Search results for: Ryan Courtney

Authors: Alison Ryan, Himani Chhabra, Mohammed Dungarwalla, Judith Jones

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Background: Impacted and ectopic teeth present in 1-2% of orthodontic patients and often require joint surgical and orthodontic management. The authors present two patients undergoing orthodontic treatment, where the impacted teeth, in a hopeless position, spontaneously erupted during the period of cessation of general anaesthetic lists during the COVID-19 pandemic. Patient information: A healthy 11-year-old boy was referred to the Department of Oral and Maxillofacial Surgery for the management of a mesioangular impacted LR7. The patient was seen by the joint oral surgery/orthodontic team, who planned for the removal of the LR7 under general anaesthetic. A healthy 13-year-old boy was referred to the same Department and team for surgical extraction of unerupted and buccally impacted UL3 and UR3 under general anaesthetic. Management and outcome: The majority of elective dental-alveolar work ceased as a result of the global pandemic. On resumption of activity, the first patient was reviewed in July 2021. The LR7 had spontaneously erupted in a favourable position, and following MDT review, a decision was made to forgo any further surgical intervention. The second patient was reviewed in July 2021. The UL3 had clinically erupted, and there was radiographic evidence of favourable movement of UR3. Due to the nature of the patient’s malocclusion, the decision was made to proceed with the extractions as previously planned. Key Learning Points: Severely impacted teeth do have a prospect of spontaneous eruption or alignment without clinical intervention, and current literature states the initial location, axial inclination, degree of root formation, and relation of the impacted tooth to adjacent teeth roots may influence spontaneous eruption. There is potential to introduce a period of observation to account for this possibility in the developing dentition, with the aim of reducing the unnecessary need for surgical intervention. This could help prevent episodes of general anaesthetic and allocate theatre space more appropriately.

Keywords: spontaneous eruption, impaction, observation, hopeless position, surgical, orthodontic, change in treatment plan

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Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

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Authors: Ryan S. Johnson, Raeesa Moolla

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Airports are known air pollution hotspots due to the variety of fuel driven activities that take place within the confines of them. As such, people working within airports are particularly vulnerable to exposure of hazardous air pollutants, including hundreds of aromatic hydrocarbons, and more specifically a group of compounds known as BTEX (viz. benzene, toluene, ethyl-benzene and xylenes). These compounds have been identified as being harmful to human and environmental health. Through the use of passive and active sampling methods, the spatial and temporal variability of benzene, toluene, ethyl-benzene and xylene concentrations within the international airport was investigated. Two sampling campaigns were conducted. In order to quantify the temporal variability of concentrations within the airport, an active sampling strategy using the Synspec Spectras Gas Chromatography 955 instrument was used. Furthermore, a passive sampling campaign, using Radiello Passive Samplers was used to quantify the spatial variability of these compounds. In addition, meteorological factors are known to affect the dispersal and dilution of pollution. Thus a Davis Pro-Weather 2 station was utilised in order to measure in situ weather parameters (viz. wind speed, wind direction and temperature). Results indicated that toluene varied on a daily, temporal scale considerably more than other concentrations. Toluene further exhibited a strong correlation with regards to the meteorological parameters, inferring that toluene was affected by these parameters to a greater degree than the other pollutants. The passive sampling campaign revealed BTEXtotal concentrations ranged between 12.95 – 124.04 µg m-3. From the results obtained it is clear that benzene, toluene, ethyl-benzene and xylene concentrations are heterogeneously spatially dispersed within the airport. Due to the slow wind speeds recorded over the passive sampling campaign (1.13 m s-1.), the hotspots were located close to the main concentration sources. The most significant hotspot was located over the main apron of the airport. It is recommended that further, extensive investigations into the seasonality of hazardous air pollutants at the airport is necessary in order for sound conclusions to be made about the temporal and spatial distribution of benzene, toluene, ethyl-benzene and xylene concentrations within the airport.

Keywords: airport, air pollution hotspot, BTEX concentrations, meteorology

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Authors: Gabrielle Peck, Ryan Hayes

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Four façade systems were tested using a reduced height BS 8414-2 (5 m) test rig. An L-shaped masonry test wall was clad with three types of insulation and an aluminum composite panel with a non-combustible filling (meeting Euroclass A2). A large (3 MW) wooden crib was ignited in a recess at the base of the L, and the fire was allowed to burn for 30 minutes. Air velocity measurements and gas samples were taken from the main ventilation duct and also a small additional ventilation duct, like those in an apartment bathroom or kitchen. This provided a direct route of travel for smoke from the building façade to a theoretical room using a similar design to many high-rise buildings where the vent is connected to (approximately) 30 m³ rooms. The times to incapacitation and lethality of the effluent were calculated for both the main exhaust vent and for a vent connected to a theoretical 30 m³ room. The rainscreen façade systems tested were the common combinations seen in many tower blocks across the UK. Three tests using ACM A2 with Stonewool, Phenolic foam, and Polyisocyanurate (PIR) foam. A fourth test was conducted with PIR and ACM-PE (polyethylene core). Measurements in the main exhaust duct were representative of the effluent from the burning wood crib. FEDs showed incapacitation could occur up to 30 times quicker with combustible insulation than non-combustible insulation, with lethal gas concentrations accumulating up to 2.7 times faster than other combinations. The PE-cored ACM/PIR combination produced a ferocious fire, resulting in the termination of the test after 13.5 minutes for safety reasons. Occupants of the theoretical room in the PIR/ACM A2 test reached a FED of 1 after 22 minutes; for PF/ACM A2, this took 25 minutes, and for stone wool, a lethal dose measurement of 0.6 was reached at the end of the 30-minute test. In conclusion, when measuring smoke toxicity in the exhaust duct, there is little difference between smoke toxicity measurements between façade systems. Toxicity measured in the main exhaust is largely a result of the wood crib used to ignite the façade system. The addition of a vent allowed smoke toxicity to be quantified in the cavity of the façade, providing a realistic way of measuring the toxicity of smoke that could enter an apartment from a façade fire.

Keywords: smoke toxicity, large-scale testing, BS8414, FED

Procedia PDF Downloads 60

Authors: Elitza Z. Ambrus, Bjoern Hartig, Ryan McKay

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Individuals’ self-judgments might be malleable and influenced by comparison with a random value. On the one hand, self-judgments reflect our self-image, which is typically considered to be stable in adulthood. Indeed, people also strive hard to maintain a fixed, positive moral image of themselves. On the other hand, research has shown the robustness of the so-called anchoring effect on judgments and decisions. The anchoring effect refers to the influence of a previously considered comparative value (anchor) on a consecutive absolute judgment and reveals that individuals’ estimates of various quantities are flexible and can be influenced by a salient random value. The present study extends the anchoring paradigm to the domain of the self. We also investigate whether participants are more susceptible to self-serving anchors, i.e., anchors that enhance participant’s self-image, especially their moral self-image. In a pre-reregistered study via the online platform Prolific, 249 participants (156 females, 89 males, 3 other and 1 who preferred not to specify their gender; M = 35.88, SD = 13.91) ranked themselves on eight personality characteristics. However, in the anchoring conditions, respondents were asked to first indicate whether they thought they would rank higher or lower than a given anchor value before providing their estimated rank in comparison to 100 other anonymous participants. A high and a low anchor value were employed to differentiate between anchors in a desirable (self-serving) direction and anchors in an undesirable (self-diminishing) direction. In the control treatment, there was no comparison question. Subsequently, participants provided their self-rankings on the eight personality traits with two personal characteristics for each combination of the factors desirable/undesirable and moral/non-moral. We found evidence of an anchoring effect for self-judgments. Moreover, anchoring was more efficient when people were anchored in a self-serving direction: the anchoring effect was enhanced when supporting a more favorable self-view and mitigated (even reversed) when implying a deterioration of the self-image. The self-serving anchoring was more pronounced for moral than for non-moral traits. The data also provided evidence in support of a better-than-average effect in general as well as a magnified better-than-average effect for moral traits. Taken together, these results suggest that self-judgments might not be as stable in adulthood as previously thought. In addition, considerations of constructing and maintaining a positive self-image might interact with the anchoring effect on self-judgments. Potential implications of our results concern the construction and malleability of self-judgments as well as the psychological mechanism shaping anchoring.

Keywords: anchoring, better-than-average effect, self-judgments, self-serving anchoring

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Authors: Gabrielle Peck, Ryan Hayes

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This research presents the design and creation of a drone gas analyser, aimed at addressing the need for independent data collection and analysis of gas emissions during large-scale fires, particularly wasteland fires. The analyser drone, comprising a lightweight gas analysis system attached to a remote-controlled drone, enables the real-time assessment of smoke toxicity and the monitoring of gases released into the atmosphere during such incidents. The key components of the analyser unit included two gas line inlets connected to glass wool filters, a pump with regulated flow controlled by a mass flow controller, and electrochemical cells for detecting nitrogen oxides, hydrogen cyanide, and oxygen levels. Additionally, a non-dispersive infrared (NDIR) analyser is employed to monitor carbon monoxide (CO), carbon dioxide (CO₂), and hydrocarbon concentrations. Thermocouples can be attached to the analyser to monitor temperature, as well as McCaffrey probes combined with pressure transducers to monitor air velocity and wind direction. These additions allow for monitoring of the large fire and can be used for predictions of fire spread. The innovative system not only provides crucial data for assessing smoke toxicity but also contributes to fire prediction and management. The remote-controlled drone's mobility allows for safe and efficient data collection in proximity to the fire source, reducing the need for human exposure to hazardous conditions. The data obtained from the gas analyser unit facilitates informed decision-making by emergency responders, aiding in the protection of both human health and the environment. This abstract highlights the successful development of a drone gas analyser, illustrating its potential for enhancing smoke toxicity analysis and fire prediction capabilities. The integration of this technology into fire management strategies offers a promising solution for addressing the challenges associated with wildfires and other large-scale fire incidents. The project's methodology and results contribute to the growing body of knowledge in the field of environmental monitoring and safety, emphasizing the practical utility of drones for critical applications.

Keywords: fire prediction, drone, smoke toxicity, analyser, fire management

Procedia PDF Downloads 90

Authors: Ryan C. Zlomek

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The value of using comics in the literacy classroom has been explored since the 1930s. At that point in time researchers had begun to implement comics into daily lesson plans and, in some instances, had started the development process for comics-supported curriculum. In the mid-1950s, this type of research was cut short due to the work of psychiatrist Frederic Wertham whose research seemingly discovered a correlation between comic readership and juvenile delinquency. Since Wertham’s allegations the comics medium has had a hard time finding its way back to education. Now, over fifty years later, the definition of literacy is in mid-transition as the world has become more visually-oriented and students require the ability to interpret images as often as words. Through this transition, comics has found a place in the field of literacy education research as the shift focuses from traditional print to multimodal and media literacies. Comics are now believed to be an effective resource in bridging the gap between these different types of literacies. This paper seeks to better understand what students learn from the process of reading comics and how those skills line up with the core principles of media literacy education in the United States. In the first section, comics are defined to determine the exact medium that is being examined. The different conventions that the medium utilizes are also discussed. In the second section, the comics reading process is explored through a dissection of the ways a reader interacts with the page, panel, gutter, and different comic conventions found within a traditional graphic narrative. The concepts of intersubjective acts and visualization are attributed to the comics reading process as readers draw in real world knowledge to decode meaning. In the next section, the learning processes that comics encourage are explored parallel to the core principles of media literacy education. Each principle is explained and the extent to which comics can act as an intermediary for this type of education is theorized. In the final section, the author examines comics use in his computer science and technology classroom. He lays out different theories he utilizes from Scott McCloud’s text Understanding Comics and how he uses them to break down media literacy strategies with his students. The article concludes with examples of how comics has positively impacted classrooms around the United States. It is stated that integrating comics into the classroom will not solve all issues related to literacy education but, rather, that comics can be a powerful multimodal resource for educators looking for new mediums to explore with their students.

Keywords: comics, graphics novels, mass communication, media literacy, metacognition

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Authors: Kimberly J. Cribbs, Ryan M. Lefers, TorOve Leiknes, Noreddine Ghaffour

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In Gulf Cooperation Council (GCC) countries, domestic agriculture is hindered by a lack of freshwater, poor soil quality, and ambient temperatures unsuitable for cultivation resulting in a heavy reliance on imported food. Attempts to minimize the risk of food insecurity by growing crops domestically creates a significant demand on limited freshwater resources in this region. Cultivating food in a greenhouse allows some of these challenges, such as poor soil quality and temperatures unsuitable for cultivation, to be overcome. One of the most common methods for greenhouse cooling is evaporative cooling. This method cools the air by the evaporation of water and requires a large amount of water relative to that needed for plant growth and air with a low relative humidity. Considering that much of the population in GCC countries live within 100 km of a coast and that sea water can be utilized for evaporative cooling, coastal agriculture could reduce the risk of food insecurity and water demand. Unfortunately, coastal regions tend to experience both high temperatures and high relative humidity causing evaporative cooling by itself to be inadequate. Therefore, dehumidification is needed prior to utilizing evaporative cooling. Utilizing a liquid desiccant for air dehumidification is promising, but the desiccant regeneration to retain its dehumidification potential remains a significant obstacle for the adoption of this technology. This project studied the regeneration of a magnesium chloride (MgCl₂) desiccant solution from 20wt% to 30wt% by direct contact membrane distillation (DCMD) and explored the possibility of using the recovered water for irrigation. Two 0.2 µm hydrophobic PTFE membranes were tested at feed temperatures of 80, 70, and 60°C and with a permeate temperature of 20°C. It was observed that the permeate flux increases as the difference between the feed and coolant temperature increases and also as the feed concentration decreases. At 21wt% the permeate flux was 34,17, and 14 L m⁻² h⁻¹ for feed temperatures of 80, 70, and 60°C, respectively. Salt rejection decreased overtime; however, it remained greater than 99.9% over an experimental time span of 10 hours. The results show that DCMD can successfully regenerate the magnesium chloride desiccant solution.

Keywords: agriculture, direct contact membrane distillation, GCC countries, liquid desiccant, water recovery

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Authors: Ben Tappin, Ryan McKay

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The political left and right appear to disagree not only over questions of value but, also, over questions of fact—over what is true “out there” in society and the world. Alarmingly, a large body of survey data collected during the past decade suggests that this disagreement tends to be greatest among the most educated and most cognitively sophisticated opposing partisans. In other words, the data show that these individuals display the widest political polarization in their reported factual beliefs. Explanations of this polarization pattern draw heavily on cultural and political factors; yet, the large majority of the evidence originates from one cultural and political context—the United States, a country with a rather unique cultural and political history. One consequence is that widening political polarization conditional on education and cognitive sophistication may be due to idiosyncratic cultural, political or historical factors endogenous to US society—rather than a more general, international phenomenon. We examined widening political polarization conditional on education across Europe, over a topic that is culturally and politically contested; immigration. To do so, we analyzed data from the European Social Survey, a premier survey of countries in and around the European area conducted biennially since 2002. Our main results are threefold. First, we see widening political polarization conditional on education over beliefs about the economic impact of immigration. The foremost countries showing this pattern are the most influential in Europe: Germany and France. However, we also see heterogeneity across countries, with some—such as Belgium—showing no evidence of such polarization. Second, we find that widening political polarization conditional on education is a product of sorting. That is, highly educated partisans exhibit stronger within-group consensus in their beliefs about immigration—the data do not support the view that the more educated partisans are more polarized simply because the less educated fail to adopt a position on the question. Third, and finally, we find some evidence that shocks to the political climate of countries in the European area—for example, the “refugee crisis” of summer 2015—were associated with a subsequent increase in political polarization over immigration conditional on education. The largest increase was observed in Germany, which was at the centre of the so-called refugee crisis in 2015. These results reveal numerous insights: they show that widening political polarization conditional on education is not restricted to the US or native English-speaking culture; that such polarization emerges in the domain of immigration; that it is a product of within-group consensus among the more educated; and, finally, that exogenous shocks to the political climate may be associated with subsequent increases in political polarization conditional on education.

Keywords: beliefs, Europe, immigration, political polarization

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Authors: Ardiansyah I. Ryan, Ashsholih K. R., Fathurrohman G. R., Kurniadi M. R., Huda P. A

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The burden of brain-related disease is very high. There are a lot of brain-related diseases with limited treatment result and thus raise the burden more. The Parkinson Disease (PD), Mental Health Problem, or Paralysis of extremities treatments had risen concern, as the patients for those diseases usually had a low quality of life and low chance to recover fully. There are also many other brain or related neural diseases with the similar condition, mainly the treatments for those conditions are still limited as our understanding of the brain function is insufficient. Brain Implant Technology had given hope to help in treating this condition. In this paper, we examine the current update of the brain implant technology. Neurotechnology is growing very rapidly worldwide. The United States Food and Drug Administration (FDA) has approved the use of Deep Brain Stimulation (DBS) as a brain implant in humans. As for neural implant both the cochlear implant and retinal implant are approved by FDA too. All of them had shown a promising result. DBS worked by stimulating a specific region in the brain with electricity. This device is planted surgically into a very specific region of the brain. This device consists of 3 main parts: Lead (thin wire inserted into the brain), neurostimulator (pacemaker-like device, planted surgically in the chest) and an external controller (to turn on/off the device by patient/programmer). FDA had approved DBS for the treatment of PD, Pain Management, Epilepsy and Obsessive Compulsive Disorder (OCD). The target treatment of DBS in PD is to reduce the tremor and dystonia symptoms. DBS has been showing the promising result in animal and limited human trial for other conditions such as Alzheimer, Mental Health Problem (Major Depression, Tourette Syndrome), etc. Every surgery has risks of complications, although in DBS the chance is very low. DBS itself had a very satisfying result as long as the subject criteria to be implanted this device based on indication and strictly selection. Other than DBS, there are several brain implant devices that still under development. It was included (not limited to) implant to treat paralysis (In Spinal Cord Injury/Amyotrophic Lateral Sclerosis), enhance brain memory, reduce obesity, treat mental health problem and treat epilepsy. The potential of neurotechnology is unlimited. When brain function and brain implant were fully developed, it may be one of the major breakthroughs in human history like when human find ‘fire’ for the first time. Support from every sector for further research is very needed to develop and unveil the true potential of this technology.

Keywords: brain implant, deep brain stimulation (DBS), deep brain stimulation, Parkinson

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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Authors: Ryan Chalk, G. M. Shafiullah

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Climate change is a pertinent issue facing governments and societies around the world. The industrial revolution has resulted in a steady increase in the average global temperature. The mining and energy production industries have been significant contributors to this change prompting government to intervene by promoting low emission technology within these sectors. This paper initially reviews the energy problem in Australia and the mining sector with a focus on the energy requirements and production methods utilised in Western Australia (WA). Renewable energy in the form of utility-scale solar photovoltaics (PV) provides a solution to these problems by providing emission-free energy which can be used to supplement the existing natural gas turbines in operation at the proposed site. This research presents a custom renewable solution for the mining site considering the specific township network, local weather conditions, and seasonal load profiles. A summary of the required PV output is presented to supply slightly over 50% of the towns power requirements during the peak (summer) period, resulting in close to full coverage in the trench (winter) period. Dig Silent Power Factory Software has been used to simulate the characteristics of the existing infrastructure and produces results of integrating PV. Large scale PV penetration in the network introduce technical challenges, that includes; voltage deviation, increased harmonic distortion, increased available fault current and power factor. Results also show that cloud cover has a dramatic and unpredictable effect on the output of a PV system. The preliminary analyses conclude that mitigation strategies are needed to overcome voltage deviations, unacceptable levels of harmonics, excessive fault current and low power factor. Mitigation strategies are proposed to control these issues predominantly through the use of high quality, made for purpose inverters. Results show that use of inverters with harmonic filtering reduces the level of harmonic injections to an acceptable level according to Australian standards. Furthermore, the configuration of inverters to supply active and reactive power assist in mitigating low power factor problems. Use of FACTS devices; SVC and STATCOM also reduces the harmonics and improve the power factor of the network, and finally, energy storage helps to smooth the power supply.

Keywords: climate change, mitigation strategies, photovoltaic (PV), power quality

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Authors: Gabrielle Peck, Ryan Hayes

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Current large scale fire tests focus on flammability and heat release measurements. Smoke toxicity isn’t considered despite it being a leading cause of death and injury in unwanted fires. A key reason could be that the practical difficulties associated with quantifying individual toxic components present in a fire effluent often require specialist equipment and expertise. Fire effluent contains a mixture of unreactive and reactive gases, water, organic vapours and particulate matter, which interact with each other. This interferes with the operation of the analytical instrumentation and must be removed without changing the concentration of the target analyte. To mitigate the need for expensive equipment and time-consuming analysis, a portable gas analysis system was designed, constructed and tested for use in large-scale fire tests as a simpler and more robust alternative to online FTIR measurements. The novel equipment aimed to be easily portable and able to run on battery or mains electricity; be able to be calibrated at the test site; be capable of quantifying CO, CO2, O2, HCN, HBr, HCl, NOx and SO2 accurately and reliably; be capable of independent data logging; be capable of automated switchover of 7 bubblers; be able to withstand fire effluents; be simple to operate; allow individual bubbler times to be pre-set; be capable of being controlled remotely. To test the analysers functionality, it was used alongside the ISO/TS 19700 Steady State Tube Furnace (SSTF). A series of tests were conducted to assess the validity of the box analyser measurements and the data logging abilities of the apparatus. PMMA and PA 6.6 were used to assess the validity of the box analyser measurements. The data obtained from the bench-scale assessments showed excellent agreement. Following this, the portable analyser was used to monitor gas concentrations during large-scale testing using the ISO 9705 room corner test. The analyser was set up, calibrated and set to record smoke toxicity measurements in the doorway of the test room. The analyser was successful in operating without manual interference and successfully recorded data for 12 of the 12 tests conducted in the ISO room tests. At the end of each test, the analyser created a data file (formatted as .csv) containing the measured gas concentrations throughout the test, which do not require specialist knowledge to interpret. This validated the portable analyser’s ability to monitor fire effluent without operator intervention on both a bench and large-scale. The portable analyser is a validated and significantly more practical alternative to FTIR, proven to work for large-scale fire testing for quantification of smoke toxicity. The analyser is a cheaper, more accessible option to assess smoke toxicity, mitigating the need for expensive equipment and specialist operators.

Keywords: smoke toxicity, large-scale tests, iso 9705, analyser, novel equipment

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Authors: Khalid Omari, Rene Chenier, Enrique Blondel, Ryan Ahola

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Northern Canadian coasts have vulnerable and very dynamic intertidal zones with very high tides occurring in several areas. The impact of climate change presents challenges not only for maintaining this biodiversity but also for navigation safety adaptation due to the high sediment mobility in these coastal areas. Thus, frequent mapping of shorelines and intertidal changes is of high importance. To help in quantifying the changes in these fragile ecosystems, remote sensing provides practical monitoring tools at local and regional scales. Traditional methods based on high-resolution optical sensors are often used to map intertidal areas by benefiting of the spectral response contrast of intertidal classes in visible, near and mid-infrared bands. Tidal areas are highly reflective in visible bands mainly because of the presence of fine sand deposits. However, getting a cloud-free optical data that coincide with low tides in intertidal zones in northern regions is very difficult. Alternatively, the all-weather capability and daylight-independence of the microwave remote sensing using synthetic aperture radar (SAR) can offer valuable geophysical parameters with a high frequency revisit over intertidal zones. Multi-polarization SAR parameters have been used successfully in mapping intertidal zones using incoherence target decomposition. Moreover, the crustal displacements caused by ocean tide loading may reach several centimeters that can be detected and quantified across differential interferometric synthetic aperture radar (DInSAR). Soil moisture change has a significant impact on both the coherence and the backscatter. For instance, increases in the backscatter intensity associated with low coherence is an indicator for abrupt surface changes. In this research, we present primary results obtained following our investigation of the potential of the fully polarimetric Radarsat-2 data for mapping an inter-tidal zone located on Tasiujaq on the south-west shore of Ungava Bay, Quebec. Using the repeat pass cycle of Radarsat-2, multiple seasonal fine quad (FQ14W) images are acquired over the site between 2016 and 2018. Only 8 images corresponding to low tide conditions are selected and used to build an interferometric stack of data. The observed displacements along the line of sight generated using HH and VV polarization are compared with the changes noticed using the Freeman Durden polarimetric decomposition and Touzi degree of polarization extrema. Results show the consistency of both approaches in their ability to monitor the changes in intertidal zones.

Keywords: SAR, degree of polarization, DInSAR, Freeman-Durden, polarimetry, Radarsat-2

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Authors: Gabrielle Peck, Ryan Hayes

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Polyurethane (PU) foam is typically sold as acoustic foam that is often used as sound insulation in settings such as night clubs and bars. As a construction product, PU is tested by being glued to the walls and ceiling of the ISO 9705 room corner test room. However, when heat is applied to PU foam, it melts and burns as a pool fire due to it being a thermoplastic. The current test layout is unable to accurately measure mass loss and doesn’t allow for the material to burn as a pool fire without seeping out of the test room floor. The lack of mass loss measurement means gas yields pertaining to smoke toxicity analysis can’t be calculated, which makes data comparisons from any other material or test method difficult. Additionally, the heat release measurements are not representative of the actual measurements taken as a lot of the material seeps through the floor (when a tray to catch the melted material is not used). This research aimed to modify the ISO 9705 test to provide the ability to measure mass loss to allow for better calculation of gas yields and understanding of decomposition. It also aimed to accurately measure smoke toxicity in both the doorway and duct and enable dilution factors to be calculated. Finally, the study aimed to examine if doubling the fuel loading would force under-ventilated flaming. The test layout was modified to be a combination of the SBI (single burning item) test set up inside oof the ISO 9705 test room. Polyurethane was tested in two different ways with the aim of altering the ventilation condition of the tests. Test one was conducted using 1 x SBI test rig aiming for well-ventilated flaming. Test two was conducted using 2 x SBI rigs (facing each other inside the test room) (doubling the fuel loading) aiming for under-ventilated flaming. The two different configurations used were successful in achieving both well-ventilated flaming and under-ventilated flaming, shown by the measured equivalence ratios (measured using a phi meter designed and created for these experiments). The findings show that doubling the fuel loading will successfully force under-ventilated flaming conditions to be achieved. This method can therefore be used when trying to replicate post-flashover conditions in future ISO 9705 room corner tests. The radiative heat generated by the two SBI rigs facing each other facilitated a much higher overall heat release resulting in a more severe fire. The method successfully allowed for accurate measurement of smoke toxicity produced from the PU foam in terms of simple gases such as oxygen depletion, CO and CO2. Overall, the proposed test modifications improve the ability to measure the smoke toxicity of materials in different fire conditions on a large-scale.

Keywords: flammability, ISO9705, large-scale testing, polyurethane, smoke toxicity

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Authors: Ryan A. Black, Stacey A. McCaffrey

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Over the past few decades, great strides have been made towards improving the science in the measurement of psychological constructs. Item Response Theory (IRT) has been the foundation upon which statistical models have been derived to increase both precision and accuracy in psychological measurement. These models are now being used widely to develop and refine tests intended to measure an individual's level of academic achievement, aptitude, and intelligence. Recently, the field of clinical psychology has adopted IRT models to measure psychopathological phenomena such as depression, anxiety, and addiction. Because advances in IRT measurement models are being made so rapidly across various fields, it has become quite challenging for psychologists and other behavioral scientists to keep abreast of the most recent developments, much less learn how to employ and decide which models are the most appropriate to use in their line of work. In the same vein, IRT measurement models vary greatly in complexity in several interrelated ways including but not limited to the number of item-specific parameters estimated in a given model, the function which links the expected response and the predictor, response option formats, as well as dimensionality. As a result, inferior methods (a.k.a. Classical Test Theory methods) continue to be employed in efforts to measure psychological constructs, despite evidence showing that IRT methods yield more precise and accurate measurement. To increase the use of IRT methods, this study endeavors to provide a comprehensive overview of binary IRT models; that is, measurement models employed on test data consisting of binary response options (e.g., correct/incorrect, true/false, agree/disagree). Specifically, this study will cover the most basic binary IRT model, known as the 1-parameter logistic (1-PL) model dating back to over 50 years ago, up until the most recent complex, 4-parameter logistic (4-PL) model. Binary IRT models will be defined mathematically and the interpretation of each parameter will be provided. Next, all four binary IRT models will be employed on two sets of data: 1. Simulated data of N=500,000 subjects who responded to four dichotomous items and 2. A pilot analysis of real-world data collected from a sample of approximately 770 subjects who responded to four self-report dichotomous items pertaining to emotional consequences to alcohol use. Real-world data were based on responses collected on items administered to subjects as part of a scale-development study (NIDA Grant No. R44 DA023322). IRT analyses conducted on both the simulated data and analyses of real-world pilot will provide a clear demonstration of how to construct, evaluate, and compare binary IRT measurement models. All analyses will be performed using the new IRT procedure in SAS 9.4. SAS code to generate simulated data and analyses will be available upon request to allow for replication of results.

Keywords: instrument development, item response theory, latent trait theory, psychometrics

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Authors: Kassahun Tilahun

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The purpose of the study was two-fold: to examine the socio-demographic and psychological predictors of well-being and formulate a socio-culturally sound approach explaining the meaning and experience of psychological well-being among Ethiopian adults. Ryan and Deci’s Self-Determination Theory was duly considered as a theoretical framework of the study. The study followed a sequential explanatory mixed method design. Both quantitative and qualitative data were obtained, via scales and open-ended questionnaires, from 438 civil servants working in Addis Ababa. 30 interviews were also conducted to gain further information. An in-depth analysis of the reliability and validity of instruments was made before employing them to the main study. The results showed that adults were better off in both their scores of psychological and subjective well-being. Besides, adults’ well-being was found to be quite a function of their gender, age, marital status, educational level and household income. Males had a healthier psychological well-being status than females, where as females were better in their subjective well-being. A significant difference in psychological well-being was also observed between emerging and young adults, in favor of the young; and between cohabitated and married adults, married being advantageous. A significant difference in subjective well-being measures was also noticed among single, cohabitated and married adults, in favor of the married adults in all measures. The finding revealed that happiness level of adults decrease as their educational status increases while the reverse is true to psychological well-being. Besides, as adults’ household income boosts, so do their psychological well-being and satisfaction in life. The regression analysis also produced significant independent contributions of household income to overall well-being of adults. As such, subjective well-being was significantly predicted by dummy variable of sex and marital status. Likewise, the agreeableness, conscientiousness, neuroticism and openness dimensions of personality were notable significant predictors of adults’ psychological well-being where as extraversion and agreeableness were significant predictors of their subjective well-being. Religiosity was also a significant predictor of adults’ psychological well-being. Besides, adults’ well-being was significantly predicted by the interaction between conscientiousness and religiosity. From goal pursuit dimensions, attainment of extrinsic life goals was a significant predictor of both psychological and subjective well-being. Importance and attainment of intrinsic life goals also significantly predicts adults’ psychological well-being. Finally, the subjective well-being of adults was significantly predicted by environmental mastery, positive relations with others, self-acceptance and overall psychological well-being scores of adults. The thematic analysis identified five major categories of themes, which are essential in explaining the psychological well-being of Ethiopian adults. These were; socio-cultural harmony, social cohesion, security, competence and accomplishment, and the self. Detailed discussion on the rational for including these themes was made and appropriate implications were proposed. Researchers are encouraged to expand the findings of this research and in turn develop a suitable approach taping the psychological well-being of adults living in countries like Ethiopia.

Keywords: psychological well-being, subjective well-being, adulthood, Ethiopia

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Authors: Johan Anker

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The purpose of this paper is to discuss the nature of gender construction in modern dystopian fiction, the development of this genre in Young Adult Literature and reasons for the enormous appeal on the adolescent readers. A recent award winning South African text in this genre, The Mark by Edith Bullring (2014), will be used as example while also comparing this text to international bestsellers like Divergent (Roth:2011), The Hunger Games (Collins:2008) and others. Theoretical insights from critics and academics in the field of children’s literature, like Ames, Coats, Bradford, Booker, Basu, Green-Barteet, Hintz, McAlear, McCallum, Moylan, Ostry, Ryan, Stephens and Westerfield will be referred to and their insights used as part of the analysis of The Mark. The role of relevant and recurring themes in this genre, like global concerns, environmental destruction, liberty, self-determination, social and political critique, surveillance and repression by the state or other institutions will also be referred to. The paper will shortly refer to the history and emergence of dystopian literature as genre in adult and young adult literature as part of the long tradition since the publishing of Orwell’s 1984 and Huxley’s Brave New World. Different factors appeal to adolescent readers in the modern versions of this hybrid genre for young adults: teenage protagonists who are questioning the underlying values of a flawed society like an inhuman or tyrannical government, a growing understanding of the society around them, feelings of isolation and the dynamic of relationships. This unease leads to a growing sense of the potential to act against society (rebellion), and of their role as agents in a larger community and independent decision-making abilities. This awareness also leads to a growing sense of self (identity and agency) and the development of romantic relationships. The specific modern tendency of a female protagonist as leader in the rebellion against state and state apparatus, who gains in agency and independence in this rebellion, an important part of the identification with and construction of gender, while being part of the traditional coming-of-age young adult novel will be emphasized. A comparison between the traditional themes, structures and plots of young adult literature (YAL) with adult dystopian literature and those of recent dystopian YAL will be made while the hybrid nature of this genre and the 'sense of unease' but also of hope, as an essential part of youth literature, in the closure to these novels will be discussed. Important questions about the role of the didactic nature of these texts and the political issues and the importance of the formation of agency and identity for the young adult reader, as well as identification with the protagonists in this genre, are also part of this discussion of The Mark and other YAL novels.

Keywords: agency, dystopian literature, gender construction, young adult literature

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Authors: Ryan B. Simpson, Margaret A. Waskow, Aishwarya Venkat, Elena N. Naumova

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The Centers for Disease Control and Prevention (CDC) estimate that 31 known foodborne pathogens cause 9.4 million cases of these illnesses annually in US. Over 90% of these illnesses are associated with exposure to Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, Shigella, Shiga-Toxin Producing E.Coli (STEC), Vibrio, and Yersinia. Contaminated products contain parasites typically causing an intestinal illness manifested by diarrhea, stomach cramping, nausea, weight loss, fatigue and may result in deaths in fragile populations. Since 1998, the National Outbreak Reporting System (NORS) has allowed for routine collection of suspected and laboratory-confirmed cases of food poisoning. While retrospective analyses have revealed common pathogen-specific seasonal patterns, little is known concerning the stability of those patterns over time and whether they can be used for preventative forecasting. The objective of this study is to construct a calendar of foodborne outbreaks of nine infections based on the peak timing of outbreak incidence in the US from 1996 to 2017. Reported cases were abstracted from FoodNet for Salmonella (135115), Campylobacter (121099), Shigella (48520), Cryptosporidium (21701), STEC (18022), Yersinia (3602), Vibrio (3000), Listeria (2543), and Cyclospora (758). Monthly counts were compiled for each agent, seasonal peak timing and peak intensity were estimated, and the stability of seasonal peaks and synchronization of infections was examined. Negative Binomial harmonic regression models with the delta-method were applied to derive confidence intervals for the peak timing for each year and overall study period estimates. Preliminary results indicate that five infections continue to lead as major causes of outbreaks, exhibiting steady upward trends with annual increases in cases ranging from 2.71% (95%CI: [2.38, 3.05]) in Campylobacter, 4.78% (95%CI: [4.14, 5.41]) in Salmonella, 7.09% (95%CI: [6.38, 7.82]) in E.Coli, 7.71% (95%CI: [6.94, 8.49]) in Cryptosporidium, and 8.67% (95%CI: [7.55, 9.80]) in Vibrio. Strong synchronization of summer outbreaks were observed, caused by Campylobacter, Vibrio, E.Coli and Salmonella, peaking at 7.57 ± 0.33, 7.84 ± 0.47, 7.85 ± 0.37, and 7.82 ± 0.14 calendar months, respectively, with the serial cross-correlation ranging 0.81-0.88 (p < 0.001). Over 21 years, Listeria and Cryptosporidium peaks (8.43 ± 0.77 and 8.52 ± 0.45 months, respectively) have a tendency to arrive 1-2 weeks earlier, while Vibrio peaks (7.8 ± 0.47) delay by 2-3 weeks. These findings will be incorporated in the forecast models to predict common paths of the spread, long-term trends, and the synchronization of outbreaks across etiological agents. The predictive modeling of foodborne outbreaks should consider long-term changes in seasonal timing, spatiotemporal trends, and sources of contamination.

Keywords: foodborne outbreak, national outbreak reporting system, predictive modeling, seasonality

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Authors: Ryan C. Igama

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The complexity of disaster risk reduction management paved the way for various innovations and approaches to mitigate the loss of lives and casualties during disaster-related situations. The efficiency of doing response operations during disasters relies on the timely and organized deployment of search, rescue and retrieval teams. Indeed, the assistance provided by the search, rescue, and retrieval teams during disaster operations is a critical service needed to further minimize the loss of lives and casualties. The Armed Forces of the Philippines was mandated to provide humanitarian assistance and disaster relief operations during calamities and disasters. Thus, this study “Interoperability of 505TH Search and Rescue Group and the 205TH Tactical Helicopter Wing of the Philippine Air Force in Search and Rescue Operations: An Assessment” was intended to provide substantial information to further strengthen and promote the capabilities of search and rescue operations in the Philippines. Further, this study also aims to assess the interoperability of the 505th Search and Rescue Group of the Philippine Air Force and the 205th Tactical Helicopter Wing Philippine Air Force. This study was undertaken covering the component units in the Philippine Air Force of the Armed Forces of the Philippines – specifically the 505th SRG and the 205th THW as the involved units who also acted as the respondents of the study. The qualitative approach was the mechanism utilized in the form of focused group discussions, key informant interviews, and documentary analysis as primary means to obtain the needed data for the study. Essentially, this study was geared towards the evaluation of the effectiveness of the interoperability of the two (2) involved PAF units during search and rescue operations. Further, it also delved into the identification of the impacts, gaps, and challenges confronted regarding interoperability as to training, equipment, and coordination mechanism vis-à-vis the needed measures for improvement, respectively. The result of the study regarding the interoperability of the two (2) PAF units during search and rescue operations showed that there was a duplication in terms of functions or tasks in HADR activities, specifically during the conduct of air rescue operations in situations like calamities. In addition, it was revealed that there was a lack of equipment and training for the personnel involved in search and rescue operations which is a vital element during calamity response activities. Based on the findings of the study, it was recommended that a strategic planning workshop/activity must be conducted regarding the duties and responsibilities of the personnel involved in the search and rescue operations to address the command and control and interoperability issues of these units. Additionally, the conduct of intensive HADR-related training for the personnel involved in search and rescue operations of the two (2) PAF Units must also be conducted so they can be more proficient in their skills and sustainably increase their knowledge of search and rescue scenarios, including the capabilities of the respective units. Lastly, the updating of existing doctrines or policies must be undertaken to adapt advancement to the evolving situations in search and rescue operations.

Keywords: interoperability, search and rescue capability, humanitarian assistance, disaster response

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Authors: Charlotte Entwistle, Ryan Boyd

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Recent developments in information retrieval techniques and natural language processing have allowed for greater exploration of psychological and social processes. Linguistic analysis methods for understanding behaviour have provided useful insights within the field of mental health. One area within mental health that has received little attention though, is borderline personality disorder (BPD). BPD is a common mental health disorder characterised by instability of interpersonal relationships, self-image and affect. It also manifests through maladaptive behaviours, such as impulsivity and self-harm. Examination of language patterns associated with BPD could allow for a greater understanding of the disorder and its links to maladaptive thoughts and behaviours. Language analysis methods could also be used in a predictive way, such as by identifying indicators of BPD or predicting maladaptive thoughts, emotions and behaviours. Additionally, associations that are uncovered between language and maladaptive thoughts and behaviours could then be applied at a more general level. This study explores linguistic characteristics of BPD, and their links to maladaptive thoughts and behaviours, through the analysis of social media data. Data were collected from a large corpus of posts from the publicly available social media platform Reddit, namely, from the ‘r/BPD’ subreddit whereby people identify as having BPD. Data were collected using the Python Reddit API Wrapper and included all users which had posted within the BPD subreddit. All posts were manually inspected to ensure that they were not posted by someone who clearly did not have BPD, such as people posting about a loved one with BPD. These users were then tracked across all other subreddits of which they had posted in and data from these subreddits were also collected. Additionally, data were collected from a random control group of Reddit users. Disorder-relevant behaviours, such as self-harming or aggression-related behaviours, outlined within Reddit posts were coded to by expert raters. All posts and comments were aggregated by user and split by subreddit. Language data were then analysed using the Linguistic Inquiry and Word Count (LIWC) 2015 software. LIWC is a text analysis program that identifies and categorises words based on linguistic and paralinguistic dimensions, psychological constructs and personal concern categories. Statistical analyses of linguistic features could then be conducted. Findings revealed distinct linguistic features associated with BPD, based on Reddit posts, which differentiated these users from a control group. Language patterns were also found to be associated with the occurrence of maladaptive thoughts and behaviours. Thus, this study demonstrates that there are indeed linguistic markers of BPD present on social media. It also implies that language could be predictive of maladaptive thoughts and behaviours associated with BPD. These findings are of importance as they suggest potential for clinical interventions to be provided based on the language of people with BPD to try to reduce the likelihood of maladaptive thoughts and behaviours occurring. For example, by social media tracking or engaging people with BPD in expressive writing therapy. Overall, this study has provided a greater understanding of the disorder and how it manifests through language and behaviour.

Keywords: behaviour analysis, borderline personality disorder, natural language processing, social media data

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Authors: Elena Chernyak, Ryan Ceresola

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Intimate partner violence is a serious social problem that affects a million women worldwide and impacts their health and wellbeing. Some risk factors for intimate partner violence against women (e.g., disobeying or arguing with a partner, women’s age, education, and employment) are similar in many countries, both developed and developing. However, one of the principal and most significant contributors to women’s vulnerability to violence perpetrated by their intimate partners is the witnessing of interparental aggression in the family of origin. Witnessing interparental violence may lead to acceptance of intimate partner violence as a normal way to resolve conflicts. Thus, utilization of violence becomes the behavioral model: men who witnessed the parental violence are more likely to employ physical violence against their female partners whereas women who observed their fathers beating their mothers learn to tolerate aggressive behavior and become victims of domestic violence themselves. Taking into consideration the importance of this subject matter, the association between witnessing intimate partner violence in family-of-origin and experience of intimate partner violence in adulthood requires further attention. The objective of this research is to analyze and compare the prevalence of intimate partner violence in ten developing countries in different regions, namely: Mali, Haiti, Jordan, Peru, the Philippines, Pakistan, Cambodia, Egypt, the Dominican Republic and Nigeria. Specifically, this research asks whether witnessing interparental violence in a family of origin is associated with the woman’s experience of intimate partner violence during adulthood and to what extent this factor varies among the countries under investigation. This study contributes to the literature on domestic violence against women, prevalence and experience of intimate partner violence against women in developing countries, and the risk factors, using recently collected, nationally representative population-based data from above-mentioned countries. The data used in this research are derived from the demographic and health surveys conducted in the ten mentioned above countries from 2013-2016. These surveys are cross-sectional, nationally representative surveys of ever-married or cohabitating women of reproductive age and the good source of high quality and comprehensive information about women, their children, partners, and households. To complete this analysis, multivariate logistic regression was run for each of the countries, and the results are presented with odds ratios, in order to highlight the effect of witnessing intimate partner violence controlling for other factors. The results of this study indicated that having witnessed partner violence in a family of origin significantly (by 50-500%) increases the likelihood of experiencing later abuse for respondents in all countries. This finding provides robust support for the intergenerational transmission of violence theory that explains the link between interparental aggression and intimate partner violence in subsequent relationships in adulthood as a result of a learned model of behavior observed in childhood. Furthermore, it was found that some of the control variables (e.g., education, number of children, and wealth) are associated with intimate partner violence in some countries under investigation while are not associated with male partner’s abusive behavior in some other, which may be explained by specific cultural and economic factors.

Keywords: intimate partner violence, domestic violence against women, developing countries, demographic and health surveys, risk factors

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Authors: Johnson C. Y. Pang, Amy S. N. Fu, Ryan K. L. Lee, Allan C. L. Fu

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Dry needling (DN) is one of the puncturing methods that involves the insertion of needles into the tender spots of the human body without the injection of any substance. DN has long been used to treat the patient with knee pain caused by knee osteoarthritis (KOA) and patellofemoral pain syndrome (PFPS), but the effectiveness is still inconsistent. This study aimed to conduct a systematic review and meta-analysis to assess the intervention methods and effects of DN with and without ultrasound guidance for treating pain and dysfunctions in people with KOA and PFPS. Design: This systematic review adhered to the PRISMA reporting guidelines. The registration number of the study protocol published in the PROSPERO database was CRD42021221419. Six electronic databases were searched manually through CINAHL Complete (1976-2020), Cochrane Library (1996-2020), EMBASE (1947-2020), Medline (1946-2020), PubMed (1966-2020), and Psychinfo (1806-2020) in November 2020. Randomized controlled trials (RCTs) and controlled clinical trials were included to examine the effects of DN on knee pain, including KOA and PFPS. The key concepts included were: DN, acupuncture, ultrasound guidance, KOA, and PFPS. Risk of bias assessment and qualitative analysis were conducted by two independent reviewers using the PEDro score. Results: Fourteen articles met the inclusion criteria, and eight of them were high-quality papers in accordance with the PEDro score. There were variations in the techniques of DN. These included the direction, depth of insertion, number of needles, duration of stay, needle manipulation, and the number of treatment sessions. Meta-analysis was conducted on eight articles. DN group showed positive short-term effects (from immediate after DN to less than 3 months) on pain reduction for both KOA and PFPS with the overall standardized mean difference (SMD) of -1.549 (95% CI=-0.588 to -2.511); with great heterogeneity (P=0.002, I²=96.3%). In subgroup analysis, DN demonstrated significant effects in pain reduction on PFPS (p < 0.001) that could not be found in subjects with KOA (P=0.302). At 3-month post-intervention, DN also induced significant pain reduction in both subjects with KOA and PFPS with an overall SMD of -0.916 (95% CI=-0.133 to -1.699, and great heterogeneity (P=0.022, I²=95.63%). Besides, DN induced significant short-term improvement in function with the overall SMD=6.069; 95% CI=8.595 to 3.544; with great heterogeneity (P<0.001, I²=98.56%) when analyzed was conducted on both KOA and PFPS groups. In subgroup analysis, only PFPS showed a positive result with SMD=6.089, P<0.001; while KOA showed statistically insignificant with P=0.198 in short-term effect. Similarly, at 3-month post-intervention, significant improvement in function after DN was found when the analysis was conducted in both groups with the overall SMD=5.840; 95% CI=9.252 to 2.428; with great heterogeneity (P<0.001, I²=99.1%), but only PFPS showed significant improvement in sub-group analysis (P=0.002, I²=99.1%). Conclusions: The application of DN in KOA and PFPS patients varies among practitioners. DN is effective in reducing pain and dysfunction at short-term and 3-month post-intervention in individuals with PFPS. To our best knowledge, no study has reported the effects of DN with ultrasound guidance on KOA and PFPS. The longer-term effects of DN on KOA and PFPS are waiting for further study.

Keywords: dry needling, knee osteoarthritis, patellofemoral pain syndrome, ultrasound guidance

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Authors: Carly Madge, Melanie Zurba, Ryan Bullock

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The Boreal Forest has experienced some of the most drastic climate change-induced temperature rises in Canada, with average winter temperatures increasing by 3°C since 1948. One of the main concerns of the province of Saskatchewan, and particularly wildfire managers, is the increased risk of wildfires due to climate change. With these concerns in mind Sakaw Askiy Management Inc., a forestry corporation located in Prince Albert, Saskatchewan with operations in the Boreal Forest biome, is developing wildfire risk reduction strategies that are supported by the shareholders of the corporation as well as the stakeholders of the Prince Albert Forest Management Area (which includes citizens, hunters, trappers, cottage owners, and outfitters). In the past, wildfire management strategies implemented through harvesting have been received with skepticism by some community members of Prince Albert. Engagement of the stakeholders of the Prince Albert Management Area through the development of the wildfire risk reduction strategies aims to reduce this skepticism and rebuild some of the trust that has been lost between industry and community. This research project works with the framework of social learning, which is defined as the learning that occurs when individuals come together to form a group with the purpose of understanding environmental challenges and determining appropriate responses to them. The project evaluates the social learning processes that occur through the development of the risk reduction strategies and how the learning has allowed Sakaw to work towards implementing the strategies into their forest harvesting plans. The incorporation of wildfire risk reduction strategies works to increase the adaptive capacity of Sakaw, which in this case refers to the ability to adjust to climate change, moderate potential damages, take advantage of opportunities, and cope with consequences. Using semi-structured interviews and wildfire workshop meetings shareholders and stakeholders shared their knowledge of wildfire, their main wildfire concerns, and changes they would like to see made in the Prince Albert Forest Management Area. Interviews and topics discussed in the workshops were inductively coded for themes related to learning, adaptive capacity, areas of concern, and preferred methods of wildfire risk reduction strategies. Analysis determined that some of the learning that has occurred has resulted through social interactions and the development of networks oriented towards wildfire and wildfire risk reduction strategies. Participants have learned new knowledge and skills regarding wildfire risk reduction. The formation of wildfire networks increases access to information on wildfire and the social capital (trust and strengthened relations) of wildfire personnel. Both factors can be attributed to increases in adaptive capacity. Interview results were shared with the General Manager of Sakaw, where the areas of concern and preferred strategies of wildfire risk reduction will be considered and accounted for in the implementation of new harvesting plans. This research also augments the growing conceptual and empirical evidence of the important role of learning and networks in regional wildfire risk management efforts.

Keywords: adaptive capacity, community-engagement, social learning, wildfire risk reduction

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Authors: Drew Commandeur, Ryan Brodie, Sandra Hundza, Marc Klimstra

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The amplitude of raw electromyography (EMG) is affected by recording conditions and often requires normalization to make meaningful comparisons. Bioelectric methods normalize with an EMG signal recorded during a standardized task or from the experimental protocol itself, while biomechanical methods often involve measurements with an additional sensor such as a force transducer. Common bioelectric normalization techniques for treadmill walking include maximum voluntary isometric contraction (MVIC), dynamic EMG peak (EMGPeak) or dynamic EMG mean (EMGMean). There are several concerns with using MVICs to normalize EMG, including poor reliability and potential discomfort. A limitation of bioelectric normalization techniques is that they could result in a misrepresentation of the absolute magnitude of force generated by the muscle and impact the interpretation of EMG between functionally disparate groups. Additionally, methods that normalize to EMG recorded during the task may eliminate some real inter-individual variability due to biological variation. This study compared biomechanical and bioelectric EMG normalization techniques during treadmill walking to assess the impact of the normalization method on the functional interpretation of EMG data. For the biomechanical method, we normalized EMG to a target torque (EMGTS) and the bioelectric methods used were normalization to the mean and peak of the signal during the walking task (EMGMean and EMGPeak). The effect of normalization on muscle activation pattern, EMG amplitude, and inter-individual variability were compared between disparate cohorts of OLD (76.6 yrs N=11) and YOUNG (26.6 yrs N=11) adults. Participants walked on a treadmill at a self-selected pace while EMG was recorded from the right lower limb. EMG data from the soleus (SOL), medial gastrocnemius (MG), tibialis anterior (TA), vastus lateralis (VL), and biceps femoris (BF) were phase averaged into 16 bins (phases) representing the gait cycle with bins 1-10 associated with right stance and bins 11-16 with right swing. Pearson’s correlations showed that activation patterns across the gait cycle were similar between all methods, ranging from r =0.86 to r=1.00 with p<0.05. This indicates that each method can characterize the muscle activation pattern during walking. Repeated measures ANOVA showed a main effect for age in MG for EMGPeak but no other main effects were observed. Interactions between age*phase of EMG amplitude between YOUNG and OLD with each method resulted in different statistical interpretation between methods. EMGTS normalization characterized the fewest differences (four phases across all 5 muscles) while EMGMean (11 phases) and EMGPeak (19 phases) showed considerably more differences between cohorts. The second notable finding was that coefficient of variation, the representation of inter-individual variability, was greatest for EMGTS and lowest for EMGMean while EMGPeak was slightly higher than EMGMean for all muscles. This finding supports our expectation that EMGTS normalization would retain inter-individual variability which may be desirable, however, it also suggests that even when large differences are expected, a larger sample size may be required to observe the differences. Our findings clearly indicate that interpretation of EMG is highly dependent on the normalization method used, and it is essential to consider the strengths and limitations of each method when drawing conclusions.

Keywords: electromyography, EMG normalization, functional EMG, older adults

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Authors: Lillian M. Seo, Curtis L. Petersen, Ryan J. Halter, David Kotz, John A. Batsis

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Background: Resistance-based exercises effectively enhance muscle strength, which is especially important in older populations as it reduces the risk of disability. Our group developed a Bluetooth-enabled handle for resistance exercise bands that wirelessly transmits relative force data through low-energy Bluetooth to a local smartphone or similar device. The system has the potential to measure home-based exercise interventions, allowing health professionals to monitor compliance. Its feasibility has already been demonstrated in both clinical and field-based settings, but it remained unclear whether the system’s usability persisted upon repeated use. The current study sought to assess the usability of this system and its users’ satisfaction with repeated use by deploying the device among younger adults to gather formative information that can ultimately improve the device’s design for older adults. Methods: A usability study was conducted in which 32 participants used the above system. Participants executed 10 repetitions of four commonly performed exercises: bicep flexion, shoulder abduction, elbow extension, and triceps extension. Each completed three exercise sessions, separated by at least 24 hours to minimize muscle fatigue. At its conclusion, subjects completed an adapted version of the usefulness, satisfaction, and ease (USE) questionnaire – assessing the system across four domains: usability, satisfaction, ease of use, and ease of learning. The 20-item questionnaire examined how strongly a participant agrees with positive statements about the device on a seven-point Likert scale, with one representing ‘strongly disagree’ and seven representing ‘strongly agree.’ Participants’ data were aggregated to calculate mean response values for each question and domain, effectively assessing the device’s performance across different facets of the user experience. Summary force data were visualized using a custom web application. Finally, an optional prompt at the end of the questionnaire allowed for written comments and feedback from participants to elicit qualitative indicators of usability. Results: Of the n=32 participants, 13 (41%) were female; their mean age was 32.4 ± 11.8 years, and no participants had a physical impairment. No usability questions received a mean score < 5 of seven. The four domains’ mean scores were: usefulness 5.66 ± 0.35; satisfaction 6.23 ± 0.06; ease of use 6.25 ± 0.43; and ease of learning 6.50 ± 0.19. Representative quotes of the open-ended feedback include: ‘A non-rigid strap-style handle might be useful for some exercises,’ and, ‘Would need different bands for each exercise as they use different muscle groups with different strength levels.’ General impressions were favorable, supporting the expectation that the device would be a useful tool in exercise interventions. Conclusions: A simple usability assessment of a Bluetooth-enabled resistance exercise band supports a consistent and positive user experience among young adults. This study provides adequate formative data, assuring the next steps can be taken to continue testing and development for the target population of older adults.

Keywords: Bluetooth, exercise, mobile health, mHealth, usability

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

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

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

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Authors: Aishwarya Venkat, Anastasia Marshak, Ryan B. Simpson, Elena N. Naumova

Abstract:

Livestock ownership is simultaneously linked to improved nutritional status through increased availability of animal-source protein, and increased risk of enteric infections through higher exposure to contaminated water sources. Agrarian and agro-pastoral households, especially those with cattle, goats, and sheep, are highly dependent on seasonally various environmental conditions, which directly impact nutrition and health. This study explores global spatiotemporally explicit evidence regarding the relationship between livestock ownership, enteric infections, and malnutrition. Seasonal and cyclical fluctuations, as well as mediating effects, are further examined to elucidate health and nutrition outcomes of individual and communal livestock ownership. The US Agency for International Development’s Demographic and Health Surveys (DHS) and the United Nations International Children's Emergency Fund’s Multi-Indicator Cluster Surveys (MICS) provide valuable sources of household-level information on anthropometry, asset ownership, and disease outcomes. These data are especially important in data-sparse regions, where surveys may only be conducted in the aftermath of emergencies. Child-level disease history, anthropometry, and household-level asset ownership information have been collected since DHS-V (2003-present) and MICS-III (2005-present). This analysis combines over 15 years of survey data from DHS and MICS to study 2,466,257 children under age five from 82 countries. Subnational (administrative level 1) measures of diarrhea prevalence, mean livestock ownership by type, mean and median anthropometric measures (height for age, weight for age, and weight for height) were investigated. Effects of several environmental, market, community, and household-level determinants were studied. Such covariates included precipitation, temperature, vegetation, the market price of staple cereals and animal source proteins, conflict events, livelihood zones, wealth indices and access to water, sanitation, hygiene, and public health services. Children aged 0 – 6 months, 6 months – 2 years, and 2 – 5 years of age were compared separately. All observations were standardized to interview day of year, and administrative units were harmonized for consistent comparisons over time. Geographically weighted regressions were constructed for each outcome and subnational unit. Preliminary results demonstrate the importance of accounting for seasonality in concurrent assessments of malnutrition and enteric infections. Household assets, including livestock, often determine the intensity of these outcomes. In many regions, livestock ownership affects seasonal fluxes in malnutrition and enteric infections, which are also directly affected by environmental and local factors. Regression analysis demonstrates the spatiotemporal variability in nutrition outcomes due to a variety of causal factors. This analysis presents a synthesis of evidence from global survey data on the interrelationship between enteric infections, malnutrition, and livestock. These results provide a starting point for locally appropriate interventions designed to address this nexus in a timely manner and simultaneously improve health, nutrition, and livelihoods.

Keywords: diarrhea, enteric infections, households, livestock, malnutrition, seasonality

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

Abstract:

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

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

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Authors: Aidan Ryan, Nahima Miah, Sahaj Kaur, Imogen Sutherland, Mohamed Saleh

Abstract:

Pulmonary symptoms are a common presentation to the emergency department. Due to a lack of understanding of the underlying pathophysiology, chronic liver disease is not often considered a cause of dyspnea. We present three patients who were admitted with significant respiratory distress secondary to hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. The first is a 27-year-old male with a 6-month history of progressive dyspnea. The patient developed a severe type 1 respiratory failure with a PaO₂ of 6.3kPa and was escalated to critical care, where he was managed with non-invasive ventilation to maintain oxygen saturation. He had an agitated saline contrast echocardiogram, which showed the presence of a possible shunt. A CT angiogram revealed significant liver cirrhosis, portal hypertension, and large para esophageal varices. Ultrasound of the abdomen showed coarse liver echo patter and enlarged spleen. Along with these imaging findings, his biochemistry demonstrated impaired synthetic liver function with an elevated international normalized ratio (INR) of 1.4 and hypoalbuminaemia of 28g/L. The patient was then transferred to a tertiary center for further management. Further investigations confirmed a shunt of 56%, and liver biopsy confirmed cirrhosis suggestive of alpha-1-antitripsyin deficiency. The findings were consistent with a diagnosis of hepatopulmonary syndrome, and the patient is awaiting a liver transplant. The second patient is a 56-year-old male with a 12-month history of worsening dyspnoea, jaundice, confusion. His medical history included liver cirrhosis, portal hypertension, and grade 1 oesophageal varices secondary to significant alcohol excess. On admission, he developed a type 1 respiratory failure with PaO₂ of 6.8kPa requiring 10L of oxygen. CT pulmonary angiogram was negative for pulmonary embolism but showed evidence of chronic pulmonary hypertension, liver cirrhosis, and portal hypertension. An echocardiogram revealed a grossly dilated right heart with reduced function, pulmonary and tricuspid regurgitation, and pulmonary artery pressures estimated at 78mmHg. His biochemical markers showed impaired synthetic liver function with an INR of 3.2, albumin of 29g/L, along with raised bilirubin of 148mg/dL. During his long admission, he was managed with diuretics with little improvement. After three weeks, he was diagnosed with portopulmonary hypertension and was commenced on terlipressin. This resulted in successfully weaning off oxygen, and he was discharged home. The third patient is a 61-year-old male who presented to the local ambulatory care unit for therapeutic paracentesis on a background of decompensated liver cirrhosis. On presenting, he complained of a 2-day history of worsening dyspnoea and a productive cough. Chest x-ray showed a large pleural effusion, increasing in size over the previous eight months, and his abdomen was visibly distended with ascitic fluid. Unfortunately, the patient deteriorated, developing a larger effusion along with an increase in oxygen demand, and passed away. Without underlying cardiorespiratory disease, in the presence of a persistent pleural effusion with underlying decompensated cirrhosis, he was diagnosed with hepatic hydrothorax. While each presented with dyspnoea, the cause and underlying pathophysiology differ significantly from case to case. By describing these complications, we hope to improve awareness and aid prompt and accurate diagnosis, vital for improving outcomes.

Keywords: dyspnea, hepatic hydrothorax, hepatopulmonary syndrome, portopulmonary syndrome

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