Search results for: left behind
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1249

Search results for: left behind

49 Blood Thicker Than Water: A Case Report on Familial Ovarian Cancer

Authors: Joanna Marie A. Paulino-Morente, Vaneza Valentina L. Penolio, Grace Sabado

Abstract:

Ovarian cancer is extremely hard to diagnose in its early stages, and those afflicted at the time of diagnosis are typically asymptomatic and in the late stages of the disease, with metastasis to other organs. Ovarian cancers often occur sporadically, with only 5% associated with hereditary mutations. Mutations in the BRCA1 and BRCA2 tumor suppressor genes have been found to be responsible for the majority of hereditary ovarian cancers. One type of ovarian tumor is Malignant Mixed Mullerian Tumor (MMMT), which is a very rare and aggressive type, accounting for only 1% of all ovarian cancers. Reported is a case of a 43-year-old G3P3 (3003), who came into our institution due to a 2-month history of difficulty of breathing. Family history reveals that her eldest and younger sisters both died of ovarian malignancy, with her younger sister having a histopathology report of endometrioid ovarian carcinoma, left ovary stage IIIb. She still has 2 asymptomatic sisters. Physical examination pointed to pleural effusion of right lung, and presence of bilateral ovarian new growth, which had a Sassone score of 13. Admitting Diagnosis was G3P3 (3003), Ovarian New Growth, bilateral, Malignant; Pleural effusion secondary to malignancy. BRCA was requested to establish a hereditary mutation; however, the patient had no funds. Once the patient was stabilized, TAHBSO with surgical staging was performed. Intraoperatively, the pelvic cavity was occupied by firm, irregularly shaped ovaries, with a colorectal metastasis. Microscopic sections from both ovaries and the colorectal metastasis had pleomorphic tumor cells lined by cuboidal to columnar epithelium exhibiting glandular complexity, displaying nuclear atypia and increased nuclear-cytoplasmic ratio, which are infiltrating the stroma, consistent with the features of Malignant Mixed Mullerian Tumor, since MMMT is composed histologically of malignant epithelial and sarcomatous elements. In conclusion, discussed is the clinic-pathological feature of a patient with primary ovarian Malignant Mixed Mullerian Tumor, a rare malignancy comprising only 1% of all ovarian neoplasms. Also, by understanding the hereditary ovarian cancer syndromes and its relation to this patient, it cannot be overemphasized that a comprehensive family history is really fundamental for early diagnosis. The familial association of the disease, given that the patient has two sisters who were diagnosed with an advanced stage of ovarian cancer and succumbed to the disease at a much earlier age than what is reported in the general population, points to a possible hereditary syndrome which occurs in only 5% of ovarian neoplasms. In a low-resource setting, being in a third world country, the following will be recommended for monitoring and/or screening women who are at high risk for developing ovarian cancer, such as the remaining sisters of the patient: 1) Physical examination focusing on the breast, abdomen, and rectal area every 6 months. 2) Transvaginal sonography every 6 months. 3) Mammography annually. 4) CA125 for postmenopausal women. 5) Genetic testing for BRCA1 and BRCA2 will be reserved for those who are financially capable.

Keywords: BRCA, hereditary breast-ovarian cancer syndrome, malignant mixed mullerian tumor, ovarian cancer

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48 Quantifying Impairments in Whiplash-Associated Disorders and Association with Patient-Reported Outcomes

Authors: Harpa Ragnarsdóttir, Magnús Kjartan Gíslason, Kristín Briem, Guðný Lilja Oddsdóttir

Abstract:

Introduction: Whiplash-Associated Disorder (WAD) is a health problem characterized by motor, neurological and psychosocial symptoms, stressing the need for a multimodal treatment approach. To achieve individualized multimodal approach, prognostic factors need to be identified early using validated patient-reported and objective outcome measures. The aim of this study is to demonstrate the degree of association between patient-reported and clinical outcome measures of WAD patients in the subacute phase. Methods: Individuals (n=41) with subacute (≥1, ≤3 months) WAD (I-II), medium to high-risk symptoms, or neck pain rating ≥ 4/10 on the Visual Analog Scale (VAS) were examined. Outcome measures included measurements for movement control (Butterfly test) and cervical active range of motion (cAROM) using the NeckSmart system, a computer system using an inertial measurement unit (IMU) that connects to a computer. The IMU sensor is placed on the participant’s head, who receives visual feedback about the movement of the head. Patient-reported neck disability, pain intensity, general health, self-perceived handicap, central sensitization, and difficulties due to dizziness were measured using questionnaires. Excel and R statistical software were used for statistical analyses. Results: Forty-one participants, 15 males (37%), 26 females (63%), mean (SD) age 36.8 (±12.7), underwent data collection. Mean amplitude accuracy (AA) (SD) in the Butterfly test for easy, medium, and difficult paths were 2.4mm (0.9), 4.4mm (1.8), and 6.8mm (2.7), respectively. Mean cAROM (SD) for flexion, extension, left-, and right rotation were 46.3° (18.5), 48.8° (17.8), 58.2° (14.3), and 58.9° (15.0), respectively. Mean scores on the Neck Disability Index (NDI), VAS, Dizziness Handicap Inventory (DHI), Central Sensitization Inventory (CSI), and 36-Item Short Form Survey RAND version (RAND) were 43% (17.4), 7 (1.7), 37 (25.4), 51 (17.5), and 39.2 (17.7) respectively. Females showed significantly greater deviation for AA compared to males for easy and medium Butterfly paths (p<0.05). Statistically significant moderate to strong positive correlation was found between the DHI and easy (r=0.6, p=0.05), medium (r=0.5, p=0.05)) and difficult (r=0.5, p<0.05) Butterfly paths, between the total RAND score and all cAROMs (r between 0.4-0.7, p≤0.05) except flexion (r=0.4, p=0.7), and between the NDI score and CSI (r=0.7, p<0.01), VAS (r=0.5, p<0.01), and DHI (r=0.7, p<0.01) scores respectively. Discussion: All patient-reported and objective measures were found to be outside the reference range. Results suggest females have worse movement control in the neck in the subacute WAD phase. However, no statistical difference based on gender was found in patient-reported measures. Suggesting females might have worse movement control than males in general in this phase. The correlation found between DHI and the Butterfly test can be explained because the DHI measures proprioceptive symptoms like dizziness and eye movement disorders that can affect the outcome of movement control tests. A correlation was found between the total RAND score and cAROM, suggesting that a reduced range of motion affects the quality of life. Significance: The NeckSmart system can detect abnormalities in cAROM, fine movement control, and kinesthesia of the neck. Results suggest females have worse movement control than males. Results show a moderate to a high correlation between several patient-reported and objective measurements.

Keywords: whiplash associated disorders, car-collision, neck, trauma, subacute

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47 Small Scale Mobile Robot Auto-Parking Using Deep Learning, Image Processing, and Kinematics-Based Target Prediction

Authors: Mingxin Li, Liya Ni

Abstract:

Autonomous parking is a valuable feature applicable to many robotics applications such as tour guide robots, UV sanitizing robots, food delivery robots, and warehouse robots. With auto-parking, the robot will be able to park at the charging zone and charge itself without human intervention. As compared to self-driving vehicles, auto-parking is more challenging for a small-scale mobile robot only equipped with a front camera due to the camera view limited by the robot’s height and the narrow Field of View (FOV) of the inexpensive camera. In this research, auto-parking of a small-scale mobile robot with a front camera only was achieved in a four-step process: Firstly, transfer learning was performed on the AlexNet, a popular pre-trained convolutional neural network (CNN). It was trained with 150 pictures of empty parking slots and 150 pictures of occupied parking slots from the view angle of a small-scale robot. The dataset of images was divided into a group of 70% images for training and the remaining 30% images for validation. An average success rate of 95% was achieved. Secondly, the image of detected empty parking space was processed with edge detection followed by the computation of parametric representations of the boundary lines using the Hough Transform algorithm. Thirdly, the positions of the entrance point and center of available parking space were predicted based on the robot kinematic model as the robot was driving closer to the parking space because the boundary lines disappeared partially or completely from its camera view due to the height and FOV limitations. The robot used its wheel speeds to compute the positions of the parking space with respect to its changing local frame as it moved along, based on its kinematic model. Lastly, the predicted entrance point of the parking space was used as the reference for the motion control of the robot until it was replaced by the actual center when it became visible again by the robot. The linear and angular velocities of the robot chassis center were computed based on the error between the current chassis center and the reference point. Then the left and right wheel speeds were obtained using inverse kinematics and sent to the motor driver. The above-mentioned four subtasks were all successfully accomplished, with the transformed learning, image processing, and target prediction performed in MATLAB, while the motion control and image capture conducted on a self-built small scale differential drive mobile robot. The small-scale robot employs a Raspberry Pi board, a Pi camera, an L298N dual H-bridge motor driver, a USB power module, a power bank, four wheels, and a chassis. Future research includes three areas: the integration of all four subsystems into one hardware/software platform with the upgrade to an Nvidia Jetson Nano board that provides superior performance for deep learning and image processing; more testing and validation on the identification of available parking space and its boundary lines; improvement of performance after the hardware/software integration is completed.

Keywords: autonomous parking, convolutional neural network, image processing, kinematics-based prediction, transfer learning

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46 Finite Element Analysis of Mini-Plate Stabilization of Mandible Fracture

Authors: Piotr Wadolowski, Grzegorz Krzesinski, Piotr Gutowski

Abstract:

The aim of the presented investigation is to recognize the possible mechanical issues of mini-plate connection used to treat mandible fractures and to check the impact of different factors for the stresses and displacements within the bone-stabilizer system. The mini-plate osteosynthesis technique is a common type of internal fixation using metal plates connected to the fractured bone parts by a set of screws. The selected two types of plate application methodology used by maxillofacial surgeons were investigated in the work. Those patterns differ in location and number of plates. The bone geometry was modeled on the base of computed tomography scans of hospitalized patient done just after mini-plate application. The solid volume geometry consisting of cortical and cancellous bone was created based on gained cloud of points. Temporomandibular joint and muscle system were simulated to imitate the real masticatory system behavior. Finite elements mesh and analysis were performed by ANSYS software. To simulate realistic connection behavior nonlinear contact conditions were used between the connecting elements and bones. The influence of the initial compression of the connected bone parts or the gap between them was analyzed. Nonlinear material properties of the bone tissues and elastic-plastic model of titanium alloy were used. The three cases of loading assuming the force of magnitude of 100N acting on the left molars, the right molars and the incisors were investigated. Stress distribution within connecting plate shows that the compression of the bone parts in the connection results in high stress concentration in the plate and the screws, however the maximum stress levels do not exceed material (titanium) yield limit. There are no significant differences between negative offset (gap) and no-offset conditions. The location of the external force influences the magnitude of stresses around both the plate and bone parts. Two-plate system gives generally lower von Misses stress under the same loading than the one-plating approach. Von Mises stress distribution within the cortical bone shows reduction of high stress field for the cases without the compression (neutral initial contact). For the initial prestressing there is a visible significant stress increase around the fixing holes at the bottom mini-plate due to the assembly stress. The local stress concentration may be the reason of bone destruction in those regions. The performed calculations prove that the bone-mini-plate system is able to properly stabilize the fractured mandible bone. There is visible strong dependency between the mini-plate location and stress distribution within the stabilizer structure and the surrounding bone tissue. The results (stresses within the bone tissues and within the devices, relative displacements of the bone parts at the interface) corresponding to different models of the connection provide a basis for the mechanical optimization of the mini-plate connections. The results of the performed numerical simulations were compared to clinical observation. They provide information helpful for better understanding of the load transfer in the mandible with the stabilizer and for improving stabilization techniques.

Keywords: finite element modeling, mandible fracture, mini-plate connection, osteosynthesis

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45 Cost-Conscious Treatment of Basal Cell Carcinoma

Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

Abstract:

Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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44 Using Participatory Action Research with Episodic Volunteers: Learning from Urban Agriculture Initiatives

Authors: Rebecca Laycock

Abstract:

Many Urban Agriculture (UA) initiatives, including community/allotment gardens, Community Supported Agriculture, and community/social farms, depend on volunteers. However, initiatives supported or run by volunteers are often faced with a high turnover of labour as a result of the involvement of episodic volunteers (a term describing ad hoc, one-time, and seasonal volunteers), leading to challenges with maintaining project continuity and retaining skills/knowledge within the initiative. This is a notable challenge given that food growing is a knowledge intensive activity where the fruits of labour appear months or sometimes years after investment. Participatory Action Research (PAR) is increasingly advocated for in the field of UA as a solution-oriented approach to research, providing concrete results in addition to advancing theory. PAR is a cyclical methodological approach involving researchers and stakeholders collaboratively 'identifying' and 'theorising' an issue, 'planning' an action to address said issue, 'taking action', and 'reflecting' on the process. Through iterative cycles and prolonged engagement, the theory is developed and actions become better tailored to the issue. The demand for PAR in UA research means that understanding how to use PAR with episodic volunteers is of critical importance. The aim of this paper is to explore (1) the challenges of doing PAR in UA initiatives with episodic volunteers, and (2) how PAR can be harnessed to advance sustainable development of UA through theoretically-informed action. A 2.5 year qualitative PAR study on three English case study student-led food growing initiatives took place between 2014 and 2016. University UA initiatives were chosen as exemplars because most of their volunteers were episodic. Data were collected through 13 interviews, 6 workshops, and a research diary. The results were thematically analysed through eclectic coding using Computer-Assisted Qualitative Data Analysis Software (NVivo). It was found that the challenges of doing PAR with transient participants were (1) a superficial understanding of issues by volunteers because of short term engagement, resulting in difficulties ‘identifying’/‘theorising’ issues to research; (2) difficulties implementing ‘actions’ given those involved in the ‘planning’ phase often left by the ‘action’ phase; (3) a lack of capacity of participants to engage in research given the ongoing challenge of maintaining participation; and (4) that the introduction of the researcher acted as an ‘intervention’. The involvement of a long-term stakeholder (the researcher) changed the group dynamics, prompted critical reflections that had not previously taken place, and improved continuity. This posed challenges for providing a genuine understanding the episodic volunteering PAR initiatives, and also challenged the notion of what constitutes an ‘intervention’ or ‘action’ in PAR. It is recommended that researchers working with episodic volunteers using PAR should (1) adopt a first-person approach by inquiring into the researcher’s own experience to enable depth in theoretical analysis to manage the potentially superficial understandings by short-term participants; and (2) establish safety mechanisms to address the potential for the research to impose artificial project continuity and knowledge retention that will end when the research does. Through these means, we can more effectively use PAR to conduct solution-oriented research about UA.

Keywords: community garden, continuity, first-person research, higher education, knowledge retention, project management, transience, university

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43 Medium-Scale Multi-Juice Extractor for Food Processing

Authors: Flordeliza L. Mercado, Teresito G. Aguinaldo, Helen F. Gavino, Victorino T. Taylan

Abstract:

Most fruits and vegetables are available in large quantities during peak season which are oftentimes marketed at low price and left to rot or fed to farm animals. The lack of efficient storage facilities, and the additional cost and unavailability of small machinery for food processing, results to low price and wastage. Incidentally, processed fresh fruits and vegetables are gaining importance nowadays and health conscious people are also into ‘juicing’. One way to reduce wastage and ensure an all-season availability of crop juices at reasonable costs is to develop equipment for effective extraction of juice. The study was conducted to design, fabricate and evaluate a multi-juice extractor using locally available materials, making it relatively cheaper and affordable for medium-scale enterprises. The study was also conducted to formulate juice blends using extracted juices and calamansi juice at different blending percentage, and evaluate its chemical properties and sensory attributes. Furthermore, the chemical properties of extracted meals were evaluated for future applications. The multi-juice extractor has an overall dimension of 963mm x 300mm x 995mm, a gross weight of 82kg and 5 major components namely; feeding hopper, extracting chamber, juice and meal outlet, transmission assembly, and frame. The machine performance was evaluated based on juice recovery, extraction efficiency, extraction rate, extraction recovery, and extraction loss considering type of crop as apple and carrot with three replications each and was analyzed using T-test. The formulated juice blends were subjected to sensory evaluation and data gathered were analyzed using Analysis of Variance appropriate for Complete Randomized Design. Results showed that the machine’s juice recovery (73.39%), extraction rate (16.40li/hr), and extraction efficiency (88.11%) for apple were significantly higher than for carrot while extraction recovery (99.88%) was higher for apple than for carrot. Extraction loss (0.12%) was lower for apple than for carrot, but was not significantly affected by crop. Based on adding percentage mark-up on extraction cost (Php 2.75/kg), the breakeven weight and payback period for a 35% mark-up is 4,710.69kg and 1.22 years, respectively and for a 50% mark-up, the breakeven weight is 3,492.41kg and the payback period is 0.86 year (10.32 months). Results on the sensory evaluation of juice blends showed that the type of juice significantly influenced all the sensory parameters while the blending percentage including their respective interaction, had no significant effect on all sensory parameters, making the apple-calamansi juice blend more preferred than the carrot-calamansi juice blend in terms of all the sensory parameter. The machine’s performance is higher for apple than for carrot and the cost analysis on the use of the machine revealed that it is financially viable with a payback period of 1.22 years (35% mark-up) and 0.86 year (50% mark-up) for machine cost, generating an income of Php 23,961.60 and Php 34,444.80 per year using 35% and 50% mark-up, respectively. The juice blends were of good qualities based on the values obtained in the chemical analysis and the extracted meal could also be used to produce another product based on the values obtained from proximate analysis.

Keywords: food processing, fruits and vegetables, juice extraction, multi-juice extractor

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42 Emotional State and Cognitive Workload during a Flight Simulation: Heart Rate Study

Authors: Damien Mouratille, Antonio R. Hidalgo-Muñoz, Nadine Matton, Yves Rouillard, Mickael Causse, Radouane El Yagoubi

Abstract:

Background: The monitoring of the physiological activity related to mental workload (MW) on pilots will be useful to improve aviation safety by anticipating human performance degradation. The electrocardiogram (ECG) can reveal MW fluctuations due to either cognitive workload or/and emotional state since this measure exhibits autonomic nervous system modulations. Arguably, heart rate (HR) is one of its most intuitive and reliable parameters. It would be particularly interesting to analyze the interaction between cognitive requirements and emotion in ecologic sets such as a flight simulator. This study aims to explore by means of HR the relation between cognitive demands and emotional activation. Presumably, the effects of cognition and emotion overloads are not necessarily cumulative. Methodology: Eight healthy volunteers in possession of the Private Pilot License were recruited (male; 20.8±3.2 years). ECG signal was recorded along the whole experiment by placing two electrodes on the clavicle and left pectoral of the participants. The HR was computed within 4 minutes segments. NASA-TLX and Big Five inventories were used to assess subjective workload and to consider the influence of individual personality differences. The experiment consisted in completing two dual-tasks of approximately 30 minutes of duration into a flight simulator AL50. Each dual-task required the simultaneous accomplishment of both a pre-established flight plan and an additional task based on target stimulus discrimination inserted between Air Traffic Control instructions. This secondary task allowed us to vary the cognitive workload from low (LC) to high (HC) levels, by combining auditory and visual numerical stimuli to respond to meeting specific criteria. Regarding emotional condition, the two dual-tasks were designed to assure analogous difficulty in terms of solicited cognitive demands. The former was realized by the pilot alone, i.e. Low Arousal (LA) condition. In contrast, the latter generates a high arousal (HA), since the pilot was supervised by two evaluators, filmed and involved into a mock competition with the rest of the participants. Results: Performance for the secondary task showed significant faster reaction times (RT) for HA compared to LA condition (p=.003). Moreover, faster RT was found for LC compared to HC (p < .001) condition. No interaction was found. Concerning HR measure, despite the lack of main effects an interaction between emotion and cognition is evidenced (p=.028). Post hoc analysis showed smaller HR for HA compared to LA condition only for LC (p=.049). Conclusion. The control of an aircraft is a very complex task including strong cognitive demands and depends on the emotional state of pilots. According to the behavioral data, the experimental set has permitted to generate satisfactorily different emotional and cognitive levels. As suggested by the interaction found in HR measure, these two factors do not seem to have a cumulative impact on the sympathetic nervous system. Apparently, low cognitive workload makes pilots more sensitive to emotional variations. These results hint the independency between data processing and emotional regulation. Further physiological data are necessary to confirm and disentangle this relation. This procedure may be useful for monitoring objectively pilot’s mental workload.

Keywords: cognitive demands, emotion, flight simulator, heart rate, mental workload

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41 Experience in Caring for a Patient with Terminal Aortic Dissection of Lung Cancer and Paralysis of the Lower Limbs after Surgery

Authors: Pei-Shan Liang

Abstract:

Objective: This article explores the care experience of a terminal lung cancer patient who developed lower limb paralysis after surgery for aortic dissection. The patient, diagnosed with aortic dissection during chemotherapy for lung cancer, faced post-surgical lower limb paralysis, leading to feelings of helplessness and hopelessness as they approached death with reduced mobility. Methods: The nursing period was from July 19 to July 27, during which the author, alongside the intensive care team and palliative care specialists, conducted a comprehensive assessment through observation, direct care, conversations, physical assessments, and medical record review. Gordon's eleven functional health patterns were used for a holistic evaluation, identifying four nursing health issues: "pain related to terminal lung cancer and invasive procedures," "decreased cardiac tissue perfusion due to hemodynamic instability," "impaired physical mobility related to lower limb paralysis," and "hopelessness due to the unpredictable prognosis of terminal lung cancer." Results: The medical team initially focused on symptom relief, administering Morphine 5mg in 0.9% N/S 50ml IVD q6h for pain management and continuing chemotherapy as prescribed. Open communication was employed to address the patient's physical, psychological, and spiritual concerns. Non-pharmacological interventions, including listening, caring, companionship, opioid medication, and distraction techniques like comfortable positioning and warm foot baths, were used to alleviate pain, reducing the pain score to 3 on the numeric rating scale and easing respiratory discomfort. The palliative care team was also involved, guiding the patient and family through the "Four Paths of Life," helping the patient achieve a good end-of-life experience and the family to experience a peaceful life. This process also served to promote the concept of palliative care, enabling more patients and families to receive high-quality and dignified care. The patient was encouraged to express inner anxiety through drawing or writing, which helped reduce the hopelessness caused by psychological distress and uncertainty about the disease's prognosis, as assessed by the Hospital Anxiety and Depression Scale, reaching a level of mild anxiety but acceptable without affecting sleep. Conclusion: What left a deep impression during the care process was the need for intensive care providers to consider the patient's psychological state, not just their physical condition, when the patient's situation changes. Family support and involvement often provide the greatest solace for the patient, emphasizing the importance of comfort and dignity. This includes oral care to maintain cleanliness and comfort, frequent repositioning to alleviate pressure and discomfort, and timely removal of invasive devices and unnecessary medications to avoid unnecessary suffering. The nursing process should also address the patient's psychological needs, offering comfort and support to ensure that they can face the end of life with peace and dignity.

Keywords: intensive care, lung cancer, aortic dissection, lower limb paralysis

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40 Foucault and Governmentality: International Organizations and State Power

Authors: Sara Dragisic

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Using the theoretical analysis of the birth of biopolitics that Foucault performed through the history of liberalism and neoliberalism, in this paper we will try to show how, precisely through problematizing the role of international institutions, the model of governance differs from previous ways of objectifying body and life. Are the state and its mechanisms still a Leviathan to fight against, or can it be even the driver of resistance against the proponents of modern governance and the biopolitical power? Do paradigmatic examples of biopolitics still appear through sovereignty and (international) law, or is it precisely this sphere that shows a significant dose of incompetence and powerlessness in relation to, not only the economic sphere (Foucault’s critique of neoliberalism) but also the new politics of freedom? Have the struggle for freedom and human rights, as well as the war on terrorism, opened a new spectrum of biopolitical processes, which are manifested precisely through new international institutions and humanitarian discourse? We will try to answer these questions, in the following way. On the one hand, we will show that the views of authors such as Agamben and Hardt and Negri, in whom the state and sovereignty are seen as enemies to be defeated or overcome, fail to see how such attempts could translate into the politicization of life like it is done in many examples through the doctrine of liberal interventionism and humanitarianism. On the other hand, we will point out that it is precisely the humanitarian discourse and the defense of the right to intervention that can be the incentive and basis for the politicization of the category of life and lead to the selective application of human rights. Zizek example of the killing of United Nations workers and doctors in a village during the Vietnam War, who were targeted even before police or soldiers, because they were precisely seen as a powerful instrument of American imperialism (as they were sincerely trying to help the population), will be focus of this part of the analysis. We’ll ask the question whether such interpretation is a kind of liquidation of the extreme left of the political (Laclau) or on this basis can be explained at least in part the need to review the functioning of international organizations, ranging from those dealing with humanitarian aid (and humanitarian military interventions) to those dealing with protection and the security of the population, primarily from growing terrorism. Based on the above examples, we will also explain how the discourse of terrorism itself plays a dual role: it can appear as a tool of liberal biopolitics, although, more superficially, it mostly appears as an enemy that wants to destroy the liberal system and its values. This brings us to the basic problem that this paper will tackle: do the mechanisms of institutional struggle for human rights and freedoms, which is often seen as opposed to the security mechanisms of the state, serve the governance of citizens in such a way that the latter themselves participate in producing biopolitical governmental practices? Is the freedom today "nothing but the correlative development of apparatuses of security" (Foucault)? Or, we can continue this line of Foucault’s argumentation and enhance the interpretation with the important question of what precisely today reflects the change in the rationality of governance in which society is transformed from a passive object into a subject of its own production. Finally, in order to understand the skills of biopolitical governance in modern civil society, it is necessary to pay attention to the status of international organizations, which seem to have become a significant place for the implementation of global governance. In this sense, the power of sovereignty can turn out to be an insufficiently strong power of security policy, which can go hand in hand with freedom policies, through neoliberal governmental techniques.

Keywords: neoliberalism, Foucault, sovereignty, biopolitics, international organizations, NGOs, Agamben, Hardt&Negri, Zizek, security, state power

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39 Variations in Spatial Learning and Memory across Natural Populations of Zebrafish, Danio rerio

Authors: Tamal Roy, Anuradha Bhat

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Cognitive abilities aid fishes in foraging, avoiding predators & locating mates. Factors like predation pressure & habitat complexity govern learning & memory in fishes. This study aims to compare spatial learning & memory across four natural populations of zebrafish. Zebrafish, a small cyprinid inhabits a diverse range of freshwater habitats & this makes it amenable to studies investigating role of native environment in spatial cognitive abilities. Four populations were collected across India from waterbodies with contrasting ecological conditions. Habitat complexity of the water-bodies was evaluated as a combination of channel substrate diversity and diversity of vegetation. Experiments were conducted on populations under controlled laboratory conditions. A square shaped spatial testing arena (maze) was constructed for testing the performance of adult zebrafish. The square tank consisted of an inner square shaped layer with the edges connected to the diagonal ends of the tank-walls by connections thereby forming four separate chambers. Each of the four chambers had a main door in the centre. Each chamber had three sections separated by two windows. A removable coloured window-pane (red, yellow, green or blue) identified each main door. A food reward associated with an artificial plant was always placed inside the left-hand section of the red-door chamber. The position of food-reward and plant within the red-door chamber was fixed. A test fish would have to explore the maze by taking turns and locate the food inside the right-side section of the red-door chamber. Fishes were sorted from each population stock and kept individually in separate containers for identification. At a time, a test fish was released into the arena and allowed 20 minutes to explore in order to find the food-reward. In this way, individual fishes were trained through the maze to locate the food reward for eight consecutive days. The position of red door, with the plant and the reward, was shuffled every day. Following training, an intermission of four days was given during which the fishes were not subjected to trials. Post-intermission, the fishes were re-tested on the 13th day following the same protocol for their ability to remember the learnt task. Exploratory tendencies and latency of individuals to explore on 1st day of training, performance time across trials, and number of mistakes made each day were recorded. Additionally, mechanism used by individuals to solve the maze each day was analyzed across populations. Fishes could be expected to use algorithm (sequence of turns) or associative cues in locating the food reward. Individuals of populations did not differ significantly in latencies and tendencies to explore. No relationship was found between exploration and learning across populations. High habitat-complexity populations had higher rates of learning & stronger memory while low habitat-complexity populations had lower rates of learning and much reduced abilities to remember. High habitat-complexity populations used associative cues more than algorithm for learning and remembering while low habitat-complexity populations used both equally. The study, therefore, helped understand the role of natural ecology in explaining variations in spatial learning abilities across populations.

Keywords: algorithm, associative cue, habitat complexity, population, spatial learning

Procedia PDF Downloads 287
38 Implementation of Cord- Blood Derived Stem Cells in the Regeneration of Two Experimental Models: Carbon Tetrachloride and S. Mansoni Induced Liver Fibrosis

Authors: Manal M. Kame, Zeinab A. Demerdash, Hanan G. El-Baz, Salwa M. Hassan, Faten M. Salah, Wafaa Mansour, Olfat Hammam

Abstract:

Cord blood (CB) derived Unrestricted Somatic Stem Cells (USSCs) with their multipotentiality hold great promise in liver regeneration. This work aims at evaluation of the therapeutic potentiality of USSCs in two experimental models of chronic liver injury induced either by S. mansoni infection in balb/c mice or CCL4 injection in hamsters. Isolation, propagation, and characterization of USSCs from CB samples were performed. USSCs were induced to differentiate into osteoblasts, adipocytes and hepatocyte-like cells. Cells of the third passage were transplanted in two models of liver fibrosis: (1) Twenty hamsters were induced to liver fibrosis by repeated i. p. injection of 100 μl CCl4 /hamster for 8 weeks. This model was designed as; 10 hamsters with liver fibrosis and treated with i.h. injection of 3x106 USSCs (USSCs transplanted group), 10 hamsters with liver fibrosis (pathological control group), and 10 hamsters with healthy livers (normal control group). (2) Murine chronics S.mansoni model: twenty mice were induced to liver fibrosis with S. mansoni ceracariae (60 cercariae/ mouse) using the tail immersion method and left for 12 weeks. This model was designed as; 10 mice with liver fibrosis were transplanted with i. v. injection of 1×106 USCCs (USSCs transplanted group). Other 2 groups were designed as in hamsters model. Animals were sacrificed 12 weeks after USSCs transplantation, and their liver sections were examined for detection of human hepatocyte-like cells by immunohistochemistry staining. Moreover, liver sections were examined for fibrosis level, and fibrotic indices were calculated. Sera of sacrificed animals were tested for liver functions. CB USSCs, with fibroblast-like morphology, expressed high levels of CD44, CD90, CD73 and CD105 and were negative for CD34, CD45, and HLA-DR. USSCs showed high expression of transcripts for Oct4 and Sox2 and were in vitro differentiated into osteoblasts, adipocytes. In both animal models, in vitro induced hepatocyte-like cells were confirmed by cytoplasmic expression of glycogen, alpha-fetoprotein, and cytokeratin18. Livers of USSCs transplanted group showed engraftment with human hepatocyte-like cells as proved by cytoplasmic expression of human alpha-fetoprotein, cytokeratin18, and OV6. In addition, livers of this group showed less fibrosis than the pathological control group. Liver functions in the form of serum AST & ALT level and serum total bilirubin level were significantly lowered in USSCs transplanted group than pathological control group (p < 0.001). Moreover, the fibrotic index was significantly lower (p< 0.001) in USSCs transplanted group than pathological control group. In addition liver sections, of i. v. injection of 1×106 USCCs of mice, stained with either H&E or sirius red showed diminished granuloma size and a relative decrease in hepatic fibrosis. Our experimental liver fibrosis models transplanted with CB-USSCs showed liver engraftment with human hepatocyte-like cells as well as signs of liver regeneration in the form of improvement in liver function assays and fibrosis level. These data provide hope that human CB- derived USSCs are introduced as multipotent stem cells with great potentiality in regenerative medicine & strengthens the concept of cellular therapy for the treatment of liver fibrosis.

Keywords: cord blood, liver fibrosis, stem cells, transplantation

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37 Influence of Bacterial Biofilm on the Corrosive Processes in Electronic Equipment

Authors: Iryna P. Dzieciuch, Michael D. Putman

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Humidity is known to degrade Navy ship electronic equipment, especially in hot moist environments. If left untreated, it can cause significant and permanent damage. Even rigorous inspection and frequent clean-up would not prevent further equipment contamination and degradation because of the constant presence of favorable growth conditions for many microorganisms. Generally, relative humidity levels of less than 60% will inhibit corrosion in electronic equipment, but because NAVY electronics often operate in hot and humid environments, prevention via dehumidification is not always possible. Currently, there is no defined research that fully describes key mechanisms which cause electronics and its coating degradation. The corrosive action of most bacteria is mainly developed through (i) mycelium adherence to the metal plates, (ii) facilitation the formation of pitting areas, (iii) production of organic acids such as citric, iso-citric, cis-aconitic, alpha-ketoglutaric, which are corrosive to electronic equipment and its components. Our approach studies corrosive action in electronic equipment: circuit-board, wires and connections that are exposed in the humid environment that gets worse during condensation. In our new approach the technical task is built on work with the bacterial communities in public areas, bacterial genetics, bioinformatics, biostatistics and Scanning Electron Microscopy (SEM) of corroded circuit boards. Based on these methods, we collect and examine environmental samples from biofilms of the corroded and non-corroded sites, where bacterial contamination of electronic equipment, such as machine racks and shore boats, is an ongoing concern. Sample collection and sample analysis is focused on addressing the key questions identified above through the following tasks: laboratory sample processing and evaluation under scanning electron microscopy, initial sequencing and data evaluation; bioinformatics and data analysis. Preliminary results from scanning electron microscopy (SEM) have revealed that metal particulates and alloys in corroded samples consists mostly of Tin ( < 40%), Silicon ( < 4%), Sulfur ( < 1%), Aluminum ( < 2%), Magnesium ( < 2%), Copper ( < 1%), Bromine ( < 2%), Barium ( <1%) and Iron ( < 2%) elements. We have also performed X 12000 magnification of the same sites and that proved existence of undisrupted biofilm organelles and crystal structures. Non-corrosion sites have revealed high presence of copper ( < 47%); other metals remain at the comparable level as on the samples with corrosion. We have performed X 1000 magnification on the non-corroded at the sites and have documented formation of copper crystals. The next step of this study, is to perform metagenomics sequencing at all sites and to compare bacterial composition present in the environment. While copper is nontoxic to the living organisms, the process of bacterial adhesion creates acidic environment by releasing citric, iso-citric, cis-aconitic, alpha-ketoglutaric acidics, which in turn release copper ions Cu++, which that are highly toxic to the bacteria and higher order living organisms. This phenomenon, might explain natural “antibiotic” properties that are lacking in elements such as tin. To prove or deny this hypothesis we will use next - generation sequencing (NGS) methods to investigate types and growth cycles of bacteria that from bacterial biofilm the on corrosive and non-corrosive samples.

Keywords: bacteria, biofilm, circuit board, copper, corrosion, electronic equipment, organic acids, tin

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36 Understanding Natural Resources Governance in Canada: The Role of Institutions, Interests, and Ideas in Alberta's Oil Sands Policy

Authors: Justine Salam

Abstract:

As a federal state, Canada’s constitutional arrangements regarding the management of natural resources is unique because it gives complete ownership and control of natural resources to the provinces (subnational level). However, the province of Alberta—home to the third largest oil reserves in the world—lags behind comparable jurisdictions in levying royalties on oil corporations, especially oil sands royalties. While Albertans own the oil sands, scholars have argued that natural resource exploitation in Alberta benefits corporations and industry more than it does Albertans. This study provides a systematic understanding of the causal factors affecting royalties in Alberta to map dynamics of power and how they manifest themselves during policy-making. Mounting domestic and global public pressure led Alberta to review its oil sands royalties twice in less than a decade through public-commissioned Royalty Review Panels, first in 2007 and again in 2015. The Panels’ task was to research best practices and to provide policy recommendations to the Government through public consultations with Albertans, industry, non-governmental organizations, and First Nations peoples. Both times, the Panels recommended a relative increase to oil sands royalties. However, irrespective of the Reviews’ recommendations, neither the right-wing 2007 Progressive Conservative Party (PC) nor the left-wing 2015 New Democratic Party (NDP) government—both committed to increase oil sands royalties—increased royalty intake. Why did two consecutive political parties at opposite ends of the political spectrum fail to account for the recommendations put forward by the Panel? Through a qualitative case-study analysis, this study assesses domestic and global causal factors for Alberta’s inability to raise oil sands royalties significantly after the two Reviews through an institutions, interests, and ideas framework. Indeed, causal factors can be global (e.g. market and price fluctuation) or domestic (e.g. oil companies’ influence on the Alberta government). The institutions, interests, and ideas framework is at the intersection of public policy, comparative studies, and political economy literatures, and therefore draws multi-faceted insights into the analysis. To account for institutions, the study proposes to review international trade agreements documents such as the North American Free Trade Agreement (NAFTA) because they have embedded Alberta’s oil sands into American energy security policy and tied Canadian and Albertan oil policy in legal international nods. To account for interests, such as how the oil lobby or the environment lobby can penetrate governmental decision-making spheres, the study draws on the Oil Sands Oral History project, a database of interviews from government officials and oil industry leaders at a pivotal time in Alberta’s oil industry, 2011-2013. Finally, to account for ideas, such as how narratives of Canada as a global ‘energy superpower’ and the importance of ‘energy security’ have dominated and polarized public discourse, the study relies on content analysis of Alberta-based pro-industry newspapers to trace the prevalence of these narratives. By mapping systematically the nods and dynamics of power at play in Alberta, the study sheds light on the factors that influence royalty policy-making in one of the largest industries in Canada.

Keywords: Alberta Canada, natural resources governance, oil sands, political economy

Procedia PDF Downloads 132
35 Need for Policy and Legal Framework for Caste Based Atrocities as Violation of International Human Rights in View of Indian Diaspora

Authors: Vijayalaxmi Khopade

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The Prima facie caste system is intrinsic to Indian society. It is an ancient system of intense social stratification based upon birth and enjoying religious sanction. The uppermost strata and privileges are ascribed and enjoyed by brahmins (priestly class), while the lowest strata are occupied by Dalits who are not ascribed with any privileges. The caste system is inherently hierarchical, patriarchal, and systematic and thrives solely on exploitation justified through means of the Brahminical system of hegemony based singularly on birth. The caste system has extended its tentacles to other religions like Christianity, Buddhism, Jainism, and Islam in South Asia. Term Dalit is colloquially used to categorize persons belonging to lower strata in the caste hierarchy. However, this category is heterogenous and highly stratified, following practices like untouchability and exclusion amongst themselves. The modern Indian legal system acknowledges the existence of Caste and its perils. Therefore, by virtue of the Indian Constitution, provisions for affirmative action for the protection and development of Dalits are made. Courts in India have liberally interpreted laws to benefit Dalits. However, the modern system of governance is not immune from Caste based biases. These biases are reflected in the implementation of governance, including the dispensation of justice. The economic reforms of the 1990s gave a huge boost to the Indian diaspora. Persons of Indian origin are now seen making great strides in almost every sector and enjoying positions of power globally. As one peels off the layer of ethnic Indian origin, a deep seated layer of Caste and Caste based patriarchy is clearly visible. Indian diaspora enjoying positions of power essentially belongs to upper castes and carry Caste based biases with them. These castes have long enjoyed the benefits of education; therefore, they were the first ones to benefit from LPG (Liberalization, Privatization, Globalization) model adopted in the 1990s. Dalits, however, had little formal education until recently. The western legal system, to the best of our knowledge, does not recognize Caste and, therefore, cannot afford protection for Dalits, wherein discrimination and exploitation take place solely on the basis of Caste. Therefore, Dalits are left with no legal remedy outside domestic jurisdiction. Countries like the UK have made an attempt to include Caste in their Equality Bill 2010. This has met with tough resistance from Upper caste Hindus who shy away from recognizing their caste privileges and, therefore, the existence of Caste. In this paper, an attempt for comparative analysis is made between various legal protections accorded to Dalits in India vis-à-vis international human rights as protected by the United Nations under its declaration of Universal Human rights. An attempt has been made to mark a distinction between race and Caste and to establish a position of women in Caste based hierarchy. The paper also makes an argument for the inclusion of atrocities committed against Dalits as a violation of international human rights, their protection by the United Nations, and the trial of their violations by International Courts. The paper puts into perspective the need for an external agency like the United Nations and International courts to interfere in rights guaranteed by the Indian Constitution, even with the existence of a modern legal system in a sovereign democratic country.

Keywords: atrocity, caste, diaspora, legal framework

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34 Sea Level Rise and Sediment Supply Explain Large-Scale Patterns of Saltmarsh Expansion and Erosion

Authors: Cai J. T. Ladd, Mollie F. Duggan-Edwards, Tjeerd J. Bouma, Jordi F. Pages, Martin W. Skov

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Salt marshes are valued for their role in coastal flood protection, carbon storage, and for supporting biodiverse ecosystems. As a biogeomorphic landscape, marshes evolve through the complex interactions between sea level rise, sediment supply and wave/current forcing, as well as and socio-economic factors. Climate change and direct human modification could lead to a global decline marsh extent if left unchecked. Whilst the processes of saltmarsh erosion and expansion are well understood, empirical evidence on the key drivers of long-term lateral marsh dynamics is lacking. In a GIS, saltmarsh areal extent in 25 estuaries across Great Britain was calculated from historical maps and aerial photographs, at intervals of approximately 30 years between 1846 and 2016. Data on the key perceived drivers of lateral marsh change (namely sea level rise rates, suspended sediment concentration, bedload sediment flux rates, and frequency of both river flood and storm events) were collated from national monitoring centres. Continuous datasets did not extend beyond 1970, therefore predictor variables that best explained rate change of marsh extent between 1970 and 2016 was calculated using a Partial Least Squares Regression model. Information about the spread of Spartina anglica (an invasive marsh plant responsible for marsh expansion around the globe) and coastal engineering works that may have impacted on marsh extent, were also recorded from historical documents and their impacts assessed on long-term, large-scale marsh extent change. Results showed that salt marshes in the northern regions of Great Britain expanded an average of 2.0 ha/yr, whilst marshes in the south eroded an average of -5.3 ha/yr. Spartina invasion and coastal engineering works could not explain these trends since a trend of either expansion or erosion preceded these events. Results from the Partial Least Squares Regression model indicated that the rate of relative sea level rise (RSLR) and availability of suspended sediment concentration (SSC) best explained the patterns of marsh change. RSLR increased from 1.6 to 2.8 mm/yr, as SSC decreased from 404.2 to 78.56 mg/l along the north-to-south gradient of Great Britain, resulting in the shift from marsh expansion to erosion. Regional differences in RSLR and SSC are due to isostatic rebound since deglaciation, and tidal amplitudes respectively. Marshes exposed to low RSLR and high SSC likely leads to sediment accumulation at the coast suitable for colonisation by marsh plants and thus lateral expansion. In contrast, high RSLR with are likely not offset deposition under low SSC, thus average water depth at the marsh edge increases, allowing larger wind-waves to trigger marsh erosion. Current global declines in sediment flux to the coast are likely to diminish the resilience of salt marshes to RSLR. Monitoring and managing suspended sediment supply is not common-place, but may be critical to mitigating coastal impacts from climate change.

Keywords: lateral saltmarsh dynamics, sea level rise, sediment supply, wave forcing

Procedia PDF Downloads 134
33 Stromal Vascular Fraction Regenerative Potential in a Muscle Ischemia/Reperfusion Injury Mouse Model

Authors: Anita Conti, Riccardo Ossanna, Lindsey A. Quintero, Giamaica Conti, Andrea Sbarbati

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Ischemia/reperfusion (IR) injury induces muscle fiber atrophy and skeletal muscle fiber death with subsequently functionality loss. The heterogeneous pool of cells, especially mesenchymal stem cells, contained in the stromal vascular fraction (SVF) of adipose tissue could promote muscle fiber regeneration. To prevent SVF dispersion, it has been proposed the use of injectable biopolymers that work as cells carrier. A significant element of the extracellular matrix is hyaluronic acid (HA), which has been widely used in regenerative medicine as a cell scaffold given its biocompatibility, degradability, and the possibility of chemical functionalization. Connective tissue micro-fragments enriched with SVF obtained from mechanical disaggregation of adipose tissue were evaluated for IR muscle injury regeneration using low molecular weight HA as a scaffold. IR induction. Hindlimb ischemia was induced in 9 athymic nude mice through the clamping of the right quadriceps using a plastic band. Reperfusion was induced by cutting the plastic band after 3 hours of ischemic period. Contralateral (left) muscular tissue was used as healthy control. Treatment. Twenty-four hours after the IR induction, animals (n=3) were intramuscularly injected with 100 µl of SVF mixed with HA (SVF-HA). Animals treated with 100 µl of HA (n=3) and 100 µl saline solution (n=3) were used as control. Treatment monitoring. All animals were in vivo monitored by magnetic resonance imaging (MRI) at 5, 7, 14 and 18 days post-injury (dpi). High-resolution morphological T2 weighed, quantitative T2 map and Dynamic Contrast-Enhanced (DCE) images were acquired in order to assess the regenerative potential of SVF-HA treatment. Ex vivo evaluation. After 18 days from IR induction, animals were sacrificed, and the muscles were harvested for histological examination. At 5 dpi T2 high-resolution MR images clearly reveal the presence of an extensive edematous area due to IR damage for all groups identifiable as an increase of signal intensity (SI) of muscular and surrounding tissue. At 7 dpi, animals of the SVF-HA group showed a reduction of SI, and the T2relaxation time of muscle tissue of the HA-SVF group was 29±0.5ms, comparable with the T2relaxation time of contralateral muscular tissue (30±0.7ms). These suggest a reduction of edematous overflow and swelling. The T2relaxation time at 7dpi of HA and saline groups were 84±2ms and 90±5ms, respectively, which remained elevated during the rest of the study. The evaluation of vascular regeneration showed similar results. Indeed, DCE-MRI analysis revealed a complete recovery of muscular tissue perfusion after 14 dpi for the SVF-HA group, while for the saline and HA group, controls remained in a damaged state. Finally, the histological examination of SVF-HA treated animals exhibited well-defined and organized fibers morphology with a lateralized nucleus, similar to contralateral healthy muscular tissue. On the contrary, HA and saline-treated animals presented inflammatory infiltrates, with HA slightly improving the diameter of the fibers and less degenerated tissue. Our findings show that connective tissue micro-fragments enriched with SVF induce higher muscle homeostasis and perfusion restoration in contrast to control groups.

Keywords: ischemia/reperfusion injury, regenerative medicine, resonance imaging, stromal vascular fraction

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32 Invisible to Invaluable - How Social Media is Helping Tackle Stigma and Discrimination Against Informal Waste Pickers of Bengaluru

Authors: Varinder Kaur Gambhir, Neema Gupta, Sonal Tickoo Chaudhuri

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Bengaluru, a rapidly growing metropolis in India, with a population of 12.5 million citizens, generates 5,757 metric tonnes of solid waste per day. Despite their invaluable contribution to waste management, society and the economy, waste pickers face significant stigma, suspicion and contempt and are left with a sense of shame about their work. In this context, BBC Media Action was funded by the H&M Foundation to develop a 3-year multi-phase social media campaign to shift perceptions of waste picking and informal waste pickers amongst the Bengaluru population. Research has been used to inform project strategy and adaptation, at all stages. Formative research to inform campaign strategy used mixed methods– 14 focused group discussions followed by 406 online surveys – to explore people’s knowledge of, and attitudes towards waste pickers, and identify potential barriers and motivators to changing perceptions. Use of qualitative techniques like metaphor maps (using bank of pictures rather than direct questions to understand mindsets) helped establish the invisibility of informal waste pickers, and the quantitative research enabled audience segmentation based on attitudes towards informal waste pickers. To pretest the campaign idea, eight I-GDs (individual interaction followed by group discussions) were conducted to allow interviewees to first freely express their feelings individually, before discussing in a group. Robert Plucthik’s ‘wheel of emotions’ was used to understand audience’s emotional response to the content. A robust monitoring and evaluation is being conducted (baseline and first phase of monitoring already completed) using a rotating longitudinal panel of 1,800 social media users (exposed and unexposed to the campaign), recruited face to face and representative of the social media universe of Bengaluru city. In addition, qualitative in-depth interviews are being conducted after each phase to better understand change drivers. The research methodology and ethical protocols for impact evaluation have been independently reviewed by an Institutional Review Board. Formative research revealed that while waste on the streets is visible and is of concern to the public, informal waste pickers are virtually ‘invisible’, for most people in Bengaluru Pretesting research revealed that the creative outputs evoked emotions like acceptance and gratitude towards waste-pickers, suggesting that the content had the potential to encourage attitudinal change. After the first phase of campaign, social media analytics show that #Invaluables content reached at least 2.6 million unique people (21% of the Bengaluru population) through Facebook and Instagram. Further, impact monitoring results show significant improvements in spontaneous awareness of different segments of informal waste pickers ( such as sorters at scrap shops or dry waste collection centres -from 10% at baseline to 16% amongst exposed and no change amongst unexposed), recognition that informal waste pickers help the environment (71% at baseline to 77% among exposed and no change among unexposed) and greater discussion about informal waste pickers among those exposed (60%) as against not exposed (49%). Using the insights from this research, the planned social media intervention is designed to increase the visibility of and appreciation for the work of waste pickers in Bengaluru, supporting a more inclusive society.

Keywords: awareness, discussion, discrimination, informal waste pickers, invisibility, social media campaign, waste management

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31 Exploring the Relationship between Mediolateral Center of Pressure and Galvanic Skin Response during Balance Tasks

Authors: Karlee J. Hall, Mark Laylor, Jessy Varghese, Paula Polastri, Karen Van Ooteghem, William McIlroy

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Balance training is a common part of physiotherapy treatment and often involves a set of proprioceptive exercises which the patient carries out in the clinic and as part of their exercise program. Understanding all contributing factors to altered balance is of utmost importance to the clinical success of treatment of balance dysfunctions. A critical role for the autonomic nervous system (ANS) in the control of balance reactions has been proposed previously, with evidence for potential involvement being inferred from the observation of phasic galvanic skin responses (GSR) evoked by external balance perturbations. The current study explored whether the coupling between ANS reactivity and balance reactions would be observed during spontaneously occurring instability while standing, including standard positions typical of physiotherapy balance assessments. It was hypothesized that time-varying changes in GSR (ANS reactivity) would be associated with time-varying changes in the mediolateral center of pressure (ML-COP) (somatomotor reactivity). Nine individuals (5 females, 4 males, aged 19-37 years) were recruited. To induce varying balance demands during standing, the study compared ML-COP and GSR data across different task conditions varying the availability of vision and width of the base of support. Subjects completed 3, 30-second trials for each of the following stance conditions: standard, narrow, and tandem eyes closed, tandem eyes open, tandem eyes open with dome to shield visual input, and restricted peripheral visual field. ANS activity was evaluated by measures of GSR recorded from Ag-AgCl electrodes on the middle phalanges of digits 2 and 4 on the left hand; balance measures include ML-COP excursion frequency and amplitude recorded from two force plates embedded in the floor underneath each foot. Subjects were instructed to stand as still as possible with arms crossed in front of their chest. When comparing mean task differences across subjects, there was an expected increase in postural sway from tasks with a wide stance and no sensory restrictions (least challenging) to those with a narrow stance and no vision (most challenging). The correlation analysis revealed a significant positive relationship between ML-COP variability and GSR variability when comparing across tasks (r=0.94, df=5, p < 0.05). In addition, correlations coincided within each subject and revealed a significant positive correlation in 7 participants (r= 0.47, 0.57, 0.62, 0.62, 0.81, 0.64, 0.69 respectively, df=19, p < 0.05) and no significant relationship in 2 participants (r=0.36, 0.29 respectively, df=19, p > 0.05). The current study revealed a significant relationship between ML-COP and GSR during balance tasks, revealing the ANS reactivity associated with naturally occurring instability when standing still, which is proportional to the degree of instability. Understanding the link between ANS activity and control of COP is an important step forward in the enhancement of assessment of contributing factors to poor balance and treatment of balance dysfunctions. The next steps will explore the temporal association between the time-varying changes in COP and GSR to establish if the ANS reactivity phase leads or lags the evoked motor reactions, as well as exploration of potential biomarkers for use in screening of ANS activity as a contributing factor to altered balance control clinically.

Keywords: autonomic nervous system, balance control, center of pressure, somatic nervous system

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30 A Case Study of a Rehabilitated Child by Joint Efforts of Parents and Community

Authors: Fouzia Arif, Arif S. Mohammad, Hifsa Altaf, Lubna Raees

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Introduction: The term "disability", refers to any condition that impedes the completion of daily tasks using traditional methods. In developing countries like Pakistan, disable population is usually excluded from the mainstream. In squatter settlements the situation is more critical. Sultanabad is one of the squatter settlements of Karachi. Purpose of case study is to improve the health of disabled children’s, and create awareness among the parents and community. Through a household visit, Shiraz, a young disabled boy of 15.5 years old was identified. Her mother articulated that her son was living normally and happily with his parents two years back. When he was 13 years old and student of class 8th, both his legs were traumatized in a Railway Train Accident while playing cricket. He got both femoral shaft fractured severely. He was taken to Jinnah Post Graduate Medical Centre (JPMC) where his left leg was amputated at above knee level and right leg was opened & fixed by reduction internally, luckily bone healed moderately with the passage of time. Methods: In Squatter settlements of Karachi Sultanabad, a survey was conducted in two sectors. Disability screening questionnaire was developed, collaboration with community through household visits, outreach sessions 23cases of disabled were identified who were socialized through sports, Musical program and get-together was organized with stockholder for creating awareness among community and parent’s. Collaboration was established with different NGOs, Government, stakeholders and community support for establishment of Physiotherapy Center. During home visit it was identified that Shiraz was on bed since last 1 year, his family could not afforded cost of physiotherapist and medical consultation due to poverty. Parents counseling was done mentioning that Shiraz needed to take treatment. After motivation his parents agreed for treatment. He was consulted by an orthopedic surgeon in AKUH, Who referred to DMC University of Health Science for rehabilitation service. There he was assessed and referred for Community Based Physiotherapy Centre Sultanabad. Physiotherapist visited home along with Coordinator for Special children and assessed him regularly, planned Physiotherapy treatment for abdominal, high muscles strutting exercise foot muscles strengthening exercise, knee mobilization weight bearing from partial to full weight gradually, also strengthen exercise were given for residual limb as the boy was dependent on it. He was also provided by an artificial leg and training was done. Result: Shiraz is now fully mobile, he can walk independently even out of home, functional ability progress improved and dependency factors reduced. It was difficult but not impossible. We all have sympathy but if we have empathy then we can rehabilitate the community in a better way. His parents are very happy and also the community is surprised to see him in such better condition. Conclusion: Combined efforts of physiotherapist, Coordinator of special children, community and parents made a drastic change in Shiraz’s case by continuously motivating him for better outcome. He is going to school regularly without support. Since he belongs to a poor family he faces financial constraints for education and clinical follow ups regularly.

Keywords: femoral shaft fracture, trauma, orthopedic surgeon, physiotherapy treatment

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29 Living in the Edge: Crisis in Indian Tea Industry and Social Deprivation of Tea Garden Workers in Dooars Region of India

Authors: Saraswati Kerketta

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Tea industry is one of the oldest organised sector of India. It employs roughly 1.5 million people directly. Since the last decade Indian tea industry, especially in the northern region is experiencing worst crisis in the post-independence period. Due to many reason the prices of tea show steady decline. The workers are paid one of the lowest wage in tea industry in the world (1.5$ a day) below the UN's $2 a day for extreme poverty. The workers rely on addition benefits from plantation which includes food, housing and medical facilities. These have been effective means of enslavement of generations of labourers by the owners. There is hardly any change in the tea estates where the owners determine the fate of workers. When the tea garden is abandoned or is closed all the facilities disappear immediately. The workers are the descendants of tribes from central India also known as 'tea tribes'. Alienated from their native place, the geographical and social isolation compounded their vulnerability of these people. The economy of the region being totally dependent on tea has resulted in absolute unemployment for the workers of these tea gardens. With no other livelihood and no land to grow food, thousands of workers faced hunger and starvation. The Plantation Labour Act which ensures the decent working and living condition is violated continuously. The labours are forced to migrate and are also exposed to the risk of human trafficking. Those who are left behind suffers from starvation, malnutrition and disease. The condition in the sick tea plantation is no better. Wage are not paid regularly, subsidised food, fuel are also not supplied properly. Health care facilities are in very bad shape. Objectives: • To study the socio-cultural and demographic characteristics of the tea garden labourers in the study area. • To examine the social situation of workers in sick estates in dooars region. • To assess the magnitude of deprivation the impact of economic crisis on abandoned and closed tea estates in the region. Data Base: The study is based on data collected from field survey. Methods: Quantative: Cross-Tabulation, Regression analysis. Qualitative: Household Survey, Focussed Group Discussion, In-depth interview of key informants. Findings: Purchasing power parity has declined since in last three decades. There has been many fold increase in migration. Males migrates long distance towards central and west and south India. Females and children migrates both long and short distance. No one has reported to migrate back to the place of origin of their ancestors. Migrant males work mostly as construction labourers and as factory workers whereas females and children work as domestic help and construction labourers. In about 37 cases either they haven't contacted their families in last six months or are not traceable. The families with single earning members are more likely to migrate. Burden of disease and the duration of sickness, abandonment and closure of plantation are closely related. Death tolls are likely to rise 1.5 times in sick tea gardens and three times in closed tea estates. Sixty percent of the people are malnourished in the sick tea gardens and more than eighty five per cent in abandoned and sick tea gardens.

Keywords: migration, trafficking, starvation death, tea garden workers

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28 Oncolytic Efficacy of Thymidine Kinase-Deleted Vaccinia Virus Strain Tiantan (oncoVV-TT) in Glioma

Authors: Seyedeh Nasim Mirbahari, Taha Azad, Mehdi Totonchi

Abstract:

Oncolytic viruses, which only replicate in tumor cells, are being extensively studied for their use in cancer therapy. A particular virus known as the vaccinia virus, a member of the poxvirus family, has demonstrated oncolytic abilities glioma. Treating Glioma with traditional methods such as chemotherapy and radiotherapy is quite challenging. Even though oncolytic viruses have shown immense potential in cancer treatment, their effectiveness in glioblastoma treatment is still low. Therefore, there is a need to improve and optimize immunotherapies for better results. In this study, we have designed oncoVV-TT, which can more effectively target tumor cells while minimizing replication in normal cells by replacing the thymidine kinase gene with a luc-p2a-GFP gene expression cassette. Human glioblastoma cell line U251 MG, rat glioblastoma cell line C6, and non-tumor cell line HFF were plated at 105 cells in a 12-well plates in 2 mL of DMEM-F2 medium with 10% FBS added to each well. Then incubated at 37°C. After 16 hours, the cells were treated with oncoVV-TT at an MOI of 0.01, 0.1 and left in the incubator for a further 24, 48, 72 and 96 hours. Viral replication assay, fluorescence imaging and viability tests, including trypan blue and crystal violet, were conducted to evaluate the cytotoxic effect of oncoVV-TT. The finding shows that oncoVV-TT had significantly higher cytotoxic activity and proliferation rates in tumor cells in a dose and time-dependent manner, with the strongest effect observed in U251 MG. To conclude, oncoVV-TT has the potential to be a promising oncolytic virus for cancer treatment, with a more cytotoxic effect in human glioblastoma cells versus rat glioma cells. To assess the effectiveness of vaccinia virus-mediated viral therapy, we have tested U251mg and C6 tumor cell lines taken from human and rat gliomas, respectively. The study evaluated oncoVV-TT's ability to replicate and lyse cells and analyzed the survival rates of the tested cell lines when treated with different doses of oncoVV-TT. Additionally, we compared the sensitivity of human and mouse glioma cell lines to the oncolytic vaccinia virus. All experiments regarding viruses were conducted under biosafety level 2. We engineered a Vaccinia-based oncolytic virus called oncoVV-TT to replicate specifically in tumor cells. To propagate the oncoVV-TT virus, HeLa cells (5 × 104/well) were plated in 24-well plates and incubated overnight to attach to the bottom of the wells. Subsequently, 10 MOI virus was added. After 48 h, cells were harvested by scraping, and viruses were collected by 3 sequential freezing and thawing cycles followed by removal of cell debris by centrifugation (1500 rpm, 5 min). The supernatant was stored at −80 ◦C for the following experiments. To measure the replication of the virus in Hela, cells (5 × 104/well) were plated in 24-well plates and incubated overnight to attach to the bottom of the wells. Subsequently, 5 MOI virus or equal dilution of PBS was added. At the treatment time of 0 h, 24 h, 48 h, 72 h and 96 h, the viral titers were determined under the fluorescence microscope (BZ-X700; Keyence, Osaka, Japan). Fluorescence intensity was quantified using the imagej software according to the manufacturer’s protocol. For the isolation of single-virus clones, HeLa cells seeded in six-well plates (5×105 cells/well). After 24 h (100% confluent), the cells were infected with a 10-fold dilution series of TianTan green fluorescent protein (GFP)virus and incubated for 4 h. To examine the cytotoxic effect of oncoVV-TT virus ofn U251mg and C6 cell, trypan blue and crystal violet assay was used.

Keywords: oncolytic virus, immune therapy, glioma, vaccinia virus

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27 Mapping Contested Sites - Permanence Of The Temporary Mouttalos Case Study

Authors: M. Hadjisoteriou, A. Kyriacou Petrou

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This paper will discuss ideas of social sustainability in urban design and human behavior in multicultural contested sites. It will focus on the potential of the re-reading of the “site” through mapping that acts as a research methodology and will discuss the chosen site of Mouttalos, Cyprus as a place of multiple identities. Through a methodology of mapping using a bottom up approach, a process of disassembling derives that acts as a mechanism to re-examine space and place by searching for the invisible and the non-measurable, understanding the site through its detailed inhabitation patterns. The significance of this study lies in the use of mapping as an active form of thinking rather than a passive process of representation that allows for a new site to be discovered, giving multiple opportunities for adaptive urban strategies and socially engaged design approaches. We will discuss the above thematic based on the chosen contested site of Mouttalos, a small Turkish Cypriot neighbourhood, in the old centre of Paphos (Ktima), SW of Cyprus. During the political unrest, between Greek and Turkish Cypriot communities, in 1963, the area became an enclave to the Turkish Cypriots, excluding any contact with the rest of the area. Following the Turkish invasion of 1974, the residents left their homes, plots and workplaces, resettling in the North of Cyprus. Greek Cypriot refugees moved into the area. The presence of the Greek Cypriot refugees is still considered to be a temporary resettlement. The buildings and the residents themselves exist in a state of uncertainty. The site is documented through a series of parallel investigations into the physical conditions and history of the site. Research methodologies use the process of mapping to expose the complex and often invisible layers of information that coexist. By registering the site through the subjective experiences, and everyday stories of inhabitants, a series of cartographic recordings reveals the space between: happening and narrative and especially space between different cultures and religions. Research put specific emphasis on engaging the public, promoting social interaction, identifying spatial patterns of occupation by previous inhabitants through social media. Findings exposed three main areas of interest. Firstly we identified inter-dependent relationships between permanence and temporality, characterised by elements such us, signage through layers of time, past events and periodical street festivals, unfolding memory and belonging. Secondly issues of co-ownership and occupation, found through particular narratives of exchange between the two communities and through appropriation of space. Finally formal and informal inhabitation of space, revealed through the presence of informal shared back yards, alternative paths, porous street edges and formal and informal landmarks. The importance of the above findings, was achieving a shift of focus from the built infrastructure to the soft network of multiple and complex relations of dependence and autonomy. Proposed interventions for this contested site were informed and led by a new multicultural identity where invisible qualities were revealed though the process of mapping, taking on issues of layers of time, formal and informal inhabitation and the “permanence of the temporary”.

Keywords: contested sites, mapping, social sustainability, temporary urban strategies

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26 Recent Findings of Late Bronze Age Mining and Archaeometallurgy Activities in the Mountain Region of Colchis (Southern Lechkhumi, Georgia)

Authors: Rusudan Chagelishvili, Nino Sulava, Tamar Beridze, Nana Rezesidze, Nikoloz Tatuashvili

Abstract:

The South Caucasus is one of the most important centers of prehistoric metallurgy, known for its Colchian bronze culture. Modern Lechkhumi – historical Mountainous Colchis where the existence of prehistoric metallurgy is confirmed by the discovery of many artifacts is a part of this area. Studies focused on prehistoric smelting sites, related artefacts, and ore deposits have been conducted during last ten years in Lechkhumi. More than 20 prehistoric smelting sites and artefacts associated with metallurgical activities (ore roasting furnaces, slags, crucible, and tuyères fragments) have been identified so far. Within the framework of integrated studies was established that these sites were operating in 13-9 centuries B.C. and used for copper smelting. Palynological studies of slags revealed that chestnut (Castanea sativa) and hornbeam (Carpinus sp.) wood were used as smelting fuel. Geological exploration-analytical studies revealed that copper ore mining, processing, and smelting sites were distributed close to each other. Despite recent complex data, the signs of prehistoric mines (trenches) haven’t been found in this part of the study area so far. Since 2018 the archaeological-geological exploration has been focused on the southern part of Lechkhumi and covered the areas of villages Okureshi and Opitara. Several copper smelting sites (Okureshi 1 and 2, Opitara 1), as well as a Colchian Bronze culture settlement, have been identified here. Three mine workings have been found in the narrow gorge of the river Rtkhmelebisgele in the vicinities of the village Opitara. In order to establish a link between the Opitara-Okureshi archaeometallurgical sites, Late Bronze Age settlements, and mines, various scientific analytical methods -mineralized rock and slags petrography and atomic absorption spectrophotometry (AAS) analysis have been applied. The careful examination of Opitara mine workings revealed that there is a striking difference between the mine #1 on the right bank of the river and mines #2 and #3 on the left bank. The first one has all characteristic features of the Soviet period mine working (e. g. high portal with angular ribs and roof showing signs of blasting). In contrast, mines #2 and #3, which are located very close to each other, have round-shaped portals/entrances, low roofs, and fairly smooth ribs and are filled with thick layers of river sediments and collapsed weathered rock mass. A thorough review of the publications related to prehistoric mine workings revealed some striking similarities between mines #2 and #3 with their worldwide analogues. Apparently, the ore extraction from these mines was conducted by fire-setting applying primitive tools. It was also established that mines are cut in Jurassic mineralized volcanic rocks. Ore minerals (chalcopyrite, pyrite, galena) are related to calcite and quartz veins. The results obtained through the petrochemical and petrography studies of mineralized rock samples from Opitara mines and prehistoric slags are in complete correlation with each other, establishing the direct link between copper mining and smelting within the study area. Acknowledgment: This work was supported by the Shota Rustaveli National Science Foundation of Georgia (grant # FR-19-13022).

Keywords: archaeometallurgy, Mountainous Colchis, mining, ore minerals

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25 The Perspective of British Politicians on English Identity: Qualitative Study of Parliamentary Debates, Blogs, and Interviews

Authors: Victoria Crynes

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The question of England’s role in Britain is increasingly relevant due to the ongoing rise in citizens identifying as English. Furthermore, the Brexit Referendum was predominantly supported by constituents identifying as English. Few politicians appear to comprehend how Englishness is politically manifested. Politics and the media have depicted English identity as a negative and extremist problem - an inaccurate representation that ignores the breadth of English identifying citizens. This environment prompts the question, 'How are British Politicians Addressing the Modern English Identity Question?' Parliamentary debates, political blogs, and interviews are synthesized to establish a more coherent understanding of the current political attitudes towards English identity, the perceived nature of English identity, and the political manifestation of English representation and governance. Analyzed parliamentary debates addressed the democratic structure of English governance through topics such as English votes for English laws, devolution, and the union. The blogs examined include party-based, multi-author style blogs, and independently authored blogs by politicians, which provide a dynamic and up-to-date representation of party and politician viewpoints. Lastly, fourteen semi-structured interviews of British politicians provide a nuanced perspective on how politicians conceptualize Englishness. Interviewee selection was based on three criteria: (i) Members of Parliament (MP) known for discussing English identity politics, (ii) MPs of strongly English identifying constituencies, (iii) MPs with minimal English identity affiliation. Analysis of parliamentary debates reveals the discussion of English representation has gained little momentum. Many politicians fail to comprehend who the English are, why they desire greater representation and believe that increased recognition of the English would disrupt the unity of the UK. These debates highlight the disconnect of parliament from the disenfranchised English towns. A failure to recognize the legitimacy of English identity politics generates an inability for solution-focused debates to occur. Political blogs demonstrate cross-party recognition of growing English disenfranchisement. The dissatisfaction with British politics derives from multiple factors, including economic decline, shifting community structures, and the delay of Brexit. The left-behind communities have seen little response from Westminster, which is often contrasted to the devolved and louder voices of the other UK nations. Many blogs recognize the need for a political response to the English and lament the lack of party-level initiatives. In comparison, interviews depict an array of local-level initiatives reconnecting MPs to community members. Local efforts include town trips to Westminster, multi-cultural cooking classes, and English language courses. These efforts begin to rebuild positive, local narratives, promote engagement across community sectors, and acknowledge the English voices. These interviewees called for large-scale, political action. Meanwhile, several interviewees denied the saliency of English identity. For them, the term held only extremist narratives. The multi-level analysis reveals continued uncertainty on Englishness within British politics, contrasted with increased recognition of its saliency by politicians. It is paramount that politicians increase discussions on English identity politics to avoid increased alienation of English citizens and to rebuild trust in the abilities of Westminster.

Keywords: British politics, contemporary identity politics and its impacts, English identity, English nationalism, identity politics

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24 Housing Recovery in Heavily Damaged Communities in New Jersey after Hurricane Sandy

Authors: Chenyi Ma

Abstract:

Background: The second costliest hurricane in U.S. history, Sandy landed in southern New Jersey on October 29, 2012, and struck the entire state with high winds and torrential rains. The disaster killed more than 100 people, left more than 8.5 million households without power, and damaged or destroyed more than 200,000 homes across the state. Immediately after the disaster, public policy support was provided in nine coastal counties that constituted 98% of the major and severely damaged housing units in NJ overall. The programs include Individuals and Households Assistance Program, Small Business Loan Program, National Flood Insurance Program, and the Federal Emergency Management Administration (FEMA) Public Assistance Grant Program. In the most severely affected counties, additional funding was provided through Community Development Block Grant: Reconstruction, Rehabilitation, Elevation, and Mitigation Program, and Homeowner Resettlement Program. How these policies individually and as a whole impacted housing recovery across communities with different socioeconomic and demographic profiles has not yet been studied, particularly in relation to damage levels. The concept of community social vulnerability has been widely used to explain many aspects of natural disasters. Nevertheless, how communities are vulnerable has been less fully examined. Community resilience has been conceptualized as a protective factor against negative impacts from disasters, however, how community resilience buffers the effects of vulnerability is not yet known. Because housing recovery is a dynamic social and economic process that varies according to context, this study examined the path from community vulnerability and resilience to housing recovery looking at both community characteristics and policy interventions. Sample/Methods: This retrospective longitudinal case study compared a literature-identified set of pre-disaster community characteristics, the effects of multiple public policy programs, and a set of time-variant community resilience indicators to changes in housing stock (operationally defined by percent of building permits to total occupied housing units/households) between 2010 and 2014, two years before and after Hurricane Sandy. The sample consisted of 51 municipalities in the nine counties in which between 4% and 58% of housing units suffered either major or severe damage. Structural equation modeling (SEM) was used to determine the path from vulnerability to the housing recovery, via multiple public programs, separately and as a whole, and via the community resilience indicators. The spatial analytical tool ArcGIS 10.2 was used to show the spatial relations between housing recovery patterns and community vulnerability and resilience. Findings: Holding damage levels constant, communities with higher proportions of Hispanic households had significantly lower levels of housing recovery while communities with households with an adult >age 65 had significantly higher levels of the housing recovery. The contrast was partly due to the different levels of total public support the two types of the community received. Further, while the public policy programs individually mediated the negative associations between African American and female-headed households and housing recovery, communities with larger proportions of African American, female-headed and Hispanic households were “vulnerable” to lower levels of housing recovery because they lacked sufficient public program support. Even so, higher employment rates and incomes buffered vulnerability to lower housing recovery. Because housing is the "wobbly pillar" of the welfare state, the housing needs of these particular groups should be more fully addressed by disaster policy.

Keywords: community social vulnerability, community resilience, hurricane, public policy

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

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

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

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

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22 Fuzzy Data, Random Drift, and a Theoretical Model for the Sequential Emergence of Religious Capacity in Genus Homo

Authors: Margaret Boone Rappaport, Christopher J. Corbally

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The ancient ape ancestral population from which living great ape and human species evolved had demographic features affecting their evolution. The population was large, had great genetic variability, and natural selection was effective at honing adaptations. The emerging populations of chimpanzees and humans were affected more by founder effects and genetic drift because they were smaller. Natural selection did not disappear, but it was not as strong. Consequences of the 'population crash' and the human effective population size are introduced briefly. The history of the ancient apes is written in the genomes of living humans and great apes. The expansion of the brain began before the human line emerged. Coalescence times for some genes are very old – up to several million years, long before Homo sapiens. The mismatch between gene trees and species trees highlights the anthropoid speciation processes, and gives the human genome history a fuzzy, probabilistic quality. However, it suggests traits that might form a foundation for capacities emerging later. A theoretical model is presented in which the genomes of early ape populations provide the substructure for the emergence of religious capacity later on the human line. The model does not search for religion, but its foundations. It suggests a course by which an evolutionary line that began with prosimians eventually produced a human species with biologically based religious capacity. The model of the sequential emergence of religious capacity relies on cognitive science, neuroscience, paleoneurology, primate field studies, cognitive archaeology, genomics, and population genetics. And, it emphasizes five trait types: (1) Documented, positive selection of sensory capabilities on the human line may have favored survival, but also eventually enriched human religious experience. (2) The bonobo model suggests a possible down-regulation of aggression and increase in tolerance while feeding, as well as paedomorphism – but, in a human species that remains cognitively sharp (unlike the bonobo). The two species emerged from the same ancient ape population, so it is logical to search for shared traits. (3) An up-regulation of emotional sensitivity and compassion seems to have occurred on the human line. This finds support in modern genetic studies. (4) The authors’ published model of morality's emergence in Homo erectus encompasses a cognitively based, decision-making capacity that was hypothetically overtaken, in part, by religious capacity. Together, they produced a strong, variable, biocultural capability to support human sociability. (5) The full flowering of human religious capacity came with the parietal expansion and smaller face (klinorhynchy) found only in Homo sapiens. Details from paleoneurology suggest the stage was set for human theologies. Larger parietal lobes allowed humans to imagine inner spaces, processes, and beings, and, with the frontal lobe, led to the first theologies composed of structured and integrated theories of the relationships between humans and the supernatural. The model leads to the evolution of a small population of African hominins that was ready to emerge with religious capacity when the species Homo sapiens evolved two hundred thousand years ago. By 50-60,000 years ago, when human ancestors left Africa, they were fully enabled.

Keywords: genetic drift, genomics, parietal expansion, religious capacity

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21 Agenesis of the Corpus Callosum: The Role of Neuropsychological Assessment with Implications to Psychosocial Rehabilitation

Authors: Ron Dick, P. S. D. V. Prasadarao, Glenn Coltman

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Agenesis of the corpus callosum (ACC) is a failure to develop corpus callosum - the large bundle of fibers of the brain that connects the two cerebral hemispheres. It can occur as a partial or complete absence of the corpus callosum. In the general population, its estimated prevalence rate is 1 in 4000 and a wide range of genetic, infectious, vascular, and toxic causes have been attributed to this heterogeneous condition. The diagnosis of ACC is often achieved by neuroimaging procedures. Though persons with ACC can perform normally on intelligence tests they generally present with a range of neuropsychological and social deficits. The deficit profile is characterized by poor coordination of motor movements, slow reaction time, processing speed and, poor memory. Socially, they present with deficits in communication, language processing, the theory of mind, and interpersonal relationships. The present paper illustrates the role of neuropsychological assessment with implications to psychosocial management in a case of agenesis of the corpus callosum. Method: A 27-year old left handed Caucasian male with a history of ACC was self-referred for a neuropsychological assessment to assist him in his employment options. Parents noted significant difficulties with coordination and balance at an early age of 2-3 years and he was diagnosed with dyspraxia at the age of 14 years. History also indicated visual impairment, hypotonia, poor muscle coordination, and delayed development of motor milestones. MRI scan indicated agenesis of the corpus callosum with ventricular morphology, widely spaced parallel lateral ventricles and mild dilatation of the posterior horns; it also showed colpocephaly—a disproportionate enlargement of the occipital horns of the lateral ventricles which might be affecting his motor abilities and visual defects. The MRI scan ruled out other structural abnormalities or neonatal brain injury. At the time of assessment, the subject presented with such problems as poor coordination, slowed processing speed, poor organizational skills and time management, and difficulty with social cues and facial expressions. A comprehensive neuropsychological assessment was planned and conducted to assist in identifying the current neuropsychological profile to facilitate the formulation of a psychosocial and occupational rehabilitation programme. Results: General intellectual functioning was within the average range and his performance on memory-related tasks was adequate. Significant visuospatial and visuoconstructional deficits were evident across tests; constructional difficulties were seen in tasks such as copying a complex figure, building a tower and manipulating blocks. Poor visual scanning ability and visual motor speed were evident. Socially, the subject reported heightened social anxiety, difficulty in responding to cues in the social environment, and difficulty in developing intimate relationships. Conclusion: Persons with ACC are known to present with specific cognitive deficits and problems in social situations. Findings from the current neuropsychological assessment indicated significant visuospatial difficulties, poor visual scanning and problems in social interactions. His general intellectual functioning was within the average range. Based on the findings from the comprehensive neuropsychological assessment, a structured psychosocial rehabilitation programme was developed and recommended.

Keywords: agenesis, callosum, corpus, neuropsychology, psychosocial, rehabilitation

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20 Quantitative Texture Analysis of Shoulder Sonography for Rotator Cuff Lesion Classification

Authors: Chung-Ming Lo, Chung-Chien Lee

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In many countries, the lifetime prevalence of shoulder pain is up to 70%. In America, the health care system spends 7 billion per year about the healthy issues of shoulder pain. With respect to the origin, up to 70% of shoulder pain is attributed to rotator cuff lesions This study proposed a computer-aided diagnosis (CAD) system to assist radiologists classifying rotator cuff lesions with less operator dependence. Quantitative features were extracted from the shoulder ultrasound images acquired using an ALOKA alpha-6 US scanner (Hitachi-Aloka Medical, Tokyo, Japan) with linear array probe (scan width: 36mm) ranging from 5 to 13 MHz. During examination, the postures of the examined patients are standard sitting position and are followed by the regular routine. After acquisition, the shoulder US images were drawn out from the scanner and stored as 8-bit images with pixel value ranging from 0 to 255. Upon the sonographic appearance, the boundary of each lesion was delineated by a physician to indicate the specific pattern for analysis. The three lesion categories for classification were composed of 20 cases of tendon inflammation, 18 cases of calcific tendonitis, and 18 cases of supraspinatus tear. For each lesion, second-order statistics were quantified in the feature extraction. The second-order statistics were the texture features describing the correlations between adjacent pixels in a lesion. Because echogenicity patterns were expressed via grey-scale. The grey-scale co-occurrence matrixes with four angles of adjacent pixels were used. The texture metrics included the mean and standard deviation of energy, entropy, correlation, inverse different moment, inertia, cluster shade, cluster prominence, and Haralick correlation. Then, the quantitative features were combined in a multinomial logistic regression classifier to generate a prediction model of rotator cuff lesions. Multinomial logistic regression classifier is widely used in the classification of more than two categories such as the three lesion types used in this study. In the classifier, backward elimination was used to select a feature subset which is the most relevant. They were selected from the trained classifier with the lowest error rate. Leave-one-out cross-validation was used to evaluate the performance of the classifier. Each case was left out of the total cases and used to test the trained result by the remaining cases. According to the physician’s assessment, the performance of the proposed CAD system was shown by the accuracy. As a result, the proposed system achieved an accuracy of 86%. A CAD system based on the statistical texture features to interpret echogenicity values in shoulder musculoskeletal ultrasound was established to generate a prediction model for rotator cuff lesions. Clinically, it is difficult to distinguish some kinds of rotator cuff lesions, especially partial-thickness tear of rotator cuff. The shoulder orthopaedic surgeon and musculoskeletal radiologist reported greater diagnostic test accuracy than general radiologist or ultrasonographers based on the available literature. Consequently, the proposed CAD system which was developed according to the experiment of the shoulder orthopaedic surgeon can provide reliable suggestions to general radiologists or ultrasonographers. More quantitative features related to the specific patterns of different lesion types would be investigated in the further study to improve the prediction.

Keywords: shoulder ultrasound, rotator cuff lesions, texture, computer-aided diagnosis

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