Search results for: Olivia Rachel Hwang
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 220

Search results for: Olivia Rachel Hwang

100 Count of Trees in East Africa with Deep Learning

Authors: Nubwimana Rachel, Mugabowindekwe Maurice

Abstract:

Trees play a crucial role in maintaining biodiversity and providing various ecological services. Traditional methods of counting trees are time-consuming, and there is a need for more efficient techniques. However, deep learning makes it feasible to identify the multi-scale elements hidden in aerial imagery. This research focuses on the application of deep learning techniques for tree detection and counting in both forest and non-forest areas through the exploration of the deep learning application for automated tree detection and counting using satellite imagery. The objective is to identify the most effective model for automated tree counting. We used different deep learning models such as YOLOV7, SSD, and UNET, along with Generative Adversarial Networks to generate synthetic samples for training and other augmentation techniques, including Random Resized Crop, AutoAugment, and Linear Contrast Enhancement. These models were trained and fine-tuned using satellite imagery to identify and count trees. The performance of the models was assessed through multiple trials; after training and fine-tuning the models, UNET demonstrated the best performance with a validation loss of 0.1211, validation accuracy of 0.9509, and validation precision of 0.9799. This research showcases the success of deep learning in accurate tree counting through remote sensing, particularly with the UNET model. It represents a significant contribution to the field by offering an efficient and precise alternative to conventional tree-counting methods.

Keywords: remote sensing, deep learning, tree counting, image segmentation, object detection, visualization

Procedia PDF Downloads 31
99 Coral Reef Fishes in the Marine Protected Areas in Southern Cebu, Philippines

Authors: Christine M. Corrales, Gloria G. Delan, Rachel Luz V. Rica, Alfonso S. Piquero

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Marine protected areas (MPAs) in the study sites were established 8-13 years ago and are presently operational. This study was conducted to gather baseline information on the diversity, density and biomass of coral reef fishes inside and outside the four marine protected areas (MPAs) of Cawayan, Dalaguete; Daan-Lungsod Guiwang, Alcoy; North Granada, Boljoon and Sta. Cruz, Ronda. Coral reef fishes in the MPAs were identified using Fish Visual Census Method. Results of the t-test showed that the mean diversity (fish species/250m2) of target and non-target reef fish species found inside and outside the MPAs were significantly different. Density (ind./1,000m2) of target species inside and outside the MPAs showed no significant difference. Similarly, density of non-target species inside and outside the MPAs also showed no significant difference. This is an indication that fish density inside and outside the MPAs were more or less of the same condition. The mean biomass (kg/1,000m2) of target species inside and outside the MPAs showed a significant difference in contrast with non-target species inside and outside the MPAs which showed a no significant difference. Higher biomass of target fish species belonging to family Caesonidae (fusiliers) and Scaridae (parrotfishes) were commonly observed inside the MPAs. Results showed that fish species were more diverse with higher density and biomass inside the MPAs than the outside area. However, fish diversity and density were mostly contributed by non-target species. Hence, long term protection and management of MPAs is needed to effectively increase fish diversity, density and biomass specifically on target fish species.

Keywords: biomass, density, diversity, marine protected area, target fish species

Procedia PDF Downloads 365
98 Audit of Post-Caesarean Section Analgesia

Authors: Rachel Ashwell, Sally Millett

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Introduction: Adequate post-operative pain relief is a key priority in the delivery of caesarean sections. This improves patient experience, reduces morbidity and enables optimal mother-infant interaction. Recommendations outlined in the NICE guidelines for caesarean section (CS) include offering peri-operative intrathecal/epidural diamorphine and post-operative opioid analgesics; offering non-steroidal anti-inflammatory drugs (NSAIDs) unless contraindicated and taking hourly observations for 12 hours following intrathecal diamorphine. Method: This audit assessed the provision of post-CS analgesia in 29 women over a two-week period. Indicators used were the use of intrathecal/epidural opioids, use of post-operative opioids and NSAIDs, frequency of observations and patient satisfaction with pain management on post-operative days 1 and 2. Results: All women received intrathecal/epidural diamorphine, 97% were prescribed post-operative opioids and all were prescribed NSAIDs unless contraindicated. Hourly observations were not maintained for 12 hours following intrathecal diamorphine. 97% of women were satisfied with their pain management on post-operative day 1 whereas only 75% were satisfied on day 2. Discussion: This service meets the proposed standards for the provision of post-operative analgesia, achieving high levels of patient satisfaction 1 day after CS. However, patient satisfaction levels are significantly lower on post-operative day 2, which may be due to reduced frequency of observations. The lack of an official audit standard for patient satisfaction on postoperative day 2 may result in reduced incentive to prioritise pain management at this stage.

Keywords: Caesarean section, analgesia, postoperative care, patient satisfaction

Procedia PDF Downloads 367
97 The Effects of Kinesio Tape® and No Tape for Muscle Facilitation and Inhibition, for Collegiate Athletes with Self-Reported Shoulder Pain

Authors: Gregory Chown, Benjamin Infantolino, Christopher Wise, Rachel Holmes, Samantha O'Donnell, Katelyn Pfeiffer, Victoria Ward

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Background: There is a lack of understanding of how Kinesio Tape® physiologically works. Furthermore, few studies compare Kinesio Tape® to other forms of taping. The research question is: Does Kinesio Tape® cause a difference in muscle facilitation, inhibition, and pain, between Kinesio Tape® and no tape for collegiate athletes with self-reported shoulder pain? Method: This quantitative non-randomized design used a convenience sampling method. There were eleven participants with self-reported shoulder pain who were athletes on the men’s and women’s lacrosse and tennis teams. Participants attended one 30-45 minute session for data collection. Each participant received all three taping conditions and performed four repetitions of 120 degrees of active shoulder flexion for the three separate trials (no tape, Kinesio Tape® inhibition, and Kinesio Tape® facilitation). Surface electromyography (sEMG) electrodes were placed on the anterior deltoid, supraspinatus, and lower trapezius to measure muscle facilitation and inhibition. Each participant completed the visual analogue scale (VAS) before and after each trial to measure pain. Results: No statistical significance was found for pain scores on the VAS between the taping methods of facilitation, inhibition, and no tape (p = .118). No statistical significance was found for the percentage of change in muscle function for each taping method; Anterior deltoid (p = .993), supraspinatus (p = .997) and lower trapezius (p = .922). Conclusion: Based on the results, Kinesio Tape® appears to not have an effect on muscle function or pain when utilizing the facilitation or inhibition taping method when compared to no tape.

Keywords: Kinesio tape, muscle facilitation, muscle inhibition, pain

Procedia PDF Downloads 160
96 Obesity, Leptin Levels and Leptin Receptor Gene Polymorphisms in Afro-Caribbean Subjects

Authors: Lydia Foucan, Christine Rambhojan, Rachel Billy, Christophe Armand, Carl-Thony Michel, Jean-Marc Lacorte, Laurent Larifla

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Leptin, an adipocyte-derived hormone, modulates insulin secretion and action via the leptin receptor (LEPR) that is expressed in pancreatic beta cells, adipose tissue, and muscle. Several polymorphisms have been described in the human LEPR gene including p.K109R (rs1137100), p.Q223R (rs1137101) and p.K656N (rs1805094) polymorphisms. The role of these polymorphisms is not yet studied in Guadeloupian population. Our aim was to explore the association of LEPR polymorphisms (K109R, Q223R and K656N) with leptin levels and obesity in non-diabetic Afro-Caribbean subjects. Genotypic analysis of the three polymorphisms was performed in 425 subjects using TaqMan and KASPar Assays. Serum leptin was measured with ELISA kits Biovendor® (RD191001100). Logistic regressions were used for assessment of statistical associations. Mean age was 47.6 ± 12.7 years. Among the participants, 238 (56 %) were women, 124 (30%) were obese and 155 (36.5%) had abdominal obesity. Carriers of LEPR K656N rs1805094 rare allele had significant higher frequencies of obesity (P = 0.007), abdominal obesity (P = 0.004) and metabolic syndrome (P = 0.021) but mean leptin level was not significantly different between both groups (P = 0.075). Odds ratios, adjusted for age and sex associated with presence of rs1805094 rare allele were 1.8 (1.1-2.9), P = 0.012 for obesity, 2.0 (1.2-3.3), P = 0.008 for abdominal obesity and 1.8 (1.1-3.0), P = 0.031 for MetS. No significant association was found with K109R, Q223R. These findings suggest that the K656N polymorphism (but not the K109R or Q223R polymorphism) of LEPR is associated with obesity, abdominal obesity and metabolic syndrome in this Afro-Caribbean non-diabetic population.

Keywords: Afro-Caribbean, leptin levels, leptin receptor gene polymorphisms, obesity

Procedia PDF Downloads 349
95 A Pilot Study Exploring Dog Owners’ Perceptions on Volunteering With Their Dogs in Animal-Assisted Therapy Program in Singapore

Authors: Julia Wong, Hua Beng Lim, Cheryl Ho, Gin Jen Gwee, Rachel Tay

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In Singapore, a few hospitals and non-governmental social service agencies have been utilising animal-assisted therapy (AAT) in their practice in recent years, although the animals used (e.g., dogs, cats, and horses) and program modality may differ due to the different practice settings, client profiles, and intervention goals. This pilot study explores dog owners’ perceptions of AAT with a focus on examining the enablers and barriers towards volunteering with their dogs in AAT programs in Singapore. A qualitative, thematic analysis study was conducted using in-depth, semi-structured interviews with 16 dog owners. 3 of the dog owners had previous experience volunteering with their dogs serving elderly patients in a community hospital, while the rest of the dog owners had no previous experience volunteering with their dogs. The former group was recruited with the help of the hospital, while the latter group was recruited via word-of-mouth. Dog owners who had volunteering experiences in AAT program versus those who had none differed in their perceptions towards AAT. Dog owners who had volunteered with their dogs in an AAT program in a hospital felt that their volunteering experience were meaningful to patients and to themselves, as they were intrinsically motivated by the desire to serve the community. Those who had not volunteered were hesitant to volunteer with their dogs as they were not comfortable with strangers touching their dogs. They also felt that it would be a huge commitment in terms of time and money; most of them do not own a car as it is uneconomical, and pets are not allowed on Singapore’s public transport systems. This study is limited by its small sample size, and its findings are not generalisable. However, given that volunteers are an invaluable resource in healthcare settings, future studies can examine more stakeholders’ perceptions towards AAT.

Keywords: animal-assisted therapy, dog-assisted therapy, volunteers, complementary therapy

Procedia PDF Downloads 71
94 “Fake It Till You Make It”: A Qualitative Study into the Well-being of Autistic Women

Authors: Kathleen Seers, Rachel Hogg

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Diagnosis of Autism Spectrum Disorder (ASD) in women is increasing, prompting research into the presentation of female ASD and exploring why females are failing to meet the diagnostic threshold. One explanation is the use of masking behaviors, where traits of ASD are suppressed and gender-appropriate behaviors are mimicked to reduce the visibility and victimization of ASD girls. Current research explores ASD presentation and the lived experiences of ASD girls and adolescents; however, there is a paucity of literature in relation to the intra- and inter- psychic experiences of ASD women. Through a social constructionist framework, this qualitative study sought to understand how the construction of gender and the medicalisation of ASD influences women’s experiences of ASD. This study also explored the use and consequence of masking strategies and the impact this has on well-being. Eight women were interviewed, and three major themes were identified. The themes outline the influence of gender expectations and social norms on the women’s experiences, the significance of diagnosis to their identity, and the influence of the medicalization of ASD. Participants shared experiences of feeling different and internalizing blame for this difference. The feeling of difference was a major contributor to the women’s positive or negative mental well-being. The process of diagnosis allowed participants to create and confirm their identity. Diagnosis also led to improvements in well-being, however, the findings also explore the complexity of labeling individuals with a disorder and the difficulties that arise from the construct of ‘functionality’ for those with Autism. The study also explores the temporal nature of ASD and the changing experiences of women as they mature. It is hoped this study promotes discussion and provides clinicians and those connected to ASD women with insights into the support ASD women require to live authentic lives.

Keywords: female autism, gender, masking, social constructionism

Procedia PDF Downloads 90
93 Simulation and Fabrication of Plasmonic Lens for Bacteria Detection

Authors: Sangwoo Oh, Jaewoo Kim, Dongmin Seo, Jaewon Park, Yongha Hwang, Sungkyu Seo

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Plasmonics has been regarded one of the most powerful bio-sensing modalities to evaluate bio-molecular interactions in real-time. However, most of the plasmonic sensing methods are based on labeling metallic nanoparticles, e.g. gold or silver, as optical modulation markers, which are non-recyclable and expensive. This plasmonic modulation can be usually achieved through various nano structures, e.g., nano-hole arrays. Among those structures, plasmonic lens has been regarded as a unique plasmonic structure due to its light focusing characteristics. In this study, we introduce a custom designed plasmonic lens array for bio-sensing, which was simulated by finite-difference-time-domain (FDTD) approach and fabricated by top-down approach. In our work, we performed the FDTD simulations of various plasmonic lens designs for bacteria sensor, i.e., Samonella and Hominis. We optimized the design parameters, i.e., radius, shape, and material, of the plasmonic lens. The simulation results showed the change in the peak intensity value with the introduction of each bacteria and antigen i.e., peak intensity 1.8711 a.u. with the introduction of antibody layer of thickness of 15nm. For Salmonella, the peak intensity changed from 1.8711 a.u. to 2.3654 a.u. and for Hominis, the peak intensity changed from 1.8711 a.u. to 3.2355 a.u. This significant shift in the intensity due to the interaction between bacteria and antigen showed a promising sensing capability of the plasmonic lens. With the batch processing and bulk production of this nano scale design, the cost of biological sensing can be significantly reduced, holding great promise in the fields of clinical diagnostics and bio-defense.

Keywords: plasmonic lens, FDTD, fabrication, bacteria sensor, salmonella, hominis

Procedia PDF Downloads 251
92 Spatial and Geostatistical Analysis of Surficial Soils of the Contiguous United States

Authors: Rachel Hetherington, Chad Deering, Ann Maclean, Snehamoy Chatterjee

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The U.S. Geological Survey conducted a soil survey and subsequent mineralogical and geochemical analyses of over 4800 samples taken across the contiguous United States between the years 2007 and 2013. At each location, samples were taken from the top 5 cm, the A-horizon, and the C-horizon. Many studies have looked at the correlation between the mineralogical and geochemical content of soils and influencing factors such as parent lithology, climate, soil type, and age, but it seems little has been done in relation to quantifying and assessing the correlation between elements in the soil on a national scale. GIS was used for the mapping and multivariate interpolation of over 40 major and trace elements for surficial soils (0-5 cm depth). Qualitative analysis of the spatial distribution across the U.S. shows distinct patterns amongst elements both within the same periodic groups and within different periodic groups, and therefore with different behavioural characteristics. Results show the emergence of 4 main patterns of high concentration areas: vertically along the west coast, a C-shape formed through the states around Utah and northern Arizona, a V-shape through the Midwest and connecting to the Appalachians, and along the Appalachians. The Band Collection Statistics tool in GIS was used to quantitatively analyse the geochemical raster datasets and calculate a correlation matrix. Patterns emerged, which were not identified in qualitative analysis, many of which are also amongst elements with very different characteristics. Preliminary results show 41 element pairings with a strong positive correlation ( ≥ 0.75). Both qualitative and quantitative analyses on this scale could increase knowledge on the relationships between element distribution and behaviour in surficial soils of the U.S.

Keywords: correlation matrix, geochemical analyses, spatial distribution of elements, surficial soils

Procedia PDF Downloads 105
91 Multi-Modality Imaging of Aggressive Hoof Wall Neoplasia in Two Horses

Authors: Hannah Nagel, Hayley Lang, Albert Sole Guitart, Natasha Lean, Rachel Allavena, Cleide Sprohnie-Barrera, Alex Young

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Aggressive neoplasia of the hoof is a rare occurrence in horses and has been only sporadically described in the literature. In the few cases reported intra-hoof wall, aggressive neoplasia has been documented radiographically and has been described with variable imaging characteristics. These include a well-defined osteolytic area, a smoothly outlined semi-circular defect, an extensive draining tract beneath the hoof wall, as well as an additional large area of osteolysis or an extensive central lytic region. A 20-year-old Quarterhorse gelding and a 10-year-old Thoroughbred gelding were both presented for chronic reoccurring lameness in the left forelimb and left hindlimb, respectively. Both of the cases displayed radiographic lesions that have been previously described but also displayed osteoproliferative expansile regions of additional bone formation. Changes associated with hoof neoplasia are often non-specific due to the nature and capacity of bone to react to pathological insult, which is either to proliferate or be absorbed. Both cases depict and describe imaging findings seen on radiography, contrast radiography, computed tomography, and magnetic resonance imaging before reaching a histological diagnosis of malignant melanoma and squamous cell carcinoma. Although aggressive hoof wall neoplasia is rare, there are some imaging features which may raise our index of suspicion for an aggressive hoof wall lesion. This case report documents two horses with similar imaging findings who underwent multiple assessments, surgical interventions, and imaging modalities with a final diagnosis of malignant neoplasia.

Keywords: horse, hoof, imaging, radiography, neoplasia

Procedia PDF Downloads 110
90 Enzymatic Repair Prior To DNA Barcoding, Aspirations, and Restraints

Authors: Maxime Merheb, Rachel Matar

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Retrieving ancient DNA sequences which in return permit the entire genome sequencing from fossils have extraordinarily improved in recent years, thanks to sequencing technology and other methodological advances. In any case, the quest to search for ancient DNA is still obstructed by the damage inflicted on DNA which accumulates after the death of a living organism. We can characterize this damage into three main categories: (i) Physical abnormalities such as strand breaks which lead to the presence of short DNA fragments. (ii) Modified bases (mainly cytosine deamination) which cause errors in the sequence due to an incorporation of a false nucleotide during DNA amplification. (iii) DNA modifications referred to as blocking lesions, will halt the PCR extension which in return will also affect the amplification and sequencing process. We can clearly see that the issues arising from breakage and coding errors were significantly decreased in recent years. Fast sequencing of short DNA fragments was empowered by platforms for high-throughput sequencing, most of the coding errors were uncovered to be the consequences of cytosine deamination which can be easily removed from the DNA using enzymatic treatment. The methodology to repair DNA sequences is still in development, it can be basically explained by the process of reintroducing cytosine rather than uracil. This technique is thus restricted to amplified DNA molecules. To eliminate any type of damage (particularly those that block PCR) is a process still pending the complete repair methodologies; DNA detection right after extraction is highly needed. Before using any resources into extensive, unreasonable and uncertain repair techniques, it is vital to distinguish between two possible hypotheses; (i) DNA is none existent to be amplified to begin with therefore completely un-repairable, (ii) the DNA is refractory to PCR and it is worth to be repaired and amplified. Hence, it is extremely important to develop a non-enzymatic technique to detect the most degraded DNA.

Keywords: ancient DNA, DNA barcodong, enzymatic repair, PCR

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89 Brazil's Olympian Tragedy: Searching for Citizenship in Vila Autodromo

Authors: Rachel K. Cremona

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Forty years ago, Vila Autodromo was a small fishing settlement in southwest Rio de Janeiro. By 2012, Vila Autodromo had established itself into a working class neighborhood – certainly not a slum, but nonetheless designated as a ‘favela’ as a consequence of its history as an illegal settlement that was thus never provided with public services. Vila Autodromo sits on a large lagoon, adjacent to the Olympic Park being constructed for the 2016 Olympic Games to be held in Rio, and looks out over the expensive high rise condominiums that have sprouted across the water. In 2009, when Rio submitted their bid for the Olympic games, there were approximately 900 families that called Vila Autodromo home, and the original plans for the games clearly show their homes remaining in place. Today, only a handful of these homes remain. This paper will utilize the case study of Vila Autodromo to examine the broader issue of Favelas in 21st century Rio de Janeiro. While race and poverty have become synonymous with Brazil’s inegalitarian social order – and personified by the thousands of favelas scattered in and around large cities like Rio and Sao Paulo – much less attention has been given to the political status of the nation’s invisible majority. In particular, this research will examine the question of citizenship and argue that the most fundamental problem of inequality in Brazil is not simply a product of history, race and social order, but more specifically a problem of ‘personhood’. The political marginalization of Brazil’s poor does not simply reinforce their social marginalization, it institutionalizes it in a way that makes it almost impossible to escape. The story of Vila Autodromo captures this problem in a way that not only illustrates the clear (though ambiguous) role of the state in the perpetuation of Brazil’s underclass, but also the human resilience that it has fostered.

Keywords: citizenship, poverty, displacement, favela

Procedia PDF Downloads 408
88 Generation of Charged Nanoparticles and Their Contribution to the Thin Film and Nanowire Growth during Chemical Vapour Deposition

Authors: Seung-Min Yang, Seong-Han Park, Sang-Hoon Lee, Seung-Wan Yoo, Chan-Soo Kim, Nong-Moon Hwang

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The theory of charged nanoparticles suggested that in many Chemical Vapour Depositions (CVD) processes, Charged Nanoparticles (CNPs) are generated in the gas-phase and become a building block of thin films and nanowires. Recently, the nanoparticle-based crystallization has become a big issue since the growth of nanorods or crystals by the building block of nanoparticles was directly observed by transmission electron microscopy observations in the liquid cell. In an effort to confirm charged gas-phase nuclei, that might be generated under conventional processing conditions of thin films and nanowires during CVD, we performed an in-situ measurement using differential mobility analyser and particle beam mass spectrometer. The size distribution and number density of CNPs were affected by process parameters such as precursor flow rate and working temperature. It was shown that many films and nanostructures, which have been believed to grow by individual atoms or molecules, actually grow by the building blocks of such charged nuclei. The electrostatic interaction between CNPs and the growing surface induces the self-assembly into films and nanowires. In addition, the charge-enhanced atomic diffusion makes CNPs liquid-like quasi solid. As a result, CNPs tend to land epitaxial on the growing surface, which results in the growth of single crystalline nanowires with a smooth surface.

Keywords: chemical vapour deposition, charged nanoparticle, electrostatic force, nanostructure evolution, differential mobility analyser, particle beam mass spectrometer

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87 Acceptability of the Carers-ID Intervention for Family Carers of People with Intellectual Disabilities

Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

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Background: Family carers of people with intellectual disabilities (ID) face ongoing challenges in accessing services and often experience poor mental health. Online support programmes may prove effective in addressing the mental health and well-being needs of family carers. This study sought to test the acceptability of a newly developed online support programme for carers of people with intellectual disabilities called Carers-ID. Methods A sequential mixed-methods explanatory design was utilised. An adapted version of the Acceptability of Health Apps among Adolescents (AHAA) Scale was distributed to family carers who had viewed the Carers-ID.com intervention. Following this, participants were invited to take part in an online interview. Interview questions focused on participants’ experiences of using the programme and its acceptability. Qualitative and quantitative data were analysed separately and then brought together through the triangulation protocol developed by Farmer et al (2006). Findings: Seventy family carers responded to the acceptability survey, whilst 10 took part in interviews. Six themes were generated from interviews with family carers. Based on our triangulation, four areas of convergence were identified, these included, programme usability and ease, attitudes towards the programme, perceptions of effectiveness, and programme relatability. Conclusions: In order to be acceptable, online interventions for carers of people with ID need to be accessible, understandable and easy to use, as carers time is precious. Further research is needed to investigate the effectiveness of online interventions for family carers, specifically considering which carers the intervention works for, and for whom it may not.

Keywords: intellectual disability, family carer, acceptability study, online intervention

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86 Experiences of Family Carers of People Intellectual Disabilities During the COVID-19 Pandemic

Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

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Background: The COVID-19 pandemic exacerbated the already significant strain placed on family carers of people with profound and multiple intellectual disabilities (PMID), given the withdrawal of many services during lockdown. The aim of this study was to explore the experiences of family carers of people with PMID during the COVID-19 pandemic. Methods: Online focus groups were conducted with family carers (n=126) from across the UK and the Republic of Ireland. Participants were asked about their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. Focus groups were audio recorded, transcribed verbatim and analyzed through thematic analysis. Findings: Three themes emerged from our analysis of the data: (i) COVID-19 as a double-edged sword, (ii) The struggle for support (iii) the Constant nature of caring. These included 11 subthemes: (i) ‘COVID-19 as a catalyst for change’, ‘Challenges during COVID-19: dealing with change’, ‘Challenges during COVID-19: fear of COVID-19’, ‘The online environment: the new normal’ (ii) ‘Invisibility of male carers’, ‘Carers supporting carers’, ‘The only service you get is lip service: non-existent services’, ‘Knowing your rights’ (iii) ‘Emotional response to the caring role: Feeling devalued’, ‘Emotional response to the caring role: Desperation of caring’, ‘Multiple demands of the caring role.’ Conclusions: Poor or inconsistent access to services and support has been an ongoing difficulty for many family carers. The COVID-19 pandemic has only further intensified these difficulties, increasing family carers' stress. There is an urgent need to design services, such as online support programs, in partnership with family carers that adequately address their needs.

Keywords: intellectual disabilities, family carer, COVID-19, disability

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85 CO2 Emission and Cost Optimization of Reinforced Concrete Frame Designed by Performance Based Design Approach

Authors: Jin Woo Hwang, Byung Kwan Oh, Yousok Kim, Hyo Seon Park

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As greenhouse effect has been recognized as serious environmental problem of the world, interests in carbon dioxide (CO2) emission which comprises major part of greenhouse gas (GHG) emissions have been increased recently. Since construction industry takes a relatively large portion of total CO2 emissions of the world, extensive studies about reducing CO2 emissions in construction and operation of building have been carried out after the 2000s. Also, performance based design (PBD) methodology based on nonlinear analysis has been robustly developed after Northridge Earthquake in 1994 to assure and assess seismic performance of building more exactly because structural engineers recognized that prescriptive code based design approach cannot address inelastic earthquake responses directly and assure performance of building exactly. Although CO2 emissions and PBD approach are recent rising issues on construction industry and structural engineering, there were few or no researches considering these two issues simultaneously. Thus, the objective of this study is to minimize the CO2 emissions and cost of building designed by PBD approach in structural design stage considering structural materials. 4 story and 4 span reinforced concrete building optimally designed to minimize CO2 emissions and cost of building and to satisfy specific seismic performance (collapse prevention in maximum considered earthquake) of building satisfying prescriptive code regulations using non-dominated sorting genetic algorithm-II (NSGA-II). Optimized design result showed that minimized CO2 emissions and cost of building were acquired satisfying specific seismic performance. Therefore, the methodology proposed in this paper can be used to reduce both CO2 emissions and cost of building designed by PBD approach.

Keywords: CO2 emissions, performance based design, optimization, sustainable design

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84 Plausible Influence of Hydroxycitric Acid and Garcinol in Garcinia indica Fruit Extract in High Fat Diet Induced Type 2 Diabetes Mellitus

Authors: Hannah Rachel Vasanthi, Paomipem Phazang, Veereshkumar, Sali, Ramesh Parjapath, Sangeetha Marimuthu Kannan

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Garcinia indica (G. indica) fruit rind extract commonly used in South Indian culinary and Indian System of medicines is reported to exhibit various biological activities. The present study envisages the influence of the phytoconstituents in G. indica extract (Vrikshamla capsules- a herbal supplement) on diabetic condition. The condition of type 2 diabetes was triggered in experimental animals by feeding high fat diet for 8 weeks followed by a sub-diabetogenic dose of 35mg/kg bw of streptozotocin intraperitoneally. Oral supplementation of the extract at two doses (100 and 200 mg/kg body weight) for 14 days reduced hyperglycemia, hypercholesterolemia and dyslipidemia (p< 0.001). Pathophysiological changes of obesity and diabetes associated complications majorly mediated by oxidative stress were analyzed by measuring the markers of oxidative stress such as lipid peroxidation, enzymatic (SOD, Catalase, GPx) and non-enzymatic markers (GSH). Conspicuous changes markers were noticed in diabetic condition which was reverted by the G. indica extract. Screening the extract by AccuTOF-DART (MS) revealed the presence of hydroxycitric acid and garcinol in abundant quantity which probably has influenced the biological activity. This was also corroborated through docking studies of hydroxycitric acid and garcinol both individually and synergistically with the antioxidant proteins. Altogether, hydroxycitric acid and garcinol present in G. indica fruit extract alleviates the pathophysiological conditions such as hyperglycemia, dyslipidemia, insulin resistance and oxidative stress mediated by diabesity.

Keywords: antioxidants , diabesity, hydroxycitric acid, garcinol, Garcinia indica, sreptozotocin

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83 Socio-economic Baselining of Selected Icrmp Sites in Southwestern Cebu, Central Philippines

Authors: Rachel Luz P. Vivas-rica, Gloria G. Delan, Christine M. Corrales, Alfonso S. Piquero, Irene A. Monte

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ABSTRACT -Selected Integrated Coastal Resource Management Program (ICRMP) sites in Southwestern Cebu were studied employing a stratified proportional sampling method using semi-structured questionnaires. Four hundred sixteen (416) respondents from five barangays with Marine Protected Areas (MPAs) and four barangays without marine sanctuaries were considered in the study. Results showed similarity of socio-economic characteristics in terms of average age, majority were middle aged, and married. Households were male dominated, obtained low education for both MPA and Non-MPA areas. In terms of occupation, majority in both areas engaged in fulltime fishing however part time jobs as carpenter, construction worker, driver or farmer as another income source. Most of the households were nuclear families with average family size of five for both MPA and Non-MPA. Fishing experience ranged from less than 1 year to more than 50 years. Fishing grounds were within the 15 kilometer radius of each considered site. Even if the respondents were totally dependent on fishing as a major source of income, still their income is way below the poverty threshold both in the MPA and Non-MPA areas. This is further explained by the marginality of their fishing implements wherein majority uses gill nets, hook & line, spear and paddle boat in fishing. Their volume of catch from an average of 6 hours fishing expedition ranges from half a kilo to a maximum of 4 kilos. Majority are not members of fishing groups or organizations.

Keywords: integrated coastal resource management program, marine protected areas, socio-economic, poverty threshold

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82 LGR5 and Downstream Intracellular Signaling Proteins Play Critical Roles in the Cell Proliferation of Neuroblastoma, Meningioma and Pituitary Adenoma

Authors: Jin Hwan Cheong, Mina Hwang, Myung Hoon Han, Je Il Ryu, Young ha Oh, Seong Ho Koh, Wu Duck Won, Byung Jin Ha

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Leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) has been reported to play critical roles in the proliferation of various cancer cells. However, the roles of LGR5 in brain tumors and the specific intracellular signaling proteins directly associated with it remain unknown. Expression of LGR5 was first measured in normal brain tissue, meningioma, and pituitary adenoma of humans. To identify the downstream signaling pathways of LGR5, siRNA-mediated knockdown of LGR5 was performed in SH-SY5Y neuroblastoma cells followed by proteomics analysis with 2-dimensional polyacrylamide gel electrophoresis (2D-PAGE). In addition, the expression of LGR5-associated proteins was evaluated in LGR5-inꠓhibited neuroblastoma cells and in human normal brain, meningioma, and pituitary adenoma tissue. Proteomics analysis showed 12 protein spots were significantly different in expression level (more than two-fold change) and subsequently identified by peptide mass fingerprinting. A protein association network was constructed from the 12 identified proteins altered by LGR5 knockdown. Direct and indirect interactions were identified among the 12 proteins. HSP 90-beta was one of the proteins whose expression was altered by LGR5 knockdown. Likewise, we observed decreased expression of proteins in the hnRNP subfamily following LGR5 knockdown. In addition, we have for the first time identified significantly higher hnRNP family expression in meningioma and pituitary adenoma compared to normal brain tissue. Taken together, LGR5 and its downstream sigꠓnaling play critical roles in neuroblastoma and brain tumors such as meningioma and pituitary adenoma.

Keywords: LGR5, neuroblastoma, meningioma, pituitary adenoma, hnRNP

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81 Free Will and Compatibilism in Decision Theory: A Solution to Newcomb’s Paradox

Authors: Sally Heyeon Hwang

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Within decision theory, there are normative principles that dictate how one should act in addition to empirical theories of actual behavior. As a normative guide to one’s actual behavior, evidential or causal decision-theoretic equations allow one to identify outcomes with maximal utility values. The choice that each person makes, however, will, of course, differ according to varying assignments of weight and probability values. Regarding these different choices, it remains a subject of considerable philosophical controversy whether individual subjects have the capacity to exercise free will with respect to the assignment of probabilities, or whether instead the assignment is in some way constrained. A version of this question is given a precise form in Richard Jeffrey’s assumption that free will is necessary for Newcomb’s paradox to count as a decision problem. This paper will argue, against Jeffrey, that decision theory does not require the assumption of libertarian freedom. One of the hallmarks of decision-making is its application across a wide variety of contexts; the implications of a background assumption of free will is similarly varied. One constant across the contexts of decision is that there are always at least two levels of choice for a given agent, depending on the degree of prior constraint. Within the context of Newcomb’s problem, when the predictor is attempting to guess the choice the agent will make, he or she is analyzing the determined aspects of the agent such as past characteristics, experiences, and knowledge. On the other hand, as David Lewis’ backtracking argument concerning the relationship between past and present events brings to light, there are similarly varied ways in which the past can actually be dependent on the present. One implication of this argument is that even in deterministic settings, an agent can have more free will than it may seem. This paper will thus argue against the view that a stable background assumption of free will or determinism in decision theory is necessary, arguing instead for a compatibilist decision theory yielding a novel treatment of Newcomb’s problem.

Keywords: decision theory, compatibilism, free will, Newcomb’s problem

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80 Nursing Documentation of Patients' Information at Selected Primary Health Care Facilities in Limpopo Province, South Africa: Implications for Professional Practice

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

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

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

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79 Benchmarking Machine Learning Approaches for Forecasting Hotel Revenue

Authors: Rachel Y. Zhang, Christopher K. Anderson

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A critical aspect of revenue management is a firm’s ability to predict demand as a function of price. Historically hotels have used simple time series models (regression and/or pick-up based models) owing to the complexities of trying to build casual models of demands. Machine learning approaches are slowly attracting attention owing to their flexibility in modeling relationships. This study provides an overview of approaches to forecasting hospitality demand – focusing on the opportunities created by machine learning approaches, including K-Nearest-Neighbors, Support vector machine, Regression Tree, and Artificial Neural Network algorithms. The out-of-sample performances of above approaches to forecasting hotel demand are illustrated by using a proprietary sample of the market level (24 properties) transactional data for Las Vegas NV. Causal predictive models can be built and evaluated owing to the availability of market level (versus firm level) data. This research also compares and contrast model accuracy of firm-level models (i.e. predictive models for hotel A only using hotel A’s data) to models using market level data (prices, review scores, location, chain scale, etc… for all hotels within the market). The prospected models will be valuable for hotel revenue prediction given the basic characters of a hotel property or can be applied in performance evaluation for an existed hotel. The findings will unveil the features that play key roles in a hotel’s revenue performance, which would have considerable potential usefulness in both revenue prediction and evaluation.

Keywords: hotel revenue, k-nearest-neighbors, machine learning, neural network, prediction model, regression tree, support vector machine

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78 Optimal Allocation of Oil Rents and Public Investment In Low-Income Developing Countries: A Computable General Equilibrium Analysis

Authors: Paule Olivia Akotto

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The recent literature suggests spending between 50%-85% of oil rents. However, there are not yet clear guidelines for allocating this windfall in the public investment system, while most of the resource-rich countries fail to improve their intergenerational mobility. We study a design of the optimal spending system in Senegal, a low-income developing country featuring newly discovered oil fields and low intergenerational mobility. We build a dynamic general equilibrium model in which rural and urban (Dakar and other urban centers henceforth OUC) households face different health, education, and employment opportunities based on their location, affecting their intergenerational mobility. The model captures the relationship between oil rents, public investment, and multidimensional inequality of opportunity. The government invests oil rents in three broad sectors: health and education, road and industries, and agriculture. Through endogenous productivity externality and human capital accumulation, our model generates the predominant position of Dakar and OUC households in terms of access to health, education, and employment in line with Senegal data. Rural households are worse off in all dimensions. We compute the optimal spending policy under two sets of simulation scenarios. Under the current Senegal public investment strategy, which weighs more health and education investments, we find that the reform maximizing the decline in inequality of opportunity between households, frontloads investment during the first eight years of the oil exploitation and spends the perpetual value of oil wealth thereafter. We will then identify the marginal winners and losers associated with this policy and its redistributive implications. Under our second set of scenarios, we will test whether the Senegalese economy can reach better equality of opportunity outcomes under this frontloading reform, by allowing the sectoral shares of investment to vary. The trade-off will be between cutting human capital investment in favor of agricultural and productive infrastructure or increasing the former. We will characterize the optimal policy by specifying where the higher weight should be. We expect that the optimal policy of the second set strictly dominates in terms of equality of opportunity, the optimal policy computed under the current investment strategy. Finally, we will quantify this optimal policy's aggregate and distributional effects on poverty, well-being, and gender earning gaps.

Keywords: developing countries, general equilibrium, inequality of opportunity, oil rents

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77 Pregnant Women and Mothers in Prison, Mother and Baby Units and Mental Health

Authors: Rachel Dolan

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Background: Over two thirds of women in prison in England are mothers, and estimates suggest between 100 and 200 women per year give birth during imprisonment. There are currently six mother and baby units (MBUs) in prisons in England which admit women and babies up to the age of 18 months. Although there are only 65 places available, and despite positive impacts, they are rarely full. Mental illness may influence the number of admissions, as may interpretation of admission criteria. They are the only current alternative to separation for imprisoned mothers and their babies. Aims: To identify the factors that affect the decision to apply for/be offered a place in a prison MBU; to measure the impact of a placement upon maternal mental health and wellbeing; To measure the Initial outcomes for mother and child. Methods: A mixed methods approach - 100 pregnant women in English prisons are currently being recruited from prisons in England. Quantitative measures will establish the prevalence of mental disorder, personality disorder, substance misuse and quality of life. Qualitative interviews will document the experiences of pregnancy and motherhood in prison. Results: Preliminary quantitative findings suggest the most prevalent mental disorders are anxiety and depression and approximately half the participants meet the criteria for one or more personality disorders. The majority of participants to date have been offered a place in a prison MBU, and those in a prison with an MBU prior to applying are more likely to be admitted. Those with a previous history of childcare issues, who are known to social services are less likely to be offered a place. Qualitative findings suggest that many women are often hungry and uncomfortable during pregnancy, many have feelings of guilt about having a child in prison and that feelings of anxiety and worry are exacerbated by lack of information.

Keywords: mothers, prison, mother and baby units, mental health

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76 Fabricating Method for Complex 3D Microfluidic Channel Using Soluble Wax Mold

Authors: Kyunghun Kang, Sangwoo Oh, Yongha Hwang

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PDMS (Polydimethylsiloxane)-based microfluidic device has been recently applied to area of biomedical research, tissue engineering, and diagnostics because PDMS is low cost, nontoxic, optically transparent, gas-permeable, and especially biocompatible. Generally, PDMS microfluidic devices are fabricated by conventional soft lithography. Microfabrication requires expensive cleanroom facilities and a lot of time; however, only two-dimensional or simple three-dimensional structures can be fabricated. In this study, we introduce fabricating method for complex three-dimensional microfluidic channels using soluble wax mold. Using the 3D printing technique, we firstly fabricated three-dimensional mold which consists of soluble wax material. The PDMS pre-polymer is cast around, followed by PDMS casting and curing. The three-dimensional casting mold was removed from PDMS by chemically dissolved with methanol and acetone. In this work, two preliminary experiments were carried out. Firstly, the solubility of several waxes was tested using various solvents, such as acetone, methanol, hexane, and IPA. We found the combination between wax and solvent which dissolves the wax. Next, side effects of the solvent were investigated during the curing process of PDMS pre-polymer. While some solvents let PDMS drastically swell, methanol and acetone let PDMS swell only 2% and 6%, respectively. Thus, methanol and acetone can be used to dissolve wax in PDMS without any serious impact. Based on the preliminary tests, three-dimensional PDMS microfluidic channels was fabricated using the mold which was printed out using 3D printer. With the proposed fabricating technique, PDMS-based microfluidic devices have advantages of fast prototyping, low cost, optically transparence, as well as having complex three-dimensional geometry. Acknowledgements: This research was supported by Supported by a Korea University Grant and Basic Science Research Program through the National Research Foundation of Korea(NRF).

Keywords: microfluidic channel, polydimethylsiloxane, 3D printing, casting

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75 Blue Whale Body Condition from Photographs Taken over a 14-Year Period in the North East Pacific: Annual Variations and Connection to Measures of Ocean Productivity

Authors: Rachel Wachtendonk, John Calambokidis, Kiirsten Flynn

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Large marine mammals can serve as an indicator of the overall state of the environment due to their long lifespan and apex position in marine food webs. Reductions in prey, driven by changes in environmental conditions can have resounding impacts on the trophic system as a whole; this can manifest in reduced fat stores that are visible on large whales. Poor health can lead to reduced survivorship and fitness, both of which can be detrimental to a recovering population. A non-invasive technique was used for monitoring blue whale health and for seeing if it changes with ocean conditions. Digital photographs of blue whales taken in the NE Pacific by Cascadia Research and collaborators from 2005-2018 (n=3,545) were scored for overall body condition based on visible vertebrae and body shape on a scale of 0-3 where a score of 0 indicated best body condition and a score of 3 indicated poorest. The data was analyzed to determine if there were patterns in the health of whales across years and whether overall poor health was related to oceanographic conditions and predictors of prey abundance on the California coast. The year was a highly significant factor in body condition (Chi-Square, p<0.001). The proportion of whales showing poor body condition (scores 2 & 3) overall was 33% but by year varied widely from a low of 18% (2008) to a high of 55% (2015). The only two years where >50% of animals had poor body condition were 2015 and 2017 (no other year was above 45%). The 2015 maximum proportion of whales in poor body condition coincide with the marine heat wave that affected the NE Pacific 2014-16 and impacted other whale populations. This indicates that the scoring method was an effective way to evaluate blue whale health and how they respond to a changing ocean.

Keywords: blue whale, body condition, environmental variability, photo-identification

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74 Development of Tutorial Courseware on Selected Topics in Mathematics, Science and the English Language

Authors: Alice D. Dioquino, Olivia N. Buzon, Emilio F. Aguinaldo, Ruel Avila, Erwin R. Callo, Cristy Ocampo, Malvin R. Tabajen, Marla C. Papango, Marilou M. Ubina, Josephine Tondo, Cromwell L. Valeriano

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The main purpose of this study was to develop, evaluate and validate courseware on Selected Topics in Mathematics, Science, and the English Language. Specifically, it aimed to: 1. Identify the appropriate Instructional Systems Design (ISD) model in the development of the courseware material; 2. Assess the courseware material according to its: a. Content Characteristics; b. Instructional Characteristics; and c. Technical Characteristics 3. Find out if there is a significant difference in the performance of students before and after using the tutorial CAI. This research is developmental as well as a one group pretest-posttest design. The study had two phases. Phase I includes the needs analysis, writing of lessons and storyboard by the respective experts in each field. Phase II includes the digitization or the actual development of the courseware by the faculty of the ICT department. In this phase it adapted an instructional systems design (ISD) model which is the ADDIE model. ADDIE stands for Analysis, Design, Development, Implementation and Evaluation. Formative evaluation was conducted simultaneously with the different phases to detect and remedy any bugs in the courseware along the areas of content, instructional and technical characteristics. The expected output are the digitized lessons in Algebra, Biology, Chemistry, Physics and Communication Arts in English. Students and some IT experts validated the CAI material using the Evaluation Form by Wong & Wong. They validated the CAI materials as Highly Acceptable with an overall mean rating of 4.527and standard deviation of 0 which means that they were one in the ratings they have given the CAI materials. A mean gain was recorded and computing the t-test for dependent samples it showed that there were significant differences in the mean achievement of the students before and after the treatment (using CAI). The identified ISD model used in the development of the tutorial courseware was the ADDIE model. The quantitative analyses of data based on ratings given by the respondents’ shows that the tutorial courseware possess the characteristics and or qualities of a very good computer-based courseware. The ratings given by the different evaluators with regard to content, instructional, and technical aspects of the Tutorial Courseware are in conformity towards being excellent. Students performed better in mathematics, biology chemistry, physics and the English Communication Arts after they were exposed to the tutorial courseware.

Keywords: CAI, tutorial courseware, Instructional Systems Design (ISD) Model, education

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73 Modelling of Heat Generation in a 18650 Lithium-Ion Battery Cell under Varying Discharge Rates

Authors: Foo Shen Hwang, Thomas Confrey, Stephen Scully, Barry Flannery

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Thermal characterization plays an important role in battery pack design. Lithium-ion batteries have to be maintained between 15-35 °C to operate optimally. Heat is generated (Q) internally within the batteries during both the charging and discharging phases. This can be quantified using several standard methods. The most common method of calculating the batteries heat generation is through the addition of both the joule heating effects and the entropic changes across the battery. In addition, such values can be derived by identifying the open-circuit voltage (OCV), nominal voltage (V), operating current (I), battery temperature (T) and the rate of change of the open-circuit voltage in relation to temperature (dOCV/dT). This paper focuses on experimental characterization and comparative modelling of the heat generation rate (Q) across several current discharge rates (0.5C, 1C, and 1.5C) of a 18650 cell. The analysis is conducted utilizing several non-linear mathematical functions methods, including polynomial, exponential, and power models. Parameter fitting is carried out over the respective function orders; polynomial (n = 3~7), exponential (n = 2) and power function. The generated parameter fitting functions are then used as heat source functions in a 3-D computational fluid dynamics (CFD) solver under natural convection conditions. Generated temperature profiles are analyzed for errors based on experimental discharge tests, conducted at standard room temperature (25°C). Initial experimental results display low deviation between both experimental and CFD temperature plots. As such, the heat generation function formulated could be easier utilized for larger battery applications than other methods available.

Keywords: computational fluid dynamics, curve fitting, lithium-ion battery, voltage drop

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72 Factors Associated with Acute Kidney Injury in Multiple Trauma Patients with Rhabdomyolysis

Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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71 Suggested Role for Neutrophil Extracellular Traps Formation in Ewing Sarcoma Immune Microenvironment

Authors: Rachel Shukrun, Szilvia Baron, Victoria Fidel, Anna Shusterman, Osnat Sher, Netanya Kollender, Dror Levin, Yair Peled, Yair Gortzak, Yoav Ben-Shahar, Revital Caspi, Sagi Gordon, Michal Manisterski, Ronit Elhasid

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Ewing sarcoma (EWS) is a highly aggressive cancer with a survival rate of 70–80% for patients with localized disease and under 30% for those with metastatic disease. Tumor-infiltrating neutrophils (TIN) can generate extracellular net-like DNA structures known as neutrophil extracellular traps (NETs). However, little is known about the presence and prognostic significance of tumor-infiltrating NETs in EWS. Herein, we investigated 46 patients diagnosed with EWS and treated in the Tel Aviv Medical Center between 2010 and 2021. TINs and NETs were identified in diagnostic biopsies of EWS by immunofluorescent. In addition, NETs were investigated in neutrophils isolated from peripheral blood samples of EWS patients at diagnosis and following neoadjuvant chemotherapy. The relationships between the presence of TINs and NETs, pathological and clinical features, and outcomes were analyzed. Our results demonstrate that TIN and NETs at diagnosis were higher in EWS patients with metastatic disease compared to those with local disease. High NETs formation at diagnosis predicted poor response to neo-adjuvant chemotherapy, relapse, and death from disease (P < .05). NETs formation in peripheral blood samples at diagnosis was significantly elevated among patients with EWS compared to pediatric controls and decreased significantly following neoadjuvant chemotherapy. In conclusion, NETs formation seems to have a role in the EWS immune microenvironment. Their presence can refine risk stratification, predict chemotherapy resistance and survival, and serve as a therapeutic target in patients with EWS.

Keywords: Ewing sarcoma, tumor microenvironment, neutrophil, neutrophil extracellular traps (NETs), prognosis

Procedia PDF Downloads 37