Search results for: motor impairment

Authors: A. Talaei, M. Ahiduzzaman, A. Kumar

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In Canada, an increase in the production of iron and steel is anticipated for satisfying the increasing demand of iron and steel in the oil sands and automobile industries. It is predicted that GHG emissions from iron and steel sector will show a continuous increase till 2030 and, with emissions of 20 million tonnes of carbon dioxide equivalent, the sector will account for more than 2% of total national GHG emissions, or 12% of industrial emissions (i.e. 25% increase from 2010 levels). Therefore, there is an urgent need to improve the energy intensity and to implement energy efficiency measures in the industry to reduce the GHG footprint. This paper analyzes the current energy consumption in the Canadian iron and steel industries and identifies energy efficiency opportunities to improve the energy intensity and mitigate greenhouse gas emissions from this industry. In order to do this, a demand tree is developed representing different iron and steel production routs and the technologies within each rout. The main energy consumer within the industry is found to be flared heaters accounting for 81% of overall energy consumption followed by motor system and steam generation each accounting for 7% of total energy consumption. Eighteen different energy efficiency measures are identified which will help the efficiency improvement in various subsector of the industry. In the sintering process, heat recovery from coolers provides a high potential for energy saving and can be integrated in both new and existing plants. Coke dry quenching (CDQ) has the same advantages. Within the blast furnace iron-making process, injection of large amounts of coal in the furnace appears to be more effective than any other option in this category. In addition, because coal-powered electricity is being phased out in Ontario (where the majority of iron and steel plants are located) there will be surplus coal that could be used in iron and steel plants. In the steel-making processes, the recovery of Basic Oxygen Furnace (BOF) gas and scrap preheating provides considerable potential for energy savings in BOF and Electric Arc Furnace (EAF) steel-making processes, respectively. However, despite the energy savings potential, the BOF gas recovery is not applicable in existing plants using steam recovery processes. Given that the share of EAF in steel production is expected to increase the application potential of the technology will be limited. On the other hand, the long lifetime of the technology and the expected capacity increase of EAF makes scrap preheating a justified energy saving option. This paper would present the results of the assessment of the above mentioned options in terms of the costs and GHG mitigation potential.

Keywords: Iron and Steel Sectors, Energy Efficiency Improvement, Blast Furnace Iron-making Process, GHG Mitigation

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Authors: Lauren Kathryn Stretch

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A study was conducted in the underprivileged setting of Nelson Mandela Bay, South Africa in order to monitor the progress of learners whose teachers receive training through the Early Inspiration Training Programme. Through tracking children’s growth & development, the effectiveness of the practitioner-training programme, which focuses on empowering women from underprivileged communities in South Africa, was analyzed. The aim was to identify impact & reach and to assess the effectiveness of this intervention programme through identifying impact on children’s growth and development. A Pre- and Post-Test was administered on about 850 young children in Pre-Grade R and Grade R classes in order to understand children’s ability level & the growth that would be evident as a result of effective teacher training. A pre-test evaluated the level of each child’s abilities, including physical-motor development, language, and speech development, cognitive development including visual perceptual skills, social-emotional development & play development. This was followed by a random selection of the classes of children into experimental and control groups. The experimental group’s teachers (practitioners) received 8-months of training & intervention, as well as mentorship & support. After the 8-month training programme, children from the experimental & control groups underwent post-assessment. The results indicate that the impact of effective practitioner training and enhancing a deep understanding of stimulation on young children, that this understanding is implemented in the classroom, highlighting the areas of growth & development in the children whose teachers received additional training & support, as compared to those who did not receive additional training. Monitoring & Evaluation systems not only track children’s ability levels, but also have a core focus on reporting systems, mentorship and providing ongoing support. As a result of the study, an Online Application (for Apple or Android Devices) was developed which is used to track children’s growth via age-appropriate assessments. The data is then statistically analysed to provide direction for relevant & impactful intervention. The App also focuses on effective reporting strategies, structures, and implementation to support organizations working with young children & maximize on outcomes.

Keywords: early childhood development, developmental child assessments, online application, monitoring and evaluating online

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Authors: A. Newman-Tancredi, R. Depoortère, P. Gruca, E. Litwa, M. Lason, M. Papp

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The N-methyl-D-aspartic acid (NMDA) receptor antagonist, ketamine, can elicit rapid-acting antidepressant (RAAD) effects in treatment-resistant patients, but it requires parenteral co-administration with a classical antidepressant under medical supervision. In addition, ketamine can also produce serious side effects that limit its long-term use, and there is much interest in identifying RAADs based on ketamine’s mechanism of action but with safer profiles. Ketamine elicits GABAergic interneuron inhibition, glutamatergic neuron stimulation, and, notably, activation of serotonin 5-HT1A receptors in the prefrontal cortex (PFC). Direct activation of the latter receptor subpopulation with selective ‘biased agonists’ may therefore be a promising strategy to identify novel RAADs and, consistent with this hypothesis, the prototypical cortical biased agonist, NLX-101, exhibited robust RAAD-like activity in the chronic mild stress model of depression (CMS). The present study compared the effects of a novel, selective 5-HT1A receptor-biased agonist, NLX-204, with those of ketamine and NLX-101. Materials and methods: CMS procedure was conducted on Wistar rats; drugs were administered either intraperitoneally (i.p.) or by bilateral intracortical microinjection. Ketamine: 10 mg/kg i.p. or 10 µg/side in PFC; NLX-204 and NLX-101: 0.08 and 0.16 mg/kg i.p. or 16 µg/side in PFC. In addition, interaction studies were carried out with systemic NLX-204 or NLX-101 (each at 0.16 mg/kg i.p.) in combination with intracortical WAY-100635 (selective 5-HT1A receptor antagonist; 2 µg/side) or muscimol (GABA-A receptor agonist, 12.5 ng/side). Anhedonia was assessed by CMS-induced decrease in sucrose solution consumption; anxiety-like behavior was assessed using the Elevated Plus Maze (EPM), and cognitive impairment was assessed by the Novel Object Recognition (NOR) test. Results: A single administration of NLX-204 was sufficient to reverse the CMS-induced deficit in sucrose consumption, similarly to ketamine and NLX-101. NLX-204 also reduced CMS-induced anxiety in the EPM and abolished CMS-induced NOR deficits. These effects were maintained (EPM and NOR) or enhanced (sucrose consumption) over a subsequent 2-week period of treatment. The anti-anhedonic response of the drugs was also maintained for several weeks Following treatment discontinuation, suggesting that they had sustained effects on neuronal networks. A single PFC administration of NLX-204 reversed deficient sucrose consumption, similarly to ketamine and NLX-101. Moreover, the anti-anhedonic activities of systemic NLX-204 and NLX 101 were abolished by coadministration with intracortical WAY-100635 or muscimol. Conclusions: (i) The antidepressant-like activity of NLX-204 in the rat CMS model was as rapid as that of ketamine or NLX-101, supporting targeting cortical 5-HT1A receptors with selective, biased agonists to achieve RAAD effects. (ii)The anti-anhedonic activity of systemic NLX-204 was mimicked by local administration of the compound in the PFC, confirming the involvement of cortical circuits in its RAAD-like effects. (iii) Notably, the effects of systemic NLX-204 and NLX-101 were abolished by PFC administration of muscimol, indicating that they act by (indirectly) eliciting a reduction in cortical GABAergic neurotransmission. This is consistent with ketamine’s mechanism of action and suggests that there are converging NMDA and 5-HT1A receptor signaling cascades in PFC underlying the RAAD-like activities of ketamine and NLX-204. Acknowledgements: The study was financially supported by NCN grant no. 2019/35/B/NZ7/00787.

Keywords: depression, ketamine, serotonin, 5-HT1A receptor, chronic mild stress

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Authors: Vikas S. Minchekar

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The eyewitness is a crucial source of evidence in the criminal judicial system. However, rely on the reminiscence of an eyewitness especially intoxicated eyewitness is not always judicious. It might lead to some serious consequences. Day by day, alcohol-related crimes or the criminal incidences in bars, nightclubs, and restaurants are increasing rapidly. Tackling such cases is very complicated to any investigation officers. The people in that incidents are violated due to the alcohol consumption hence, their ability to identify the suspects or recall these phenomena is affected. The studies on the effects of alcohol consumption on motor activities such as driving and surgeries have received much attention. However, the effect of alcohol intoxication on memory has received little attention from the psychology, law, forensic and criminology scholars across the world. In the Indian context, the published articles on this issue are equal to none up to present day. This field experiment investigation aimed at to finding out the effect of alcohol consumption on identification accuracy in lineups. Forty adult, social drinkers, and twenty sober adults were randomly recruited for the study. The sober adults were assigned into 'placebo' beverage group while social drinkers were divided into two group e. g. 'low dose' of alcohol (0.2 g/kg) and 'high dose' of alcohol (0.8 g/kg). The social drinkers were divided in such a way that their level of blood-alcohol concentration (BAC) will become different. After administering the beverages for the placebo group and liquor to the social drinkers for 40 to 50 minutes of the period, the five-minute video clip of mock crime is shown to all in a group of four to five members. After the exposure of video, clip subjects were given 10 portraits and asked them to recognize whether they are involved in mock crime or not. Moreover, they were also asked to describe the incident. The subjects were given two opportunities to recognize the portraits and to describe the events; the first opportunity is given immediately after the video clip and the second was 24 hours later. The obtained data were analyzed by one-way ANOVA and Scheffe’s posthoc multiple comparison tests. The results indicated that the 'high dose' group is remarkably different from the 'placebo' and 'low dose' groups. But, the 'placebo' and 'low dose' groups are equally performed. The subjects in a 'high dose' group recognized only 20% faces correctly while the subjects in a 'placebo' and 'low dose' groups are recognized 90 %. This study implied that the intoxicated witnesses are less accurate to recognize the suspects and also less capable of describing the incidents where crime has taken place. Moreover, this study does not assert that intoxicated eyewitness is generally less trustworthy than their sober counterparts.

Keywords: intoxicated eyewitness, memory, social drinkers, lineups

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Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria

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Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.

Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders

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Authors: John Acire, Wilfred Lajul, Ogwang Tom

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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.

Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools

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Authors: Sonja Giese, Tess N. Peacock

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South African based Innovation Edge is experimenting with technology to drive positive behavior change, enable data-driven decision making, and scale quality early years services. This paper uses five case studies to illustrate how technology can be used in resource-constrained environments to first, encourage parenting practices that build early language development (using a stage-based mobile messaging pilot, ChildConnect), secondly, to improve the quality of ECD programs (using a mobile application, CareUp), thirdly, how to affordably scale services for the early detection of visual and hearing impairments (using a mobile tool, HearX), fourthly, how to build a transparent and accountable system for the registration and funding of ECD (using a blockchain enabled platform, Amply), and finally enable rapid data collection and feedback to facilitate quality enhancement of programs at scale (the Early Learning Outcomes Measure). ChildConnect and CareUp were both developed using a design based iterative research approach. The usage and uptake of ChildConnect and CareUp was evaluated with qualitative and quantitative methods. Actual child outcomes were not measured in the initial pilots. Although parents who used and engaged on either platform felt more supported and informed, parent engagement and usage remains a challenge. This is contrast to ECD practitioners whose usage and knowledge with CareUp showed both sustained engagement and knowledge improvement. HearX is an easy-to-use tool to identify hearing loss and visual impairment. The tool was tested with 10000 children in an informal settlement. The feasibility of cost-effectively decentralising screening services was demonstrated. Practical and financial barriers remain with respect to parental consent and for successful referrals. Amply uses mobile and blockchain technology to increase impact and accountability of public services. In the pilot project, Amply is being used to replace an existing paper-based system to register children for a government-funded pre-school subsidy in South Africa. Early Learning Outcomes Measure defines what it means for a child to be developmentally ‘on track’ at aged 50-69 months. ELOM administration is enabled via a tablet which allows for easy and accurate data collection, transfer, analysis, and feedback. ELOM is being used extensively to drive quality enhancement of ECD programs across multiple modalities. The nature of ECD services in South Africa is that they are in large part provided by disconnected private individuals or Non-Governmental Organizations (in contrast to basic education which is publicly provided by the government). It is a disparate sector which means that scaling successful interventions is that much harder. All five interventions show the potential of technology to support and enhance a range of ECD services, but pathways to scale are still being tested.

Keywords: assessment, behavior change, communication, data, disabilities, mobile, scale, technology, quality

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Authors: Okanlawon Simon Ayorinde, Odunjo Oluronke Omolola, Fadamiro Joseph Akinlabi, Adedibu Afolabi Adebgite

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A road is a path established over land, especially prepared way between places for the use of pedestrian, riders, and vehicles: a hard surface built for vehicles to travel on. The social, economic and health importance of roads in any community and nation cannot be underestimated. Roads provide access to properties and they also provide mobility which is ability to transport goods and services from one place to another. In the residential zones of many indigenous cities in Nigeria, roads are usually blocked for social ceremonies. Road blocked for ceremonies as used in this study are a temporary barrier across a road, used to stop or hinder traffic from passing through to the other side. Social ceremonies that could warrant road blockage include marriage, child naming, funeral, celebration of life’s achievement, birthday anniversary etc. These activities are likely to generate environmental hazards and their attendant risks. The assessment of these hazards and risks in residential zones of indigenous cities in Nigeria becomes imperative. The study is focused on Ogbomoso, Oyo State, Nigeria. The town has two local government councils namely Ogbomoso North and Ogbomoso South. Urban tracts that are easy to identify are political wards in the absence of land use segregation, houses numbering and street naming. The wards that had residential having a minimum of 60% of their land use components were surveyed and fifteen out of twenty wards identified in the town were surveyed. The study utilized primary data collected through questionnaire administration The three major road categories (Trunk A-Federal; Trunk B- State; Trunk C-Local) were identified and trunk C-Local roads were purposively selected being the concern of this study because they are the ones often blocked for social activities. The major stakeholders interviewed and the respective sampling methods are residents (random and systematic), social ceremony organizers (purposive), government officials (purposive) and road users namely commercial motorists and commercial motor cyclists (random and incidental). Data analysis was mainly descriptive. Two indices to measure respondents’ perception were developed. These are ‘Hazard Severity Index’ (HSI) and ‘Relative Awareness Index’ (RAI).Thereafter, policy implications and recommendations were provided.

Keywords: road, residential zones, indigenous cities, blocked, social ceremonies

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Authors: Ruchi Sharma, Rajasekhar Balasubramanian

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Motor vehicles emit a number of air pollutants, among which fine particulate matter (PM₂.₅) is of major concern in cities with high population density due to its negative impacts on air quality and human health. Typically, people spend more than 80% of their time indoors. Consequently, human exposure to traffic-related PM₂.₅ in indoor environments has received considerable attention. Most of the public residential buildings in tropical countries are designed for natural ventilation where indoor air quality tends to be strongly affected by the migration of air pollutants of outdoor origin. However, most of the previously reported traffic-related PM₂.₅ exposure assessment studies relied on ambient PM₂.₅ concentrations and thus, the health impact of traffic-related PM₂.₅ on occupants in naturally ventilated buildings remains largely unknown. Therefore, a systematic field study was conducted to assess indoor human exposure to traffic-related PM₂.₅ with and without mitigation measures in a typical naturally ventilated residential apartment situated near a road carrying a large volume of traffic. Three PM₂.₅ exposure scenarios were simulated in this study, i.e., Case 1: keeping all windows open with a ceiling fan on as per the usual practice, Case 2: keeping all windows fully closed as a mitigation measure, and Case 3: keeping all windows fully closed with the operation of a portable indoor air cleaner as an additional mitigation measure. The indoor to outdoor (I/O) ratios for PM₂.₅ mass concentrations were assessed and the effectiveness of using the indoor air cleaner was quantified. Additionally, potential human health risk based on the bioavailable fraction of toxic trace elements was also estimated for the three cases in order to identify a suitable mitigation measure for reducing PM₂.₅ exposure indoors. Traffic-related PM₂.₅ levels indoors exceeded the air quality guidelines (12 µg/m³) in Case 1, i.e., under natural ventilation conditions due to advective flow of outdoor air into the indoor environment. However, while using the indoor air cleaner, a significant reduction (p < 0.05) in the PM₂.₅ exposure levels was noticed indoors. Specifically, the effectiveness of the air cleaner in terms of reducing indoor PM₂.₅ exposure was estimated to be about 74%. Moreover, potential human health risk assessment also indicated a substantial reduction in potential health risk while using the air cleaner. This is the first study of its kind that evaluated the indoor human exposure to traffic-related PM₂.₅ and identified a suitable exposure mitigation measure that can be implemented in densely populated cities to realize health benefits.

Keywords: fine particulate matter, indoor air cleaner, potential human health risk, vehicular emissions

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Authors: Emanuela Chiarella, Annamaria Aloisio, Nisticò Clelia, Maria Mesuraca

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ZNF521 is a stem cell-associated transcription co-factor, that plays a crucial role in the homeostatic regulation of the stem cell compartment in the hematopoietic, osteo-adipogenic, and neural system. In normal hematopoiesis, primary human CD34+ hematopoietic stem cells display typically a high expression of ZNF521, while its mRNA levels rapidly decrease when these progenitors progress towards erythroid, granulocytic, or B-lymphoid differentiation. However, most acute myeloid leukemias (AMLs) and leukemia-initiating cells keep high ZNF521 expression. In particular, AMLs are often characterized by chromosomal translocations involving the Mixed Lineage Leukemia (MLL) gene, which MLL gene includes a variety of fusion oncogenes arisen from genes normally required during hematopoietic development; once they are fused, they promote epigenetic and transcription factor dysregulation. The chromosomal translocation t(9;11)(p21-22;q23), fusing the MLL gene with AF9 gene, results in a monocytic immune phenotype with an aggressive course, frequent relapses, and a short survival time. To better understand the dysfunctional transcriptional networks related to genetic aberrations, AML gene expression profile datasets were queried for ZNF521 expression and its correlations with specific gene rearrangements and mutations. The results showed that ZNF521 mRNA levels are associated with specific genetic aberrations: the highest expression levels were observed in AMLs involving t(11q23) MLL rearrangements in two distinct datasets (MILE and den Boer); elevated ZNF521 mRNA expression levels were also revealed in AMLs with t(7;12) or with internal rearrangements of chromosome 16. On the contrary, relatively low ZNF521 expression levels seemed to be associated with the t(8;21) translocation, that in turn is correlated with the AML1-ETO fusion gene or the t(15;17) translocation and in AMLs with FLT3-ITD, NPM1, or CEBPα double mutations. Invitro, we found that the enforced co-expression of ZNF521 in cord blood-derived CD34+ cells induced a significant proliferative advantage, improving MLL-AF9 effects on the induction of proliferation and the expansion of leukemic progenitor cells. Transcriptome profiling of CD34+ cells transduced with either MLL-AF9, ZNF521, or a combination of the two transgenes highlighted specific sets of up- or down-regulated genes that are involved in the leukemic phenotype, including those encoding transcription factors, epigenetic modulators, and cell cycle regulators as well as those engaged in the transport or uptake of nutrients. These data enhance the functional cooperation between ZNF521 and MA9, resulting in the development, maintenance, and clonal expansion of leukemic cells. Finally, silencing of ZNF521 in MLL-AF9-transformed primary CD34+ cells inhibited their proliferation and led to their extinction, as well as ZNF521 silencing in the MLL-AF9+ THP-1 cell line resulted in an impairment of their growth and clonogenicity. Taken together, our data highlight ZNF521 role in the control of self-renewal and in the immature compartment of malignant hematopoiesis, which, by altering the gene expression landscape, contributes to the development and/or maintenance of AML acting in concert with the MLL-AF9 fusion oncogene.

Keywords: AML, human zinc finger protein 521 (hZNF521), mixed lineage leukemia gene (MLL) AF9 (MLLT3 or LTG9), cord blood-derived hematopoietic stem cells (CB-CD34+)

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Authors: Sakshi Chopra, Ashima Nehra, Sumit Sinha, Harsimarpreet Kaur, Ravindra Mohan Pandey

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Background: Cognitive rehabilitation aims to retrain brain injured individuals with cognitive deficits to restore or compensate lost functions. As illiterates or people with low literacy levels represent a significant proportion of the world, specific rehabilitation modules for such populations are indispensable. Literacy is significantly associated with all neuropsychological measures and retraining programs widely use written or spoken techniques which essentially require the patient to read or write. So, the aim of the study was to develop and standardize a literacy free neuropsychological rehabilitation program for improving cognitive functioning in patients with mild and moderate Traumatic Brain Injury (TBI). Several studies have pointed out to the impairments seen in memory, executive functioning, and attention and concentration post-TBI, so the rehabilitation program focussed on these domains. Visual item memorization, stick constructions, symbol cancellations, and colouring techniques were used to construct the retraining program. Methodology: The development of the program consisted of planning, preparing, analyzing, and revising the different modules. The construction focussed on areas of retraining immediate and delayed visual memory, planning ability, focused and divided attention, concentration, and response inhibition (to control irritability and aggression). A total of 98 home based retraining modules were prepared in the 4 domains (42 for memory, 42 for executive functioning, 7 for attention and concentration, and 7 for response inhibition). The standardization was done on 20 healthy controls to review, select and edit items. For each module, the time, errors made and errors per second were noted down, to establish the difficulty level of each module and were arranged in increasing level of difficulty over a period of 6 weeks. The retraining tasks were then administered on 11 brain injured individuals (5 after Mild TBI and 6 after Moderate TBI). These patients were referred from the Trauma Centre to Clinical Neuropsychology OPD, All India Institute of Medical Sciences, New Delhi, India. Results: The time was taken, errors made and errors per second were analysed for all domains. Education levels were divided into illiterates, up to 10 years, 10 years to graduation and graduation and above. Mean and standard deviations were calculated. Between group and within group analysis was done using the t-test. The performance of 20 healthy controls was analyzed and only a significant difference was observed on the time taken for the attention tasks and all other domains had non-significant differences in performance between different education levels. Comparing the errors, time taken between patient and control group, there was a significant difference in all the domains at the 0.01 level except the errors made on executive functioning, indicating that the tool can successfully differentiate between healthy controls and patient groups. Conclusions: Apart from the time taken for symbol cancellations, the entire cognitive rehabilitation program is literacy free. As it taps the major areas of impairment post-TBI, it could be a useful tool to rehabilitate the patient population with low literacy levels across the world. The next step is already underway to test its efficacy in improving cognitive functioning in a randomized clinical controlled trial.

Keywords: cognitive rehabilitation, illiterates, India, traumatic brain injury

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Authors: Vijay Samuel, Tina Thekkekkara, Shoma Ganguly

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There is no reported Hanta Seoul virus infection in children in the UK so far, making it quite challenging for clinicians in diagnosing, predicting and prognosticating the outcome of the infection to patients and parents. We report a case of a ten-year-old girl who presented with pyrexia associated with headache, photophobia and abdominal pain. The family had recently acquired two pet rats six weeks ago. She appeared flushed with peri-oral pallor, coated the strawberry tongue, inflamed tonsils and bilateral cervical lymphadenopathy. Her liver and splenic edges were palpable. Investigations showed that she was thrombocytopenic with deranged renal and liver functions. An ultrasound abdomen demonstrated a mildly enlarged spleen, peripancreatic lymph node and an acalculous cholecystitis. In view of her clinical presentation, a diagnosis of leptospirosis was considered and she was commenced on intravenous benzylpenicillin. The following day she became oliguric, developed significant proteinuria and her renal function deteriorated. Following conservative management, her urine output gradually improved along with her renal function, proteinuria and thrombocytopaenia. Serology for leptospirosis and various other viruses were negative. Following discussion with the Rare and Imported Pathogens Laboratory at Porton hanta virus serology was requested and found to be strongly positive for Seoul hanta virus. Following discharge she developed palpitations, fatigue, severe headache and cognitive difficulties including memory loss and difficulties in spelling, reading and mathematics. Extensive investigations including ECG, MRI brain and CSF studies were performed and revealed no significant abnormalities. Since 2012, there have been six cases of acute kidney injury due to Hantavirus infection in the UK. Two cases were from the Humber region and were exposure to wild rats and the other four were exposed to specially bred pet fancy rats. Hanta virus infections can cause mild flu like symptoms but two clinical syndromes are associated with severe disease including haemorrhagic fever with renal syndrome, which may be associated with thrombocytopenia and Hantavirus cardiopulmonary syndrome. Neuropsychological impairments reported following hantavirus pulmonary syndrome and following Puumala virus infection have been reported. Minor white matter lesions were found in about half of the patients investigated with MRI brain. Seoul virus has a global distribution owing to the dispersal of its carrier host rats, through global trade. Several ports in the region could explain the possible establishment of Seoul virus in local populations of rats in the Yorkshire and Humber region. The risk of infection for occupationally exposed groups is 1-3% compared to 32.9% for specialist pet rat owners. The report highlight’s the importance of routinely asking about pets in the family. We hope to raise awareness of the emergence of hantavirus infection in the UK, particularly in the Yorkshire and Humber region. Clinicians should consider hantavirus infection as a potential cause of febrile illness causing renal impairment in children. Awareness of the possible neuro-cognitive sequele would help the clinicians offer appropriate information and support to children and their families. Contacting Rare and Imported Pathogens Laboratory at Porton is a useful resource for clinicians in UK when they consider unusual infections.

Keywords: Seoul hantavirus in child Porton, UK Acute kidney injury

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Authors: Usman Asif, Klaus Schmidt

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In recent years, the development of alternate fuel vehicles has helped to reduce carbon emissions worldwide. As the number of vehicles will continue to increase in the future, the energy demand will also increase. Therefore, we must consider automotive technologies that are efficient and less harmful to the environment in the long run. Battery Electric Vehicles (BEVs) have gained popularity in recent years because of their lower maintenance, lower fuel costs, and lower carbon emissions. Nevertheless, BEVs show several disadvantages, such as slow charging times and lower range than traditional combustion-powered vehicles. These factors keep many people from switching to BEVs. The authors of this research believe that these limitations can be overcome by using fuel cell technology. Fuel cell technology converts chemical energy into electrical energy from hydrogen power and therefore serves as fuel to power the motor and thus replacing heavy lithium batteries that are expensive and hard to recycle. Also, in contrast to battery-powered electric vehicle technology, Fuel Cell Electric Vehicles (FCEVs) offer higher ranges and lower fuel-up times and therefore are more competitive with electric vehicles. However, FCEVs have not gained the same popularity as electric vehicles due to stringent legal frameworks, underdeveloped infrastructure, high fuel transport, and storage costs plus the expense of fuel cell technology itself. This research will focus on the legal frameworks for hydrogen-powered vehicles, and how a change in these policies may affect and improve hydrogen fueling infrastructure and lower hydrogen transport and storage costs. These policies may also facilitate reductions in fuel cell technology costs. In order to attain a better framework, a number of countries have developed conceptual roadmaps. These roadmaps have set out a series of objectives to increase the access of FCEVs to their respective markets. This research will specifically focus on policies in Japan, Europe, and the USA in their attempt to shape the automotive industry of the future. The researchers also suggest additional policies that may help to accelerate the advancement of FCEVs to mass-markets. The approach was to provide a solid literature review using resources from around the globe. After a subsequent analysis and synthesis of this review, the authors concluded that in spite of existing legal challenges that have hindered the advancement of fuel-cell technology in the automobile industry in the past, new initiatives that enhance and advance the very same technology in the future are underway.

Keywords: fuel cell electric vehicles, fuel cell technology, legal frameworks, policies and regulations

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Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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The history of gaseous fuel use in the motive power of vehicles dates back to the second half of the nineteenth century, and thus the beginnings of the automotive industry. The engines were powered by coal gas and became the prototype for internal combustion engines built so far. It can thus be considered that this construction gave rise to the automotive industry. As the socio-economic development advances, so does the number of motor vehicles. Although, due to technological progress in recent decades, the emissions generated by internal combustion engines of cars have been reduced, a sharp increase in the number of cars and the rapidly growing traffic are an important source of air pollution and a major cause of acoustic threat, in particular in large urban agglomerations. One of the solutions, in terms of reducing exhaust emissions and improving air quality, is a more extensive use of alternative fuels: CNG, LNG, electricity and hydrogen. In the case of electricity use for transport, it should be noted that the environmental outcome depends on the structure of electricity generation. The paper shows selected regulations affecting the use of alternative fuels for transport (including Directive 2014/94/EU) and its dynamics between 2000 and 2015 in Poland and selected EU countries. The paper also gives a focus on the impact of alternative fuels on the environment by comparing the volume of individual emissions (compared to the emissions from conventional fuels: petrol and diesel oil). Bearing in mind that the extent of various alternative fuel use is determined in first place by economic conditions, the article describes the price relationships between alternative and conventional fuels in Poland and selected EU countries. It is pointed out that although Poland has a wealth of experience in using methane alternative fuels for transport, one of the main barriers to their development in Poland is the extensive use of LPG. In addition, a poorly developed network of CNG stations in Poland, which does not allow easy transport, especially in the northern part of the country, is a serious problem to a further development of CNG use as fuel for transport. An interesting solution to this problem seems to be the use of home CNG filling stations: Home Refuelling Appliance (HRA, refuelling time 8-10 hours) and Home Refuelling Station (HRS, refuelling time 8-10 minutes). The team is working on HRA and HRS technologies. The article also highlights the impact of alternative fuel use on energy security by reducing reliance on imports of crude oil and petroleum products.

Keywords: alternative fuels, CNG (Compressed Natural Gas), CNG stations, LNG (Liquefied Natural Gas), NGVs (Natural Gas Vehicles), pollutant emissions

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Authors: Caroline Seo, Jennifer Stephens, Kirstin H. Heinrich

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Background: Clostridiodes (formerly Clostridium) difficile infection (CDI) is an anaerobic, spore-forming bacterium with manifestations including diarrhea, pseudomembranous colitis and toxic megacolon. Despite general understanding that CDI may be associated with marked burden on patients’ health, there has been limited information available on the humanistic burden of CDI. The objective of this literature review was to summarize the published data on the humanistic burden of CDI globally, in order to better inform future research efforts and increase awareness of the patient perspective in this disease. Methods: A comprehensive literature review of the past 15 years (2002-2017) was conducted using MEDLINE, Embase and Cumulative Index of Nursing and Allied Health Literature. Additional searches were conducted from conference proceedings (2015-2017). Articles selected were studies specifically designed to examine the humanistic burden of illness associated with adult patients with CDI. Results: Of 3,325 articles or abstracts identified, 33 remained after screening and full text review. Sixty percent (60%) were published in 2016 or 2017. Data from the United States or Western Europe were most common. Data from Brazil, Canada, China and Spain also exist. Thirteen (13) studies used validated patient-reported outcomes instruments, mostly EQ-5D utility and SF-36 generic instruments. Three (3) studies used CDI-specific instruments (CDiff32, CDI-DaySyms). The burden of CDI impacts patients in multiple health-related quality of life (HRQOL) domains. SF-36 domains with the largest decrements compared to other GI diarrheal diseases (IBS-D and Crohn’s) were role physical, physical functioning, vitality, social functioning, and role emotional. Reported EQ-5D utilities for CDI ranged from 0.35-0.42 compared to 0.65 in Crohn’s and 0.72 in IBS-D. The majority of papers addressed physical functioning and mental health domains (67% for both). Across various studies patients reported weakness, lack of appetite, sleep disturbance, functional dependence, and decreased activities of daily lives due to the continuous diarrhea. Due to lack of control over this infection, CDI also impacts the psychological and emotional quality of life of the patients. Patients reported feelings of fear, anxiety, frustration, depression, and embarrassment. Additionally, the type of disease (primary vs. recurrent) may impact mental health. One study indicated that there is a decrement in SF-36 mental scores in patients with recurrent CDI, in comparison to patients with primary CDI. Other domains highlighted by these studies include pain (27%), social isolation (27%), vitality and fatigue (24%), self-care (9%), and caregiver burden (0%). Two studies addressed work productivity, with 1 of these studies reporting that CDI patients had the highest work productivity and activity impairment scores among the gastrointestinal diseases. No study specifically included caregiver self-report. However, 3 studies did provide mention of patients’ worry on how their diagnosis of CDI would impact family, caregivers, and/or friends. Conclusions: Despite being a serious public health issue there has been a paucity of research on the HRQOL among those with CDI. While progress is being made, gaps exist in understanding the burden on patients, caregivers, and families. Future research is warranted to aid understanding of the CDI patient perspective.

Keywords: burden, Clostridiodes, difficile, humanistic, infection

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Authors: Aryati Yashadhana, Ted Fields Jnr., Wendy Fernando, Kelvin Brown, Godfrey Blitner, Francis Hayes, Ruby Stanley, Brian Donnelly, Bridgette Jerrard, Anthea Burnett, Anthony B. Zwi

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Indigenous Australians experience some of the worst health outcomes globally, with life expectancy being significantly poorer than those of non-Indigenous Australians. This is largely attributed to preventable diseases such as diabetes (prevalence 39% in Indigenous Australian adults > 55 years), which is attributed to a raised risk of diabetic visual impairment and cataract among Indigenous adults. Our study aims to explore the interface between structural and sociocultural determinants and human agency, in order to understand how they impact (1) accessibility of eye health and chronic disease services and (2) the potential for Indigenous patients to achieve positive clinical eye health outcomes. We used Participatory Action Research methods, and aimed to privilege the voices of Indigenous people through community collaboration. Semi-structured interviews (n=82) and patient focus groups (n=8) were conducted by Indigenous Community-Based Researchers (CBRs) with diabetic Indigenous adults (> 40 years) in four remote communities in Australia. Interviews (n=25) and focus groups (n=4) with primary health care clinicians in each community were also conducted. Data were audio recorded, transcribed verbatim, and analysed thematically using grounded theory, comparative analysis and Nvivo 10. Preliminary analysis occurred in tandem with data collection to determine theoretical saturation. The principal investigator (AY) led analysis sessions with CBRs, fostering cultural and contextual appropriateness to interpreting responses, knowledge exchange and capacity building. Identified themes were conceptualised into three spheres of influence: structural (health services, government), sociocultural (Indigenous cultural values, distrust of the health system, ongoing effects of colonialism and dispossession) and individual (health beliefs/perceptions, patient phenomenology). Permeating these spheres of influence were three core determinants: economic disadvantage, health literacy/education, and cultural marginalisation. These core determinants affected accessibility of services, and the potential for patients to achieve positive clinical outcomes at every level of care (primary, secondary, tertiary). Our findings highlight the clinical realities of institutionalised and structural inequities, illustrated through the lived experiences of Indigenous patients and primary care clinicians in the four sampled communities. The complex determinants surrounding inequity in health for Indigenous Australians, are entrenched through a longstanding experience of cultural discrimination and ostracism. Secure and long term funding of Aboriginal Community Controlled Health Services will be valuable, but are insufficient to address issues of inequity. Rather, working collaboratively with communities to build trust, and identify needs and solutions at the grassroots level, while leveraging community voices to drive change at the systemic/policy level are recommended.

Keywords: indigenous, Australia, culture, public health, eye health, diabetes, social determinants of health, sociology, anthropology, health equity, aboriginal and Torres strait islander, primary care

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Authors: Kakali Roy, Sahana P. Raju, Subhra Dhar, Sandipan Dhar

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Introduction: Xeroderma pigmentosa (XP) is a rare inherited (autosomal recessive) disease resulting from impairment in DNA repair that involves recognition and repair of ultraviolet radiation (UVR) induced DNA damage in the nucleotide excision repair pathway. Which results in increased photosensitivity, UVR induced damage to skin and eye, increased susceptibility of skin and ocular cancer, and progressive neurodegeneration in some patients. XP is present worldwide, with higher incidence in areas having frequent consanguinity. Being extremely rare, there is limited literature on XP and associated complications. Here, the clinico-pathological experience (spectrum of clinical presentation, histopathological findings of malignant skin lesions, and progression) of managing 8 cases of XP is presented. Methodology: A retrospective study was conducted in a pediatric tertiary care hospital in eastern India during a ten-year period from 2013 to 2022. A clinical diagnosis was made based on severe sun burn or premature photo-aging and/or onset of cutaneous malignancies at early age (1st decade) in background of consanguinity and autosomal recessive inheritance pattern in family. Results: The mean age of presentation was 1.2 years (range of 7month-3years), while three children presented during their infancy. Male to female ratio was 5:3, and all were born of consanguineous marriage. They presented with dermatological manifestations (100%) followed by ophthalmic (75%) and/or neurological symptoms (25%). Patients had normal skin at birth but soon developed extreme sensitivity to UVR in the form of exaggerated sun tanning, burning, and blistering on minimal sun exposure, followed by abnormal skin pigmentation like freckles and lentiginosis. Subsequently, over time there was progressive xerosis, atrophy, wrinkling, and poikiloderma. Six patients had varied degree of ocular involvement, while three of them had severe manifestation, including madarosis, tylosis, ectropion, Lagopthalmos, Pthysis bulbi, clouding and scarring of the cornea with complete or partial loss of vision, and ophthalmic malignancies. 50% (n=4) cases had skin and ocular pre-malignant (actinic keratosis) and malignant lesions, including melanoma and non melanoma skin cancer (NMSC) like squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in their early childhood. One patient had simultaneous occurrence of multiple malignancies together (SCC, BCC, and melanoma). Subnormal intelligence was noticed as neurological feature, and none had sensory neural hearing loss, microcephaly, neuroregression, or neurdeficit. All the patients had been being managed by a multidisciplinary team of pediatricians, dermatologists, ophthalmologists, neurologists and psychiatrists. Conclusion: Although till date there is no complete cure for XP and the disease is ultimately fatal. But increased awareness, early diagnosis followed by persistent vigorous protection from UVR, and regular screening for early detection of malignancies along with psychological support can drastically improve patients’ quality of life and life expectancy. Further research is required on formulating optimal management of XP, specifically the role and possibilities of gene therapy in XP.

Keywords: childhood malignancies, dermato-pathological findings, eastern India, Xeroderma pigmentosa

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Authors: Eric Shannon, Mark J. McGuire, John P. Parmigiani

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A hazard associated with the use of timber harvesters is chain shot. Harvester saw chain is subjected to large dynamic mechanical stresses which can cause it to fracture. The resulting open loop of saw chain can fracture a second time and create a projectile consisting of several saw-chain links referred to as a chain shot. Its high kinetic energy enables it to penetrate operator enclosures and be a significant hazard. Accurate data on projectile composition, mass, and speed are needed for the design of both operator enclosures resistant to projectile penetration and for saw chain resistant to fracture. The work presented here contributes to providing this data through the use of a test machine designed and built at Oregon State University. The machine’s enclosure is a standard shipping container. To safely contain any anticipated chain shot, the container was lined with both 9.5 mm AR500 steel plates and 50 mm high-density polyethylene (HDPE). During normal operation, projectiles are captured virtually undamaged in the HDPE enabling subsequent analysis. Standard harvester components are used for bar mounting and chain tensioning. Standard guide bars and saw chains are used. An electric motor with flywheel drives the system. Testing procedures follow ISO Standard 11837. Chain speed at break was approximately 45.5 m/s. Data was collected using both a 75 cm solid bar (Oregon 752HSFB149) and 90 cm solid bar (Oregon 902HSFB149). Saw chains used were 89 Drive Link .404”-18HX loops made from factory spools. Standard 16-tooth sprockets were used. Projectile speed was measured using both a high-speed camera and a chronograph. Both rotational and translational kinetic energy are calculated. For this study 50 chain shot events were executed. Results showed that projectiles consisted of a variety combinations of drive links, tie straps, and cutter links. Most common (occurring in 60% of the events) was a drive-link / tie-strap / drive-link combination having a mass of approximately 10.33 g. Projectile mass varied from a minimum of 2.99 g corresponding to a drive link only to a maximum of 18.91 g corresponding to a drive-link / tie-strap / drive-link / cutter-link / drive-link combination. Projectile translational speed was measured to be approximately 270 m/s and rotational speed of approximately 14000 r/s. The calculated translational and rotational kinetic energy magnitudes each average over 600 J. This study provides useful information for both timber harvester manufacturers and saw chain manufacturers to design products that reduce the hazards associated with timber harvesting.

Keywords: chain shot, timber harvesters, safety, testing

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Authors: Elizabeth Parrott, Harry Pointon, Frederic Bezombes, Heather Panter

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Unmanned aerial vehicles (UAV’s) are making a profound effect within policing, forensic and fire service procedures worldwide. These intelligent devices have already proven useful in photographing and recording large-scale outdoor and indoor sites using orthomosaic and three-dimensional (3D) modelling techniques, for the purpose of capturing and recording sites during and post-incident. UAV’s are becoming an established tool as they are extending the reach of the photographer and offering new perspectives without the expense and restrictions of deploying full-scale aircraft. 3D reconstruction quality is directly linked to the resolution of captured images; therefore, close proximity flights are required for more detailed models. As technology advances deployment of UAVs in confined spaces is becoming more common. With this in mind, this study investigates the effects of UAV operation within active crimes scenes with regard to the dispersal of particulate evidence. To date, there has been little consideration given to the potential effects of using UAV’s within active crime scenes aside from a legislation point of view. Although potentially the technology can reduce the likelihood of contamination by replacing some of the roles of investigating practitioners. There is the risk of evidence dispersal caused by the effect of the strong airflow beneath the UAV, from the downwash of the propellers. The initial results of this study are therefore presented to determine the height of least effect at which to fly, and the commercial propeller type to choose to generate the smallest amount of disturbance from the dataset tested. In this study, a range of commercially available 4-inch propellers were chosen as a starting point due to the common availability and their small size makes them well suited for operation within confined spaces. To perform the testing, a rig was configured to support a single motor and propeller powered with a standalone mains power supply and controlled via a microcontroller. This was to mimic a complete throttle cycle and control the device to ensure repeatability. By removing the variances of battery packs and complex UAV structures to allow for a more robust setup. Therefore, the only changing factors were the propeller and operating height. The results were calculated via computer vision analysis of the recorded dispersal of the sample particles placed below the arm-mounted propeller. The aim of this initial study is to give practitioners an insight into the technology to use when operating within confined spaces as well as recognizing some of the issues caused by UAV’s within active crime scenes.

Keywords: dispersal, evidence, propeller, UAV

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Authors: Alexandre Faure, Yoko Mizokami, éRic Dinet

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These recent years, the potential of light in assisting visually impaired people in their indoor mobility has been demonstrated by different studies. Implementing smart lighting systems for selective visual enhancement, especially designed for low-vision people, is an approach that breaks with the existing visual aids. The appearance of the surface of an object is significantly influenced by the lighting conditions and the constituent materials of the objects. Appearance of objects may appear to be different from expectation. Therefore, lighting conditions lead to an important part of accurate material recognition. The main objective of this work was to investigate the effect of the spatial distribution of light on object identification in the context of low vision. The purpose was to determine whether and what specific lighting approaches should be preferred for visually impaired people. A psychophysical experiment was designed to study the ability of individuals to identify the smallest cube of a pair under different lighting diffusion conditions. Participants were divided into two distinct groups: a reference group of observers with normal or corrected-to-normal visual acuity and a test group, in which observers were required to wear visual impairment simulation glasses. All participants were presented with pairs of cubes in a "miniature room" and were instructed to estimate the relative size of the two cubes. The miniature room replicates real-life settings, adorned with decorations and separated from external light sources by black curtains. The correlated color temperature was set to 6000 K, and the horizontal illuminance at the object level at approximately 240 lux. The objects presented for comparison consisted of 11 white cubes and 11 black cubes of different sizes manufactured with a 3D printer. Participants were seated 60 cm away from the objects. Two different levels of light diffuseness were implemented. After receiving instructions, participants were asked to judge whether the two presented cubes were the same size or if one was smaller. They provided one of five possible answers: "Left one is smaller," "Left one is smaller but unsure," "Same size," "Right one is smaller," or "Right one is smaller but unsure.". The method of constant stimuli was used, presenting stimulus pairs in a random order to prevent learning and expectation biases. Each pair consisted of a comparison stimulus and a reference cube. A psychometric function was constructed to link stimulus value with the frequency of correct detection, aiming to determine the 50% correct detection threshold. Collected data were analyzed through graphs illustrating participants' responses to stimuli, with accuracy increasing as the size difference between cubes grew. Statistical analyses, including 2-way ANOVA tests, showed that light diffuseness had no significant impact on the difference threshold, whereas object color had a significant influence in low vision scenarios. The first results and trends derived from this pilot experiment clearly and strongly suggest that future investigations could explore extreme diffusion conditions to comprehensively assess the impact of diffusion on object identification. For example, the first findings related to light diffuseness may be attributed to the range of manipulation, emphasizing the need to explore how other lighting-related factors interact with diffuseness.

Keywords: Lighting, Low Vision, Visual Aid, Object Identification, Psychophysical Experiment

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Authors: Stephanie Zuba-Bates

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Purpose: This qualitative research study explored the lived experience of people with functional movement disorder (FMD) including how it impacts their quality of life and participation in life activities. It aims to educate health care professionals about FMD from the perspective of those living with the disorder. Background: Functional movement disorder is characterized by abnormal motor movements including tremors, abnormal gait, paresis, and dystonia with no known underlying pathophysiological cause. Current research estimates that FMD may account for 2-20% of clients seen by neurologists. Getting a diagnosis of FMD is typically long and difficult. In addition, many healthcare professionals are unfamiliar with the disorder which may delay treatment. People living with FMD face great disruption in major areas of life including activities of daily living (ADLs), work, leisure, and community participation. OT practitioners have expertise in working with people with both physical disabilities as well as mental illness and this expertise has the potential to guide treatment and become part of the standard of care. In order for occupational therapists to provide these services, they must be aware of the disorder and must advocate for clients to be referred to OT services. In addition, referring physicians and other health professionals need to understand how having FMD impacts the daily functioning of people living with the disorder and how OT services can intervene to improve their quality of life. This study aimed to answer the following research questions: 1) What is the lived experience of individuals with FMD?; 2) How has FMD impacted their participation in major areas of life?; and, 3) What treatment have they found to be effective in improving their quality of life? Method: A naturalistic approach was used to collect qualitative data through semi-structured telephone interviews of five individuals living with FMD. Subjects were recruited from social media websites and resources for people with FMD. Data was analyzed for common themes among participants. Results: Common themes including the variability of symptoms of the disorder; challenges to receiving a diagnosis; frustrations with and distrust of health care professionals; the impact of FMD on the participant’s ability to perform daily activities; and, strategies for living with the symptoms of FMD. Conclusion: All of the participants in the study had to modify their daily activities, roles and routines as a result of the disorder. This is an area where occupational therapists may intervene to improve the quality of life of these individuals. Additionally, participants reported frustration with the medical community regarding the awareness of the disorder and how they were treated by medical professionals. Much more research and awareness of the disorder is in order.

Keywords: functional movement disorder, occupational therapy, participation, quality of life

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Authors: Pedro G. Morouço

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One utmost challenge in Tissue Engineering is the production of 3D constructs capable of mimicking the functional hierarchy of native tissues. This is well stated for osteochondral tissue due to the complex mechanical functional unit based on the junction of articular cartilage and bone. Thus, the aim of the present study was to develop a new additive manufacturing system coupling micro-extrusion with hydrogels printing. An integrated system was developed with 2 main features: (i) the printing of up to three distinct hydrogels; (ii) in coordination with the printing of a thermoplastic structural support. The hydrogel printing module was projected with a ‘revolver-like’ system, where the hydrogel selection was made by a rotating mechanism. The hydrogel deposition was then controlled by pressured air input. The use of specific components approved for medical use was incorporated in the material dispensing system (Nordson EDF Optimum® fluid dispensing system). The thermoplastic extrusion modulus enabled the control of required extrusion temperature through electric resistances in the polymer reservoir and the extrusion system. After testing and upgrades, a hydrogel modulus with 3 syringes (3cm3 capacity each), with a pressure range of 0-2.5bar, a rotational speed of 0-5rpm, and working with needles from 200-800µm was obtained. This modulus was successfully coupled to the extrusion system that presented a temperature up to 300˚C, a pressure range of 0-12bar, and working with nozzles from 200-500µm. The applied motor could provide a velocity range 0-2000mm/min. Although, there are distinct printing requirements for hydrogels and polymers, the novel system could develop hybrid scaffolds, combining the 2 moduli. The morphological analysis showed high reliability (n=5) between the theoretical and obtained filament and pore size (350µm and 300µm vs. 342±4µm and 302±3µm, p>0.05, respectively) of the polymer; and multi-material 3D constructs were successfully obtained. Human tissues present very distinct and complex structures regarding their mechanical properties, organization, composition and dimensions. For osteochondral regenerative medicine, a multiphasic scaffold is required as subchondral bone and overlying cartilage must regenerate at the same time. Thus, a scaffold with 3 layers (bone, intermediate and cartilage parts) can be a promising approach. The developed system may give a suitable solution to construct those hybrid scaffolds with enhanced properties. The present novel system is a step-forward regarding osteochondral tissue engineering due to its ability to generate layered mechanically stable implants through the double-printing of hydrogels with thermoplastics.

Keywords: 3D bioprinting, bone regeneration, cartilage regeneration, regenerative medicine, tissue engineering

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Authors: Candy Chieh Lee

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Objective: The purpose of this study is to investigate the relationship between visual perception and social function in patients with schizophrenia. The specific aims are: 1) To explore performances in visual perception and social function in patients with schizophrenia 2) to examine the correlation between visual perceptual skills and social function in patients with schizophrenia The long-term goal is to be able to provide the most adequate intervention program for promoting patients’ visual perceptual skills and social function, as well as compensatory techniques. Background: Perceptual deficits in schizophrenia have been well documented in the visual system. Clinically, a considerable portion (up to 60%) of schizophrenia patients report distorted visual experiences such as visual perception of motion, color, size, and facial expression. Visual perception is required for the successful performance of most activities of daily living, such as dressing, making a cup of tea, driving a car and reading. On the other hand, patients with schizophrenia usually exhibit psychotic symptoms such as auditory hallucination and delusions which tend to alter their perception of reality and affect their quality of interpersonal relationship and limit their participation in various social situations. Social function plays an important role in the prognosis of patients with schizophrenia; lower social functioning skills can lead to poorer prognosis. Investigations on the relationship between social functioning and perceptual ability in patients with schizophrenia are relatively new but important as the results could provide information for effective intervention on visual perception and social functioning in patients with schizophrenia. Methods: We recruited 50 participants with schizophrenia in the mental health hospital (Taipei City Hospital, Songde branch, Taipei, Taiwan) acute ward. Participants who have signed consent forms, diagnosis of schizophrenia and having no organic vision deficits were included. Participants were administered the test of visual-perceptual skills (non-motor), third edition (TVPS-3) and the personal and social performance scale (PSP) for assessing visual perceptual skill and social function. The assessments will take about 70-90 minutes to complete. Data Analysis: The IBM SPSS 21.0 will be used to perform the statistical analysis. First, descriptive statistics will be performed to describe the characteristics and performance of the participants. Lastly, Pearson correlation will be computed to examine the correlation between PSP and TVPS-3 scores. Results: Significant differences were found between the means of participants’ TVPS-3 raw scores of each subtest with the age equivalent raw score provided by the TVPS-3 manual. Significant correlations were found between all 7 subtests of TVPS-3 and PSP total score. Conclusions: The results showed that patients with schizophrenia do exhibit visual perceptual deficits and is correlated social functions. Understanding these facts of patients with schizophrenia can assist health care professionals in designing and implementing adequate rehabilitative treatment according to patients’ needs.

Keywords: occupational therapy, social function, schizophrenia, visual perception

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Authors: Tom S. Owens, Tom A. Calverley, Benjamin S. Stacey, Christopher J. Marley, George Rose, Lewis Fall, Gareth L. Jones, Priscilla Williams, John P. R. Williams, Martin Steggall, Damian M. Bailey

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Introduction and aims: Sports-related concussion (SRC) represents a significant and growing public health concern in rugby union, yet remains one of the least understood injuries facing the health community today. Alongside increasing SRC incidence rates, there is concern that prior recurrent concussion may contribute to long-term neurologic sequelae in later-life. This may be due to an accelerated decline in cerebral perfusion, a major risk factor for neurocognitive decline and neurodegeneration, though the underlying mechanisms remain to be established. The present study hypothesised that recurrent concussion in current professional rugby union players would result in elevated systemic oxidative-nitrosative stress, reflected by a free radical-mediated reduction in nitric oxide (NO) bioavailability and impaired cerebrovascular and cognitive function. Methodology: A longitudinal study design was adopted across the 2017-2018 rugby union season. Ethical approval was obtained from the University of South Wales Ethics Committee. Data collection is ongoing, and therefore the current report documents result from the pre-season and first half of the in-season data collection. Participants were initially divided into two subgroups; 23 professional rugby union players (aged 26 ± 5 years) and 22 non-concussed controls (27 ± 8 years). Pre-season measurements were performed for cerebrovascular function (Doppler ultrasound of middle cerebral artery velocity (MCAv) in response to hypocapnia/normocapnia/hypercapnia), cephalic venous concentrations of the ascorbate radical (A•-, electron paramagnetic resonance spectroscopy), NO (ozone-based chemiluminescence) and cognition (neuropsychometric tests). Notational analysis was performed to assess contact in the rugby group throughout each competitive game. Results: 1001 tackles and 62 injuries, including three concussions were observed across the first half of the season. However, no associations were apparent between number of tackles and any injury type (P > 0.05). The rugby group expressed greater oxidative stress as indicated by increased A•- (P < 0.05 vs. control) and a subsequent decrease in NO bioavailability (P < 0.05 vs. control). The rugby group performed worse in the Ray Auditory Verbal Learning Test B (RAVLT-B, learning, and memory) and the Grooved Pegboard test using both the dominant and non-dominant hands (visuomotor coordination, P < 0.05 vs. control). There were no between-group differences in cerebral perfusion at baseline (MCAv: 54 ± 13 vs. 59 ± 12, P > 0.05). Likewise, no between-group differences in CVRCO2Hypo (2.58 ± 1.01 vs. 2.58 ± 0.75, P > 0.05) or CVRCO2Hyper (2.69 ± 1.07 vs. 3.35 ± 1.28, P > 0.05) were observed. Conclusion: The present study identified that the rugby union players are characterized by impaired cognitive function subsequent to elevated systemic-oxidative-nitrosative stress. However, this appears to be independent of any functional impairment in cerebrovascular function. Given the potential long-term trajectory towards accelerated cognitive decline in populations exposed to SRC, prophylaxis to increase NO bioavailability warrants consideration.

Keywords: cognition, concussion, mild traumatic brain injury, rugby

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Authors: Jiabei Zhang

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Although adapted physical education (APE) teacher preparation programs are available in the nation, a consistent standards-based competency evaluation scale for preparing of qualified personnel for teaching children with disabilities in APE cannot be identified in the literature. The purpose of this study was to develop a standard-based competency evaluation scale for assessing qualifications for teaching children with disabilities in APE. Standard-based competencies were reviewed and identified based on research evidence documented as effective in teaching children with disabilities in APE. A standard-based competency scale was developed for assessing qualifications for teaching children with disabilities in APE. This scale included 20 standard-based competencies and a 4-point Likert-type scale for each standard-based competency. The first standard-based competency is knowledgeable of the causes of disabilities and their effects. The second competency is the ability to assess physical education skills of children with disabilities. The third competency is able to collaborate with other personnel. The fourth competency is knowledgeable of the measurement and evaluation. The fifth competency is to understand federal and state laws. The sixth competency is knowledgeable of the unique characteristics of all learners. The seventh competency is the ability to write in behavioral terms for objectives. The eighth competency is knowledgeable of developmental characteristics. The ninth competency is knowledgeable of normal and abnormal motor behaviors. The tenth competency is the ability to analyze and adapt the physical education curriculums. The eleventh competency is to understand the history and the philosophy of physical education. The twelfth competency is to understand curriculum theory and development. The thirteenth competency is the ability to utilize instructional designs and plans. The fourteenth competency is the ability to create and implement physical activities. The fifteenth competency is the ability to utilize technology applications. The sixteenth competency is to understand the value of program evaluation. The seventeenth competency is to understand professional standards. The eighteenth competency is knowledgeable of the focused instruction and individualized interventions. The nineteenth competency is able to complete a research project independently. The twentieth competency is to teach children with disabilities in APE independently. The 4-point Likert-type scale ranges from 1 for incompetent to 4 for highly competent. This scale is used for assessing if one completing all course works is eligible for receiving an endorsement for teaching children with disabilities in APE, which is completed based on the grades earned on three courses targeted for each standard-based competency. A mean grade received in three courses primarily addressing a standard-based competency will be marked on a competency level in the above scale. The level 4 is marked for a mean grade of A one receives over three courses, the level 3 for a mean grade of B over three courses, and so on. One should receive a mean score of 3 (competent level) or higher (highly competent) across 19 standard-based competencies after completing all courses specified for receiving an endorsement for teaching children with disabilities in APE. The validity, reliability, and objectivity of this standard-based competency evaluation scale are to be documented.

Keywords: evaluation scale, teacher preparation, adapted physical education teachers, and children with disabilities

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Authors: Walter Sebron, Hans Tschürtz, Peter Krebs

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The choice of applicable analysis methods in safety or systems engineering depends on the depth of knowledge about a system, and on the respective lifecycle phase. However, the analysis method chain still shows gaps as it should support system analysis during the lifecycle of a system from a rough concept in pre-project phase until end-of-life. This paper’s goal is to discuss an analysis method, the VISSE Shell Model Analysis (VISMA) method, which aims at closing the gap in the early system lifecycle phases, like the conceptual or pre-project phase, or the project start phase. It was originally developed to aid in the definition of the system boundary of electronic system parts, like e.g. a control unit for a pump motor. Furthermore, it can be also applied to non-electronic system parts. The VISMA method is a graphical sketch-like method that stratifies a system and its parts in inner and outer shells, like the layers of an onion. It analyses a system in a two-step approach, from the innermost to the outermost components followed by the reverse direction. To ensure a complete view of a system and its environment, the VISMA should be performed by (multifunctional) development teams. To introduce the method, a set of rules and guidelines has been defined in order to enable a proper shell build-up. In the first step, the innermost system, named system under consideration (SUC), is selected, which is the focus of the subsequent analysis. Then, its directly adjacent components, responsible for providing input to and receiving output from the SUC, are identified. These components are the content of the first shell around the SUC. Next, the input and output components to the components in the first shell are identified and form the second shell around the first one. Continuing this way, shell by shell is added with its respective parts until the border of the complete system (external border) is reached. Last, two external shells are added to complete the system view, the environment and the use case shell. This system view is also stored for future use. In the second step, the shells are examined in the reverse direction (outside to inside) in order to remove superfluous components or subsystems. Input chains to the SUC, as well as output chains from the SUC are described graphically via arrows, to highlight functional chains through the system. As a result, this method offers a clear and graphical description and overview of a system, its main parts and environment; however, the focus still remains on a specific SUC. It helps to identify the interfaces and interfacing components of the SUC, as well as important external interfaces of the overall system. It supports the identification of the first internal and external hazard causes and causal chains. Additionally, the method promotes a holistic picture and cross-functional understanding of a system, its contributing parts, internal relationships and possible dangers within a multidisciplinary development team.

Keywords: analysis methods, functional safety, hazard identification, system and safety engineering, system boundary definition, system safety

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Authors: Sherif Fakher

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Hydrogen has been gaining a lot of global attention as an uprising contributor in the energy sector. Labeled as an energy carrier, hydrogen is used in many industries and can be used to generate electricity via fuel cells. Blue hydrogen involves the production of hydrogen from hydrocarbons using different processes that emit CO₂. However, the CO₂ is captured and stored. Hence, very little environmental damage occurs during the hydrogen production process. This research investigates the ability to use different catalysts for the production of hydrogen from different hydrocarbon sources, including coal, oil, and gas, using a two-step Aquathermolysis reaction. The research presents the results of experiments conducted to evaluate different catalysts and also highlights the main advantages of this process over other blue hydrogen production methods, including methane steam reforming, autothermal reforming, and oxidation. Two methods of hydrogen generation were investigated including partial oxidation and aquathermolysis. For those two reactions, the reaction kinetics, thermodynamics, and medium were all investigated. Following this, experiments were conducted to test the hydrogen generation potential from both methods. The porous media tested were sandstone, ash, and prozzolanic material. The spent oils used were spent motor oil and spent vegetable oil from cooking. Experiments were conducted at temperatures up to 250 C and pressures up to 3000 psi. Based on the experimental results, mathematical models were developed to predict the hydrogen generation potential at higher thermodynamic conditions. Since both partial oxidation and aquathermolysis require relatively high temperatures to undergo, it was important to devise a method by which these high temperatures can be generated at a low cost. This was done by investigating two factors, including the porous media used and the reliance on the spent oil. Of all the porous media used, the ash had the highest thermal conductivity. The second step was the partial combustion of part of the spent oil to generate the heat needed to reach the high temperatures. This reduced the cost of the heat generation significantly. For the partial oxidation reaction, the spent oil was burned in the presence of a limited oxygen concentration to generate carbon monoxide. The main drawback of this process was the need for burning. This resulted in the generation of other harmful and environmentally damaging gases. Aquathermolysis does not rely on burning, which makes it the cleaner alternative. However, it needs much higher temperatures to run the reaction. When comparing the hydrogen generation potential for both using gas chromatography, aquathermolysis generated 23% more hydrogen using the same volume of spent oil compared to partial oxidation. This research introduces the concept of using spent oil for hydrogen production. This can be a very promising method to produce a clean source of energy using a waste product. This can also help reduce the reliance on freshwater for hydrogen generation which can divert the usage of freshwater to other more important applications.

Keywords: blue hydrogen production, catalytic aquathermolysis, direct carbon dioxide capture, CCUS

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Authors: Marita Pigłowska, Beata Kurc, Paweł Daszkiewicz

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Railway vehicles are divided into two groups: traction (powered) vehicles and wagons. The traction vehicles include locomotives (line and shunting), railcars (sometimes referred to as railbuses), and multiple units (electric and diesel), consisting of several or a dozen carriages. In vehicles with diesel traction, fuel energy (petrol, diesel, or compressed gas) is converted into mechanical energy directly in the internal combustion engine or via electricity. In the latter case, the combustion engine generator produces electricity that is then used to drive the vehicle (diesel-electric drive or electric transmission). In Poland, such a solution dominates both in heavy linear and shunting locomotives. The classic diesel drive is available for the lightest shunting locomotives, railcars, and passenger diesel multiple units. Vehicles with electric traction do not have their own source of energy -they use pantographs to obtain electricity from the traction network. To determine the competitiveness of the hydrogen propulsion system, it is essential to understand how it works. The basic elements of the construction of a railway vehicle drive system that uses hydrogen as a source of traction force are fuel cells, batteries, fuel tanks, traction motors as well as main and auxiliary converters. The compressed hydrogen is stored in tanks usually located on the roof of the vehicle. This resource is supplemented with the use of specialized infrastructure while the vehicle is stationary. Hydrogen is supplied to the fuel cell, where it oxidizes. The effect of this chemical reaction is electricity and water (in two forms -liquid and water vapor). Electricity is stored in batteries (so far, lithium-ion batteries are used). Electricity stored in this way is used to drive traction motors and supply onboard equipment. The current generated by the fuel cell passes through the main converter, whose task is to adjust it to the values required by the consumers, i.e., batteries and the traction motor. The work will attempt to construct a fuel cell with unique electrodes. This research is a trend that connects industry with science. The first goal will be to obtain hydrogen on a large scale in tube furnaces, to thoroughly analyze the obtained structures (IR), and to apply the method in fuel cells. The second goal is to create low-energy energy storage and distribution station for hydrogen and electric vehicles. The scope of the research includes obtaining a carbon variety and obtaining oxide systems on a large scale using a tubular furnace and then supplying vehicles. Acknowledgments: This work is supported by the Polish Ministry of Science and Education, project "The best of the best! 4.0", number 0911/MNSW/4968 – M.P. and grant 0911/SBAD/2102—B.K.

Keywords: railway, hydrogen, fuel cells, hybrid vehicles

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Authors: Marina Fuertes

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Introduction: In everyday life experiences, children are solicited to cooperate with others. Often they perform cooperative tasks with their parents (e.g., setting the table for dinner) or in school. These tasks are very significant since children may learn to turn taking in interactions, to participate as well to accept others participation, to trust, to respect, to negotiate, to self-regulate their emotions, etc. Indeed, cooperative tasks contribute to children social, motor, cognitive and linguistic development. Therefore, it is important to study what learning, social and affective experiences are provided to children during these tasks. In this study, we included parents and preschool educators. Parents and educators are both significant: educative, interactive and affective figures. Rarely parents and educators behavior have been compared in studies about cooperative tasks. Parents and educators have different but complementary styles of interaction and communication. Aims: Therefore, this study aims to compare parents and educators' (of both genders) interactive behavior (cooperativity, empathy, ability to challenge the child, reciprocity, elaboration) during a play/individualized situation involving a cooperative task. Moreover, to compare parents and educators' behavior with girls and boys. Method: A quasi-experimental study with 45 dyads educators-children and 45 dyads with parents and their children. In this study, participated children between 3 and 5 years old and with age appropriate development. Adults and children were videotaped using a variety of materials (e.g., pencils, wood, wool) and tools (e.g., scissors, hammer) to produce together something of their choice during 20-minutes. Each dyad (one adult and one child) was observed and videotaped independently. Adults and children agreed and consented to participate. Experimental conditions were suitable, pleasant and age appropriated. Results: Findings indicate that parents and teachers offer different learning experiences. Teachers were more likely to challenged children to explore new concepts and to accept children ideas. In turn, parents gave more support to children actions and were more likely to use their own example to teach children. Multiple regression analysis indicates that parent versus educator status predicts their behavior. Gender of both children and adults affected the results. Adults acted differently with girls and boys (e.g., adults worked more cooperatively with girls than boys). Male participants supported more girls participation rather than boys while female adults allowed boys to make more decisions than girls. Discussion: Taking our results and past studies, we learn that different qualitative interactions and learning experiences are offered by parents, educators according to parents and children gender. Thus, the same child needs to learn different cooperative strategies according to their interactive patterns and specific context. Yet, cooperative play and individualized activities with children generate learning opportunities and benefits children participation and involvement.

Keywords: early childhood education, parenting, gender, cooperative tasks, adult-child interaction

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Authors: M. Zielinski, M. Debowski, P. Rusanowska, A. Glowacka-Gil, M. Zielinska, A. Cydzik-Kwiatkowska, J. Kazimierowicz

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Technologies for the micro-biogas plant with heating and mixing systems are presented as a part of the Research Coordination for a Low-Cost Biomethane Production at Small and Medium Scale Applications (Record Biomap). The main objective of the Record Biomap project is to build a network of operators and scientific institutions interested in cooperation and the development of promising technologies in the sector of small and medium-sized biogas plants. The activities carried out in the project will bridge the gap between research and market and reduce the time of implementation of new, efficient technological and technical solutions. Reactor with simultaneously mixing and heating system is a concrete tank with a rectangular cross-section. In the reactor, heating is integrated with the mixing of substrate and anaerobic sludge. This reactor is solution dedicated for substrates with high solids content, which cannot be introduced to the reactor with pumps, even with positive displacement pumps. Substrates are poured to the reactor and then with a screw pump, they are mixed with anaerobic sludge. The pumped sludge, flowing through the screw pump, is simultaneously heated by a heat exchanger. The level of the fermentation sludge inside the reactor chamber is above the bottom edge of the cover. Cover of the reactor is equipped with the screw pump driver. Inside the reactor, an electric motor is installed that is driving a screw pump. The heated sludge circulates in the digester. The post-fermented sludge is collected using a drain well. The inlet to the drain well is below the level of the sludge in the digester. The biogas is discharged from the reactor by the biogas intake valve located on the cover. The technology is very useful for fermentation of lignocellulosic biomass and substrates with high content of dry mass (organic wastes). The other technology is a reactor for micro-biogas plant with a pressure mixing system. The reactor has a form of plastic or concrete tank with a circular cross-section. The effective mixing of sludge is ensured by profiled at 90° bottom of the tank. Substrates for fermentation are supplied by an inlet well. The inlet well is equipped with a cover that eliminates odour release. The introduction of a new portion of substrates is preceded by pumping of digestate to the disposal well. Optionally, digestate can gravitationally flow to digestate storage tank. The obtained biogas is discharged into the separator. The valve supplies biogas to the blower. The blower presses the biogas from the fermentation chamber in such a way as to facilitate the introduction of a new portion of substrates. Biogas is discharged from the reactor by valve that enables biogas removal but prevents suction from outside the reactor.

Keywords: biogas, digestion, heating system, mixing system

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