the advent of collison software modelling tools, this data helps set a benchmark for future comparison of other techniques effectiveness at the ten year mark.

Keywords: femoroacetabular impingement, hip pain, surgical hip dislocation, hip debridement

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Authors: Ayush Satija, Ritu Raj

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Escalating demand for elevated structures as a remedy for traffic congestion has led to a surge in the construction of viaducts and bridges predominantly employing prestressed beams. However, post-tensioned I-girder superstructures are gaining traction for their attributes like structural efficiency, cost-effectiveness, and easy construction. Recently, Ultra-high-performance fiber-reinforced concrete (UHPFRC) has emerged as a revolutionary material in reshaping conventional infrastructure engineering. UHPFRC offers exceptional properties including high compressive and tensile strength, alongside enhanced durability. Its adoption in bridges yields benefits, notably a remarkable strength-to-weight ratio enabling the design of lighter and slender structural elements, enhancing functionality and sustainability. Despite its myriad advantages, integration of UHPFRC in construction is still evolving, hindered by factors like cost, material availability, and design standardization. Consequently, there's a need to assess the feasibility of substituting ordinary concrete (OC) with UHPFRC in bridges, focusing on economic considerations. This research undertakes an efficacy study between post-tensioned I-girders fabricated from UHPFRC and OC, evaluating cost parameters associated with concrete production, reinforcement, and erection. The study reveals that UHPFRC becomes economically viable for spans exceeding 40.0m. This shift in cost-effectiveness is attributed to factors like reduced girder depth, elimination of un-tensioned steel, diminished need for shear reinforcement and decreased erection costs.

Keywords: post tensioned I girder, superstructure, ultra-high-performance fiber reinforced concrete, ordinary concrete

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Authors: Raymond Xu, Ashley Hua, Andrew Wang, Yuru Lin

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During COVID-19, the depression rate has increased dramatically. Young adults are most vulnerable to the mental health effects of the pandemic. Lower-income families have a higher ratio to be diagnosed with depression than the general population, but less access to clinics. This research aims to achieve early depression detection at low cost, large scale, and high accuracy with an interdisciplinary approach by incorporating clinical practices defined by American Psychiatric Association (APA) as well as multimodal AI framework. The proposed approach detected the nine depression symptoms with Natural Language Processing sentiment analysis and a symptom-based Lexicon uniquely designed for young adults. The experiments were conducted on the multimedia survey results from adolescents and young adults and unbiased Twitter communications. The result was further aggregated with the facial emotional cues analyzed by the Convolutional Neural Network on the multimedia survey videos. Five experiments each conducted on 10k data entries reached consistent results with an average accuracy of 88.31%, higher than the existing natural language analysis models. This approach can reach 300+ million daily active Twitter users and is highly accessible by low-income populations to promote early depression detection to raise awareness in adolescents and young adults and reveal complementary cues to assist clinical depression diagnosis.

Keywords: artificial intelligence, COVID-19, depression detection, psychiatric disorder

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Authors: Amber Shahi, Ayesha Tazeen, Abdus Samad, Shama Parveen

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Nanoparticles (NPs) are tiny particles. According to the International Organization for Standardization, the size range of NPs is in the nanometer range (1-100 nm). They show distinct properties that are not shown by larger particles of the same material. NPs are currently being used in different fields due to their unique physicochemical nature. NPs are a boon for medical sciences, environmental sciences, electronics, and textile industries. However, there is growing concern about their potential adverse effects on human health. This poster presents a comprehensive review of the current literature on the pros and cons of NPs on human health. The poster will discuss the various types of interactions of NPs with biological systems. There are a number of beneficial uses of NPs in the field of health and environmental welfare. NPs are very useful in disease diagnosis, antimicrobial action, and the treatment of diseases like Alzheimer’s. They can also cross the blood-brain barrier, making them capable of treating brain diseases. Additionally, NPs can target specific tumors and be used for cancer treatment. To treat environmental health, NPs also act as catalytic converters to reduce pollution from the environment. On the other hand, NPs also have some negative impacts on the human body, such as being cytotoxic and genotoxic. They can also affect the reproductive system, such as the testis and ovary, and sexual behavior. The poster will further discuss the routes of exposure of NPs. The poster will conclude with a discussion of the current regulations and guidelines on the use of NPs in various applications. It will highlight the need for further research and the development of standardized toxicity testing methods to ensure the safe use of NPs in various applications. When using NPs in diagnosis and treatment, we should also take into consideration their safe concentration in the body. Overall, this poster aims to provide a comprehensive overview of the pros and cons of NPs on human health and to promote awareness and understanding of the potential risks and benefits associated with their use.

Keywords: disease diagnosis, human health, nanoparticles, toxicity testing

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Authors: Wanessa G. Oliveira, Fernando C. Capovilla

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Capovilla and Raphael’s Libras Dictionary documents a corpus of 4,200 Brazilian Sign Language (Libras) signs. Duduchi and Capovilla’s software SignTracking permits users to retrieve signs even when ignoring the gloss corresponding to it and to discover the meaning of all 4,200 signs sign simply by clicking on graphic menus of the sign characteristics (phonemes). Duduchi and Capovilla have discovered that the ease with which any given sign can be retrieved is an inverse function of the average popularity of its component phonemes. Thus, signs composed of rare (distinct) phonemes are easier to retrieve than are those composed of common phonemes. SignTracking offers a means of computing the average popularity of the phonemes that make up each one of 4,200 signs. It provides a precise measure of the degree of ease with which signs can be retrieved, and sign meanings can be discovered. Duduchi and Capovilla’s logarithmic model proved valid: The degree with which any given sign can be retrieved is an inverse function of the arithmetic mean of the logarithm of the popularity of each component phoneme. Capovilla, Raphael and Mauricio’s New Libras Dictionary documents a corpus of 10,400 Libras signs. The present analysis revealed Libras DNA structure by mapping the incidence of 501 sign phonemes resulting from the layered distribution of five parameters: 163 handshape phonemes (CherEmes-ManusIculi); 34 finger shape phonemes (DactilEmes-DigitumIculi); 55 hand placement phonemes (ArtrotoToposEmes-ArticulatiLocusIculi); 173 movement dimension phonemes (CinesEmes-MotusIculi) pertaining to direction, frequency, and type; and 76 Facial Expression phonemes (MascarEmes-PersonalIculi).

Keywords: Brazilian sign language, lexical retrieval, libras sign, sign phonology

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Lucian Vasile Bagiu, Paraschiva Bagiu

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The novel written in Italian and published in Italy in 1992 by the Romanian scholar Marin Mincu is meant for the foreign reader, aiming apparently at a better knowledge of the historical character of Vlad the Empalor (Vlad Dracul), within the European cultural, political and historical context of 1463. Throughout the very well written tome, one comes to realize that one of the underlining levels of the fiction is the exposing of various fundamental features of the Romanian culture and civilization. The author of the diary, Dracula, makes mention of Corpus Hermeticum no less than fifteen times, suggesting his own diary is some sort of a philosophical counterpart. The essay focuses on several ‘truths’ and ‘wisdom’ revealed in the fictional teachings of Dracula. The boycott of History by the Romanians is identified as an echo of the philosophical approach of the famous Romanian scholar and writer Lucian Blaga. The orality of the Romanian culture is a landmark opposed to written culture of the Western Europe. The religion of the ancient Dacian God Zalmoxis is seen as the basis for the Romanian existential and/or metaphysical ethnic philosophy (a feature tackled by the famous Romanian historian of religion Mircea Eliade), with a suggestion that Hermes Trismegistus may have written his Corpus Hermeticum being influenced by Zalmoxis. The historical figure of the last Dacian king Decebalus (death 106 AD) is a good pretext for a tantalizing Indo-European suggestion that the prehistoric Thraco-Dacian people may have been the ancestors of the first Romans settled in Latium. The lost diary of the Emperor Trajan The Bello Dacico may have proved that the unknown language of the Dacians was very much alike Latin language (a secret well hidden by the Vatican). The attitude towards death of the Dacians, as described by Herodotus, may have later inspired Pitagora, Socrates, the Eleusinian and Orphic Mysteries, etc. All of these within the Humanistic and Renascentist European context of the epoch, Dracula having a close relationship with scholars such as Nicolaus Cusanus, Cosimo de Medici, Marsilio Ficino, Pope Pius II, etc. Thus The Diary of Dracula turns out as exciting and stupefying as Corpus Hermeticum, a book impossible to assimilate entirely, yet a reference not wise to be ignored.

Keywords: Corpus Hermeticum, Dacians, Dracula, Zalmoxis

Procedia PDF Downloads 146