Search results for: overton database

Authors: Priyajeet Kaur Kaleka

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Introduction: A dentist is often the first responder in the battle for a patient’s healthy body and maybe the first health professional to observe signs of child abuse, be it physical, emotional, and/or sexual mistreatment. Therefore, it is an ethical responsibility for the dental clinician to detect and report suspected cases of child abuse and neglect (CAN). The main reasons for not reporting suspected cases of CAN, with special emphasis on the third: 1) Uncertainty of the diagnosis, 2) Lack of knowledge of the reporting procedure, and 3) Child abuse and neglect somewhat remained the subject of ignorance among dental professionals because of a lack of advance clinical training. Given these epidemic proportions, there is a scope of further research about dental school curriculum design. Purpose: This study aimed to assess the knowledge and attitude of dentists in Canada regarding signs and symptoms of child abuse and neglect (CAN), reporting procedures, and whether educational strategies followed by dental schools address this sensitive issue. In pursuit of that aim, this abstract summarizes the evidence related to this question. Materials and Methods: Data was collected through a specially designed questionnaire adapted and modified from the author’s previous cross-sectional study on (CAN), which was conducted in Pune, India, in 2016 and is available on the database of PubMed. Design: A random sample was drawn from the targeted population of registered dentists and dental students in Canada regarding their knowledge, professional responsibilities, and behavior concerning child abuse. Questionnaire data were distributed to 200 members. Out of which, a total number of 157 subjects were in the final sample for statistical analysis, yielding response of 78.5%. Results: Despite having theoretical information on signs and symptoms, 55% of the participants indicated they are not confident to detect child physical abuse cases. 90% of respondents believed that recognition and handling the CAN cases should be a part of undergraduate training. Only 4.5% of the participants have correctly identified all signs of abuse due to inadequate formal training in dental schools and workplaces. Although nearly 96.3% agreed that it is a dentist’s legal responsibility to report CAN, only a small percentage of the participants reported an abuse case in the past. While 72% stated that the most common factor that might prevent a dentist from reporting a case was doubt over the diagnosis. Conclusion: The goal is to motivate dental schools to deal with this critical issue and provide their students with consummate training to strengthen their capability to care for and protect children. The educational institutions should make efforts to spread awareness among dental students regarding the management and tackling of CAN. Clinical Significance: There should be modifications in the dental school curriculum focusing on problem-based learning models to assist graduates to fulfill their legal and professional responsibilities. CAN literacy should be incorporated into the dental curriculum, which will eventually benefit future dentists to break this intergenerational cycle of violence.

Keywords: abuse, child abuse and neglect, dentist knowledge, dental school curriculum, problem-based learning

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Authors: Aikaterini-Melpomeni Papadopoulou, Kyriaki Apergi, Margarita-Vasiliki Panagopoulou, Olga Malisova

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Introduction: Adequate hydration is a vital factor that enhances concentration, memory, and decision-making abilities throughout the workday. Various factors may affect hydration status in workplace settings, and many variables, such as age, gender and activity level affect hydration needs. Employees frequently overlook their hydration needs amid busy schedules and demanding tasks, leading to dehydration that can negatively affect cognitive function, productivity, and overall well-being In addition, dietary habits, including fluid intake and food choices, can either support or hinder optimal hydration. However, factors that affect hydration balance among workers in Greece have not been adequately studied. Objective: This study aims to evaluate the hydration status of the working population in Greece and investigate the various factors that impact hydration status in workplace settings, considering demographic, dietary, and occupational influences in a Greek sample of employees from diverse working environments Materials & Methods: The study included 212 participants (46.2% women) from the working population in Greece. Water intake from both solid and liquid foods was recorded using a semi-quantified drinking frequency questionnaire the validated Water Balance Questionnaire was used to evaluate hydration status. The calculation of water from solid and liquid foods was based on data from the USDA National Nutrient Database. Water balance was calculated subtracting the total fluid loss from the total fluid intake in the body. Furthermore, the questionnaire including additional questions on drinking habits and work-related factors.volunteers answered questions of different categories such as a) demographic socio-economic b) work style characteristics c) health, d) physical activity, e) food and fluid intake, f) fluid excretion and g) trends on fluid and water intake. Individual and multivariate regression analyses were performed to assess the relationships between demographic, work-related factors, and hydration balance. Results: Analysis showed that demographic factors like gender, age, and BMI, as well as certain work-related factors, had a weak and statistically non-significant effect on hydration balance. However, the use of a bottle or water container during work hours (b = 944.93, p < 0.001) and engaging in intense physical activity outside of work (b = -226.28, p < 0.001) were found to have a significant impact. Additionally, the consumption of beverages other than water (b = -416.14, p = 0.059) could negatively impact hydration balance. On average, the total consumption of the sample is 3410 ml of water daily, with men consuming approximately 440 ml / day more water (3470 ml / day) compared to women (3030 ml / day) with this difference also being statistically significant. Finally, the water balance, defined as the difference between water intake and water excretion, was found to be negative on average for the entire sample. Conclusions: This study is among the first to explore hydration status within the Greek working population. Findings indicate that awareness of adequate hydration and individual actions, such as using a water bottle during work, may influence hydration balance.

Keywords: hydration, working population, water balance, workplace behavior

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Authors: Inese Trusina, Elita Jermolajeva, Viktors Gopejenko, Viktor Abramov

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Global challenges require a transition from the existing linear economic model to a model that will consider nature as a life support system for the development of the way to social well-being in the frame of the ecological economics paradigm. The objective of the article is to present the results of the analysis of socio-economic systems in the context of sustainable development using the systems power (energy flows) changes analyzing method and structural Kaldor's model of GDP. In accordance with the principles of life's development and the ecological concept was formalized the tasks of sustainable development of the open, non-equilibrium, stable socio-economic systems were formalized using the energy flows analysis method. The methodology of monitoring sustainable development and level of life were considered during the research of interactions in the system ‘human - society - nature’ and using the theory of a unified system of space-time measurements. Based on the results of the analysis, the time series consumption energy and economic structural model were formulated for the level, degree and tendencies of sustainable development of the system and formalized the conditions of growth, degrowth and stationarity. In order to design the future state of socio-economic systems, a concept was formulated, and the first models of energy flows in systems were created using the tools of system dynamics. During the research, the authors calculated and used a system of universal indicators of sustainable development in the invariant coordinate system in energy units. In order to design the future state of socio-economic systems, a concept was formulated, and the first models of energy flows in systems were created using the tools of system dynamics. In the context of the proposed approach and methods, universal sustainable development indicators were calculated as models of development for the USA and China. The calculations used data from the World Bank database for the period from 1960 to 2019. Main results: 1) In accordance with the proposed approach, the heterogeneous energy resources of countries were reduced to universal power units, summarized and expressed as a unified number. 2) The values of universal indicators of the life’s level were obtained and compared with generally accepted similar indicators.3) The system of indicators in accordance with the requirements of sustainable development can be considered as a basis for monitoring development trends. This work can make a significant contribution to overcoming the difficulties of forming socio-economic policy, which is largely due to the lack of information that allows one to have an idea of the course and trends of socio-economic processes. The existing methods for the monitoring of the change do not fully meet this requirement since indicators have different units of measurement from different areas and, as a rule, are the reaction of socio-economic systems to actions already taken and, moreover, with a time shift. Currently, the inconsistency or inconsistency of measures of heterogeneous social, economic, environmental, and other systems is the reason that social systems are managed in isolation from the general laws of living systems, which can ultimately lead to a systemic crisis.

Keywords: sustainability, system dynamic, power, energy flows, development

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Authors: Sarah Elshahat, Tina Moffat

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Suboptimal mental health is a considerable global public health challenge that leads to considerable inequalities worldwide. Newcomers are at elevated risk for developing mental health issues as a result of social exclusion, stigmatization, racism, unequal employment opportunities, and discrimination. The problem can be especially serious amongst Arabic-speaking immigrants and refugees (ASIR) whose mental wellness may have already been affected by exposure to political violence, persecution, hunger or war in their countries of origin. A scoping review was conducted to investigate pre- and post-migration mental health determinants amongst ASIR in North America (the U.S. and Canada), who are a rapidly growing population in both regions. Pertinent peer-reviewed papers and grey literature were located through a systematic search of five electronic databases (Medline, Embase, PsycINFO, Anthropology Plus, and Sociology Database). A stakeholder consultation was implemented to validate the analyzed findings of the included 44 studies. About 80% of the studies were carried out in the US, underscoring a lack of Canadian ASIR-mental health research. A gap in qualitative, mixed-method, and longitudinal research was detected, where approximately two-thirds of the studies adopted a cross-sectional method. Pre-migration determinants of mental health were related to the political unrest, violence and armed conflict in the Arab world, increasing post-traumatic stress disorder and psychological distress levels among ASIR. English language illiteracy and generational variations in acculturation patterns were major post-migration mental health triggering factors. Exposure to domestic violence, stigmatization, poverty, racialization, and harassment were significant post-migration mental health determinants that stem from social inequalities, triggering depression, and distress amongst ASIR. Family conflicts linked to child-rearing and gendered norms were considered as both pre- and post-migration mental health triggering factors. Most post-migration mental health protective factors were socio-culturally related and included the maintenance of positive ethnic identity, faith, family support, and community cohesion. Individual resilience, articulated as self-esteem and hope, was a significant negative predictor of depression and psychological distress among ASIR. Community-engaged, mixed-methods, and longitudinal studies are required to address the current gap in mental health research among ASIR in North America. A more thorough determination of potential mental health triggers and protective factors would help inform the development of mental wellness and resilience-promoting programs that are culturally sensitive to ASIR. On the policy level, the Health in All Policies framework of the World Health Organization can be potentially useful for addressing social and health inequalities among ASIR, reducing mental health challenges.

Keywords: depression, post-traumatic stress disorder, psychological distress, resilience

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Authors: Md. Afroz Ansari

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The Bengal basin is a spectacular example of a peripheral foreland basin formed by the convergence of the Indian plate beneath the Eurasian and Burmese plates. The basin is embraced on three sides; north, west and east by different fault-controlled tectonic features whereas released in the south where the rivers are drained into the Bay of Bengal. The Bengal basin in the eastern part of the Indian subcontinent constitutes the largest fluvio-deltaic to shallow marine sedimentary basin in the world today. This continental basin coupled with the offshore Bengal Fan under the Bay of Bengal forms the biggest sediment dispersal system. The continental basin is continuously receiving the sediments by the two major rivers Ganga and Brahmaputra (known as Jamuna in Bengal), and Meghna (emerging from the point of conflux of the Ganga and Brahmaputra) and large number of rain-fed, small tributaries originating from the eastern Indian Shield. The drained sediments are ultimately delivered into the Bengal fan. The significance of the present study is to delineate the variations in thicknesses of the sediments, different crustal structures, and the mantle lithosphere throughout the onshore-offshore Bengal basin. In the present study, the different crustal/geological units and the shallower mantle lithosphere were delineated by analyzing the Bouguer Gravity Anomaly (BGA) data along two long traverses South-North (running from Bengal fan cutting across the transition offshore-onshore of the Bengal basin and intersecting the Main Frontal Thrust of India-Himalaya collision zone in Sikkim-Bhutan Himalaya) and West-East (running from the Peninsular Indian Shield across the Bengal basin to the Chittagong–Tripura Fold Belt). The BGA map was derived from the analysis of topex data after incorporating Bouguer correction and all terrain corrections. The anomaly map was compared with the available ground gravity data in the western Bengal basin and the sub-continents of India for consistency of the data used. Initially, the anisotropy associated with the thicknesses of the different crustal units, crustal interfaces and moho boundary was estimated through spectral analysis of the gravity data with varying window size over the study area. The 2D density sections along the traverses were finalized after a number of iterations with the acceptable root mean square (RMS) errors. The estimated thicknesses of the different crustal units and dips of the Moho boundary along both the profiles are consistent with the earlier results. Further the results were encouraged by examining the earthquake database and focal mechanism solutions for better understanding the geodynamics. The earthquake data were taken from the catalogue of US Geological Survey, and the focal mechanism solutions were compiled from the Harvard Centroid Moment Tensor Catalogue. The concentrations of seismic events at different depth levels are not uncommon. The occurrences of earthquakes may be due to stress accumulation as a result of resistance from three sides.

Keywords: anisotropy, interfaces, seismicity, spectrum analysis

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Authors: Ruth Hegarty, Noel Connaughton

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Sustainability reporting has become a priority for many global multinational companies. This is associated with ever-increasing expectations from key stakeholders for companies to be transparent about their strategies, activities and management with regard to sustainability issues. The Global Reporting Initiative (GRI) encourages reporters to only provide information on the issues that are really critical in order to achieve the organisation’s goals for sustainability and manage its impact on environment and society. A key challenge for most reporting organisations is how to identify relevant issues for sustainability reporting and prioritise those material issues in accordance with company and stakeholder needs. A recent study indicates that most of the largest companies listed on the world’s stock exchanges are failing to provide data on key sustainability indicators such as employee turnover, energy, greenhouse gas emissions (GHGs), injury rate, pay equity, waste and water. This paper takes an indepth look at the approaches used by a select number of international sustainability leader corporates to identify key sustainability issues. The research methodology involves performing a detailed analysis of the sustainability report content of up to 50 companies listed on the 2014 Dow Jones Sustainability Indices (DJSI). The most recent sustainability report content found on the GRI Sustainability Disclosure Database is then compared with 91 GRI Specific Standard Disclosures and a small number of GRI Standard Disclosures. Preliminary research indicates significant gaps in the information disclosed in corporate sustainability reports versus the indicator content specified in the GRI Content Index. The following outlines some of the key findings to date: Most companies made a partial disclosure with regard to the Economic indicators of climate change risks and infrastructure investments, but did not focus on the associated negative impacts. The top Environmental indicators disclosed were energy consumption and reductions, GHG emissions, water withdrawals, waste and compliance. The lowest rates of indicator disclosure included biodiversity, water discharge, mitigation of environmental impacts of products and services, transport, environmental investments, screening of new suppliers and supply chain impacts. The top Social indicators disclosed were new employee hires, rates of injury, freedom of association in operations, child labour and forced labour. Lesser disclosure rates were reported for employee training, composition of governance bodies and employees, political contributions, corruption and fines for non-compliance. The reporting on most other Social indicators was found to be poor. In addition, most companies give only a brief explanation on how material issues are defined, identified and ranked. Data on the identification of key stakeholders and the degree and nature of engagement for determining issues and their weightings is also lacking. Generally, little to no data is provided on the algorithms used to score an issue. Research indicates that most companies lack a rigorous and thorough methodology to systematically determine the material issues of sustainability reporting in accordance with company and stakeholder needs.

Keywords: identification of key stakeholders, material issues, sustainability reporting, transparency

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Authors: Kaomud Tyagi, Rajasree Chakraborty, Shantanu Kundu, Devkant Singha, Kailash Chandra, Vikas Kumar

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The melon thrips, Thrips palmi is a serious pest of a wide range of agriculture crops and also act as vectors for plant viruses (genus Tospovirus, family Bunyaviridae). More molecular data on this species is required to understand the cryptic speciation and evolutionary affiliations. Mitochondrial genomes have been widely used in phylogenetic and evolutionary studies in insect. So far, mitogenomes of five thrips species (Anaphothrips obscurus, Frankliniella intonsa, Frankliniella occidentalis, Scirtothrips dorsalis and Thrips imaginis) is available in the GenBank database. In this study, we sequenced the first complete mitogenome T. palmi and compared it with available thrips mitogenomes. We assembled the mitogenome from the whole genome sequencing data generated using Illumina Hiseq2500. Annotation was performed using MITOS web-server to estimate the location of protein coding genes (PCGs), transfer RNA (tRNAs), ribosomal RNAs (rRNAs) and their secondary structures. The boundaries of PCGs and rRNAs was confirmed manually in NCBI. Phylogenetic analyses were performed using the 13 PCGs data using maximum likelihood (ML) in PAUP, and Bayesian inference (BI) in MrBayes 3.2. The complete mitogenome of T. palmi was 15,333 base pairs (bp), which was greater than the genomes of A. obscurus (14,890bp), F. intonsa (15,215 bp), F. occidentalis (14,889 bp) and S. dorsalis South Asia strain (SA1) (14,283 bp), but smaller than the genomes of T. imaginis (15,407 bp) and S. dorsalis East Asia strain (EA1) (15,343bp). Like in other thrips species, the mitochondrial genome of T. palmi was represented by 37 genes, including 13 PCGs, large and small ribosomal RNA (rrnL and rrnS) genes, 22 transfer RNA (tRNAs) genes (with one extra gene for trn-Serine) and two A+T-rich control regions (CR1 and CR2). Thirty one genes were observed on heavy (H) strand and six genes on the light (L) strand. The six tRNA genes (trnG,trnK, trnY, trnW, trnF, and trnH) were found to be conserved in all thrips species mitogenomes in their locations relative to a protein-coding or rRNA gene upstream or downstream. The gene arrangements of T. palmi is very close to T. imaginis except the rearrangements in tRNAs genes: trnR (arginine), and trnE (glutamic acid) were found to be located between cox3 and CR2 in T. imaginis which were translocated between atp6 and CR1 in T. palmi; trnL1 (Leucine) and trnS1(Serine) were located between atp6 and CR1 in T. imaginis which were translocated between cox3 and CR2 in T. palmi. The location of CR1 upstream of nad5 gene was suggested to be ancestral condition of the thrips species in subfamily Thripinae, was also observed in T. palmi. Both the Maximum likelihood (ML) and Bayesian Inference (BI) phylogenetic trees generated resulted in similar topologies. The T. palmi was clustered with T. imaginis. We concluded that more molecular data on the diverse thrips species from different hierarchical level is needed, to understand the phylogenetic and evolutionary relationships among them.

Keywords: thrips, comparative mitogenomics, gene rearrangements, phylogenetic analysis

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Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell

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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.

Keywords: BME, UK, meta-ethnographic, adults

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Authors: Merve Begum Terzi, Orhan Arikan, Adnan Abaci, Mustafa Candemir

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Acute myocardial infarction is a major cause of death in the world. Therefore, its fast and reliable diagnosis is a major clinical need. ECG is the most important diagnostic methodology which is used to make decisions about the management of the cardiovascular diseases. In patients with acute myocardial ischemia, temporary chest pains together with changes in ST segment and T wave of ECG occur shortly before the start of myocardial infarction. In this study, a technique which detects changes in ST/T sections of ECG is developed for the early diagnosis of acute myocardial ischemia. For this purpose, a database of real ECG recordings that contains a set of records from 75 patients presenting symptoms of chest pain who underwent elective percutaneous coronary intervention (PCI) is constituted. 12-lead ECG’s of the patients were recorded before and during the PCI procedure. Two ECG epochs, which are the pre-inflation ECG which is acquired before any catheter insertion and the occlusion ECG which is acquired during balloon inflation, are analyzed for each patient. By using pre-inflation and occlusion recordings, ECG features that are critical in the detection of acute myocardial ischemia are identified and the most discriminative features for the detection of acute myocardial ischemia are extracted. A classification technique based on support vector machine (SVM) approach operating with linear and radial basis function (RBF) kernels to detect ischemic events by using ST-T derived joint features from non-ischemic and ischemic states of the patients is developed. The dataset is randomly divided into training and testing sets and the training set is used to optimize SVM hyperparameters by using grid-search method and 10fold cross-validation. SVMs are designed specifically for each patient by tuning the kernel parameters in order to obtain the optimal classification performance results. As a result of implementing the developed classification technique to real ECG recordings, it is shown that the proposed technique provides highly reliable detections of the anomalies in ECG signals. Furthermore, to develop a detection technique that can be used in the absence of ECG recording obtained during healthy stage, the detection of acute myocardial ischemia based on ECG recordings of the patients obtained during ischemia is also investigated. For this purpose, a Gaussian mixture model (GMM) is used to represent the joint pdf of the most discriminating ECG features of myocardial ischemia. Then, a Neyman-Pearson type of approach is developed to provide detection of outliers that would correspond to acute myocardial ischemia. Neyman – Pearson decision strategy is used by computing the average log likelihood values of ECG segments and comparing them with a range of different threshold values. For different discrimination threshold values and number of ECG segments, probability of detection and probability of false alarm values are computed, and the corresponding ROC curves are obtained. The results indicate that increasing number of ECG segments provide higher performance for GMM based classification. Moreover, the comparison between the performances of SVM and GMM based classification showed that SVM provides higher classification performance results over ECG recordings of considerable number of patients.

Keywords: ECG classification, Gaussian mixture model, Neyman–Pearson approach, support vector machine

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Authors: Zhao Gao, Eran Edirisinghe

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The production of an accurate sketch of a suspect based on a verbal description obtained from a witness is an essential task for most criminal investigations. The criminal investigation system employs specifically trained professional artists to manually draw a facial image of the suspect according to the descriptions of an eyewitness for subsequent identification. Within the advancement of Deep Learning, Recurrent Neural Networks (RNN) have shown great promise in Natural Language Processing (NLP) tasks. Additionally, Generative Adversarial Networks (GAN) have also proven to be very effective in image generation. In this study, a trained GAN conditioned on textual features such as keywords automatically encoded from a verbal description of a human face using an RNN is used to generate photo-realistic facial images for criminal investigations. The intention of the proposed system is to map corresponding features into text generated from verbal descriptions. With this, it becomes possible to generate many reasonably accurate alternatives to which the witness can use to hopefully identify a suspect from. This reduces subjectivity in decision making both by the eyewitness and the artist while giving an opportunity for the witness to evaluate and reconsider decisions. Furthermore, the proposed approach benefits law enforcement agencies by reducing the time taken to physically draw each potential sketch, thus increasing response times and mitigating potentially malicious human intervention. With publically available 'CelebFaces Attributes Dataset' (CelebA) and additionally providing verbal description as training data, the proposed architecture is able to effectively produce facial structures from given text. Word Embeddings are learnt by applying the RNN architecture in order to perform semantic parsing, the output of which is fed into the GAN for synthesizing photo-realistic images. Rather than the grid search method, a metaheuristic search based on genetic algorithms is applied to evolve the network with the intent of achieving optimal hyperparameters in a fraction the time of a typical brute force approach. With the exception of the ‘CelebA’ training database, further novel test cases are supplied to the network for evaluation. Witness reports detailing criminals from Interpol or other law enforcement agencies are sampled on the network. Using the descriptions provided, samples are generated and compared with the ground truth images of a criminal in order to calculate the similarities. Two factors are used for performance evaluation: The Structural Similarity Index (SSIM) and the Peak Signal-to-Noise Ratio (PSNR). A high percentile output from this performance matrix should attribute to demonstrating the accuracy, in hope of proving that the proposed approach can be an effective tool for law enforcement agencies. The proposed approach to criminal facial image generation has potential to increase the ratio of criminal cases that can be ultimately resolved using eyewitness information gathering.

Keywords: RNN, GAN, NLP, facial composition, criminal investigation

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Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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Authors: Ana L. M. Pavan, Guilherme Giacomini, Allan F. F. Alves, Marcela De Oliveira, Fernando A. B. Neto, Maria E. D. Rosa, Andre P. Trindade, Diana R. De Pina

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Mammography is a worldwide image modality used to diagnose breast cancer, even in asymptomatic women. Due to its large availability, mammograms can be used to measure breast density and to predict cancer development. Women with increased mammographic density have a four- to sixfold increase in their risk of developing breast cancer. Therefore, studies have been made to accurately quantify mammographic breast density. In clinical routine, radiologists perform image evaluations through BIRADS (Breast Imaging Reporting and Data System) assessment. However, this method has inter and intraindividual variability. An automatic objective method to measure breast density could relieve radiologist’s workload by providing a first aid opinion. However, pectoral muscle is a high density tissue, with similar characteristics of fibroglandular tissues. It is consequently hard to automatically quantify mammographic breast density. Therefore, a pre-processing is needed to segment the pectoral muscle which may erroneously be quantified as fibroglandular tissue. The aim of this work was to develop an automatic algorithm to segment and extract pectoral muscle in digital mammograms. The database consisted of thirty medio-lateral oblique incidence digital mammography from São Paulo Medical School. This study was developed with ethical approval from the authors’ institutions and national review panels under protocol number 3720-2010. An algorithm was developed, in Matlab® platform, for the pre-processing of images. The algorithm uses image processing tools to automatically segment and extract the pectoral muscle of mammograms. Firstly, it was applied thresholding technique to remove non-biological information from image. Then, the Hough transform is applied, to find the limit of the pectoral muscle, followed by active contour method. Seed of active contour is applied in the limit of pectoral muscle found by Hough transform. An experienced radiologist also manually performed the pectoral muscle segmentation. Both methods, manual and automatic, were compared using the Jaccard index and Bland-Altman statistics. The comparison between manual and the developed automatic method presented a Jaccard similarity coefficient greater than 90% for all analyzed images, showing the efficiency and accuracy of segmentation of the proposed method. The Bland-Altman statistics compared both methods in relation to area (mm²) of segmented pectoral muscle. The statistic showed data within the 95% confidence interval, enhancing the accuracy of segmentation compared to the manual method. Thus, the method proved to be accurate and robust, segmenting rapidly and freely from intra and inter-observer variability. It is concluded that the proposed method may be used reliably to segment pectoral muscle in digital mammography in clinical routine. The segmentation of the pectoral muscle is very important for further quantifications of fibroglandular tissue volume present in the breast.

Keywords: active contour, fibroglandular tissue, hough transform, pectoral muscle

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Authors: Maggie Hall, Haley O'Neill

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The U.S. faces a severe shortage of abortion providers, exacerbated by the June 2022 Dobbs v. Jackson Women’s Health Organization decision. Midwives, especially certified nurse midwives, are well-positioned to fill this gap in abortion care. However, a lack of clinical education and training prevents midwives from exercising their full scope of practice. National and international organizations that set obstetrics and midwifery education standards, including the International Confederation of Midwives, American College of Obstetricians and Gynecologists, and American Public Health Association, call for expansion of midwifery-managed abortion care through the first trimester. In the U.S., midwifery programs are accredited based on compliance with ACME standards and compliance is a prerequisite for the American Midwifery Certification Board exams. We conducted a literature review of studies in the last five years regarding abortion didactic and clinical education barriers via CINAHL, EBSCO and PubMed database reviews. We gave preference for primary sources within the last five years; however, due to the rapid changes in abortion education and access, we also included literature from 2012-2022. We evaluated ACME-accredited programs in relation to their geography within abortion-protected or restricted states and assessed state-specific barriers to abortion care education and provision as clinical students. There are 43 AMCB-accredited midwifery schools in 28 states across the U.S. Twenty schools (47%) are in the 15 states in which advanced practice clinicians can provide non-surgical abortion care, such as medication abortion and MVA procedures. Twenty-four schools (56%) are in the 16 states in which abortion care provision is restricted to Licensed Physicians and cannot offer in-state clinical training opportunities for midwifery students. Six schools are in the five states in which abortion is completely banned and are geographically concentrated in the southernmost region of the U.S., including Alabama, Kentucky, Louisiana, Tennessee, and Texas. Subsequently, these programs cannot offer in-state clinical training opportunities for midwifery students. Notably, there are seven ACME programs in six states that do not restrict abortion access by gestational age, including Colorado, Connecticut, Washington, D.C., New Jersey, New Mexico, and Oregon. These programs may be uniquely positioned for midwifery involvement in abortion care beyond the first trimester. While the following states don’t house ACME programs, abortion care can be provided by advanced practice clinicians in Rhode Island, Delaware, Hawaii, Maine, Maryland, Montana, New Hampshire, and Vermont, offering clinical placement and/or new ACME program development opportunities. We identify existing barriers to clinical education and training opportunities for midwifery-managed abortion care, which are both geographic and institutional in nature. We recommend expansion and standardization of clinical education and training opportunities for midwifery-managed abortion care in ACME-accredited programs to improve access to abortion care. Midwifery programs and teaching hospitals need to expand education, training, and residency opportunities for midwifery students to strengthen access to midwife-managed abortion care. ACNM and ACME should re-evaluate accreditation criteria and the implications of ACME programs in states where students are not able to learn abortion care in clinical contexts due to state-specific abortion restrictions.

Keywords: midwifery education, abortion, abortion education, abortion access

Procedia PDF Downloads 81

Authors: Priya Nangia, Sanchita Bansal

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As fashion cycles become more rapid, some segments of the fashion industry have adopted increasingly unsustainable production processes to keep up with demand and enhance profit margins. The growing threat to environmental and social wellbeing posed by unethical fast fashion practices and the need to integrate the targets of SDGs into this industry necessitates a shift in the fashion industry's unsustainable nature, which can only be accomplished in the long run if consumers support sustainable fashion by purchasing it. Fast fashion is defined as low-cost, trendy apparel that takes inspiration from the catwalk or celebrity culture and rapidly transforms it into garments at high-street stores to meet consumer demand. Given the importance of identity formation to many consumers, the desire to be “fashionable” often outweighs the desire to be ethical or sustainable. This paradox exemplifies the tension between the human drive to consume and the will to do so in moderation. Previous research suggests that there is an attitude-behavior gap when it comes to determining consumer purchasing behavior, but to the best of our knowledge, no study has analysed how to encourage customers to shift from fast to slow fashion. Against this backdrop, the aim of this study is twofold: first, to identify and examine the factors that impact consumers' decisions to engage in sustainable fashion, and second, the authors develop a comprehensive framework for conceptualizing and encouraging researchers and practitioners to foster sustainable consumer behavior. This study used a systematic approach to collect data and analyse literature. The approach included three key steps: review planning, review execution, and findings reporting. Authors identified the keywords “sustainable consumption” and “sustainable fashion” and retrieved studies from the Web of Science (WoS) (126 records) and Scopus database (449 records). To make the study more specific, the authors refined the subject area to management, business, and economics in the second step, retrieving 265 records. In the third step, the authors removed the duplicate records and manually reviewed the articles to examine their relevance to the research issue. The final 96 research articles were used to develop this study's systematic scheme. The findings indicate that societal norms, demographics, positive emotions, self-efficacy, and awareness all have an effect on customers' decisions to purchase sustainable apparel. The authors propose a framework, denoted by the acronym SHIFT, in which consumers are more likely to engage in sustainable behaviors when the message or context leverages the following factors: (s)social influence, (h)habit formation, (i)individual self, (f)feelings, emotions, and cognition, and (t)tangibility. Furthermore, the authors identify five broad challenges that encourage sustainable consumer behavior and use them to develop novel propositions. Finally, the authors discuss how the SHIFT framework can be used in practice to drive sustainable consumer behaviors. This research sought to define the boundaries of existing research while also providing new perspectives on future research, with the goal of being useful for the development and discovery of new fields of study, thereby expanding knowledge.

Keywords: consumer behavior, fast fashion, sustainable consumption, sustainable fashion, systematic literature review

Procedia PDF Downloads 90

Authors: Ricardo Godoy, Herbert Venthur, Hector Jimenez, Andres Quiroz, Ana Mutis

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In agriculture, grape production has great economic importance at global level, considering that in 2013 it reached 7.4 million hectares (ha) covered by plantations of this fruit worldwide. Chile is the number one exporter in the world with 800,000 tons. However, these values have been threatened by the attack of the grapevine moth, Lobesia botrana (Denis & Schiffermuller) (Lepidoptera: Tortricidae), since its detection in 2008. Nowadays, the use of semiochemicals, in particular the major component of the sex pheromone, (E,Z)-7.9-dodecadienil acetate, are part of mating disruption methods to control L. botrana. How insect pests can recognize these molecules, is being part of huge efforts to deorphanize their olfactory mechanism at molecular level. Thus, an interesting group of proteins has been identified in the antennae of insects, where odorant-binding proteins (OBPs) are known by transporting molecules to odorant receptors (ORs) and a co-receptor (ORCO) causing a behavioral change in the insect. Other proteins such as chemosensory proteins (CSPs), ionotropic receptors (IRs), odorant degrading enzymes (ODEs) and sensory neuron membrane proteins (SNMPs) seem to be involved, but few studies have been performed so far. The above has led to an increasing interest in insect communication at a molecular level, which has contributed to both a better understanding of the olfaction process and the design of new pest management strategies. To date, it has been reported that the ORs can detect one or a small group of odorants in a specific way. Therefore, the objective of this study is the identification of genes that encode these ORs using the antennal transcriptome of L. botrana. Total RNA was extracted for females and males of L. botrana, and the antennal transcriptome sequenced by Next Generation Sequencing service using an Illumina HiSeq2500 platform with 50 million reads per sample. Unigenes were assembled using Trinity v2.4.0 package and transcript abundance was obtained using edgeR. Genes were identified using BLASTN and BLASTX locally installed in a Unix system and based on our own Tortricidae database. Those Unigenes related to ORs were characterized using ORFfinder and protein Blastp server. Finally, a phylogenetic analysis was performed with the candidate amino acid sequences for LbotORs including amino acid sequences of other moths ORs, such as Bombyx mori, Cydia pomonella, among others. Our findings suggest 61 genes encoding ORs and one gene encoding an ORCO in both sexes, where the greatest difference was found in the OR6 because of the transcript abundance according to the value of FPKM in females and males was 1.48 versus 324.00. In addition, according to phylogenetic analysis OR6 is closely related to OR1 in Cydia pomonella and OR6, OR7 in Epiphyas postvittana, which have been described as pheromonal receptors (PRs). These results represent the first evidence of ORs present in the antennae of L. botrana and a suitable starting point for further functional studies with selected ORs, such as OR6, which is potentially related to pheromonal recognition.

Keywords: antennal transcriptome, lobesia botrana, odorant receptors (ORs), phylogenetic analysis

Procedia PDF Downloads 200

Authors: Su Mon Saw, Joe Rothnagel

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Short open reading frames (sORFs) located in 5’UTR of mRNAs are known as uORFs. Characterization of uORF-encoded peptides (uPEPs) i.e., a subset of short open reading frame encoded peptides (sPEPs) and their translation regulation lead to understanding of causes of genetic disease, proteome complexity and development of treatments. Existence of uORFs within cellular proteome could be detected by LC-MS/MS. The ability of uORF to be translated into uPEP and achievement of uPEP identification will allow uPEP’s characterization, structures, functions, subcellular localization, evolutionary maintenance (conservation in human and other species) and abundance in cells. It is hypothesized that a subset of sORFs are translatable and that their encoded sPEPs are functional and are endogenously expressed contributing to the eukaryotic cellular proteome complexity. This project aimed to investigate whether sORFs encode functional peptides. Liquid chromatography-mass spectrometry (LC-MS) and bioinformatics were thus employed. Due to probable low abundance of sPEPs and small in sizes, the need for efficient peptide enrichment strategies for enriching small proteins and depleting the sub-proteome of large and abundant proteins is crucial for identifying sPEPs. Low molecular weight proteins were extracted using SDS-PAGE from Human Embryonic Kidney (HEK293) cells and Strong Cation Exchange Chromatography (SCX) from secreted HEK293 cells. Extracted proteins were digested by trypsin to peptides, which were detected by LC-MS/MS. The MS/MS data obtained was searched against Swiss-Prot using MASCOT version 2.4 to filter out known proteins, and all unmatched spectra were re-searched against human RefSeq database. ProteinPilot v5.0.1 was used to identify sPEPs by searching against human RefSeq, Vanderperre and Human Alternative Open Reading Frame (HaltORF) databases. Potential sPEPs were analyzed by bioinformatics. Since SDS PAGE electrophoresis could not separate proteins <20kDa, this could not identify sPEPs. All MASCOT-identified peptide fragments were parts of main open reading frame (mORF) by ORF Finder search and blastp search. No sPEP was detected and existence of sPEPs could not be identified in this study. 13 translated sORFs in HEK293 cells by mass spectrometry in previous studies were characterized by bioinformatics. Identified sPEPs from previous studies were <100 amino acids and <15 kDa. Bioinformatics results showed that sORFs are translated to sPEPs and contribute to proteome complexity. uPEP translated from uORF of SLC35A4 was strongly conserved in human and mouse while uPEP translated from uORF of MKKS was strongly conserved in human and Rhesus monkey. Cross-species conserved uORFs in association with protein translation strongly suggest evolutionary maintenance of coding sequence and indicate probable functional expression of peptides encoded within these uORFs. Translation of sORFs was confirmed by mass spectrometry and sPEPs were characterized with bioinformatics.

Keywords: bioinformatics, HEK293 cells, liquid chromatography-mass spectrometry, ProteinPilot, Strong Cation Exchange Chromatography, SDS-PAGE, sPEPs

Procedia PDF Downloads 188

Authors: Rajinder Kumar Gupta, Rajni Kant Agrawal, Jaganniwas

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One of the most frightening phenomena of nature is the occurrence of earthquake as it has terrible and disastrous effects. Many earthquakes occur every day worldwide. There is need to have knowledge regarding the trends in earthquake occurrence worldwide. The recoding and interpretation of data obtained from the establishment of the worldwide system of seismological stations made this possible. From the analysis of recorded earthquake data, the earthquake parameters and source parameters can be computed and the earthquake catalogues can be prepared. These catalogues provide information on origin, time, epicenter locations (in term of latitude and longitudes) focal depths, magnitude and other related details of the recorded earthquakes. Theses catalogues are used for seismic hazard estimation. Manual interpretation and analysis of these data is tedious and time consuming. A geographical information system is a computer based system designed to store, analyzes and display geographic information. The implementation of integrated GIS technology provides an approach which permits rapid evaluation of complex inventor database under a variety of earthquake scenario and allows the user to interactively view results almost immediately. GIS technology provides a powerful tool for displaying outputs and permit to users to see graphical distribution of impacts of different earthquake scenarios and assumptions. An endeavor has been made in present study to compile the earthquake data for the whole world in visual Basic on ARC GIS Plate form so that it can be used easily for further analysis to be carried out by earthquake engineers. The basic data on time of occurrence, location and size of earthquake has been compiled for further querying based on various parameters. A preliminary analysis tool is also provided in the user interface to interpret the earthquake recurrence in region. The user interface also includes the seismic hazard information already worked out under GHSAP program. The seismic hazard in terms of probability of exceedance in definite return periods is provided for the world. The seismic zones of the Indian region are included in the user interface from IS 1893-2002 code on earthquake resistant design of buildings. The City wise satellite images has been inserted in Map and based on actual data the following information could be extracted in real time: • Analysis of soil parameters and its effect • Microzonation information • Seismic hazard and strong ground motion • Soil liquefaction and its effect in surrounding area • Impacts of liquefaction on buildings and infrastructure • Occurrence of earthquake in future and effect on existing soil • Propagation of earth vibration due of occurrence of Earthquake GIS based earthquake information system has been prepared for whole world in Visual Basic on ARC GIS Plate form and further extended micro level based on actual soil parameters. Individual tools has been developed for liquefaction, earthquake frequency etc. All information could be used for development of infrastructure i.e. multi story structure, Irrigation Dam & Its components, Hydro-power etc in real time for present and future.

Keywords: GIS based earthquake information system, microzonation, analysis and real time information about liquefaction, infrastructure development

Procedia PDF Downloads 316

Authors: Sabrina Neururer, Marco Schweitzer, Werner Hackl, Bernhard Tilg, Patrick Raudaschl, Andreas Huber, Bernhard Pfeifer

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History and the current outbreak of Covid-19 have shown the deadly potential of infectious diseases. However, infectious diseases also have a serious impact on areas other than health and healthcare, such as the economy or social life. These areas are strongly codependent. Therefore, disease control measures, such as social distancing, quarantines, curfews, or lockdowns, have to be adopted in a very considerate manner. Infectious disease modeling can support policy and decision-makers with adequate information regarding the dynamics of the pandemic and therefore assist in planning and enforcing appropriate measures that will prevent the healthcare system from collapsing. In this work, an agent-based simulation package named “survival” for simulating infectious diseases is presented. A special focus is put on SARS-Cov-2. The presented simulation package was used in Austria to model the SARS-Cov-2 outbreak from the beginning of 2020. Agent-based modeling is a relatively recent modeling approach. Since our world is getting more and more complex, the complexity of the underlying systems is also increasing. The development of tools and frameworks and increasing computational power advance the application of agent-based models. For parametrizing the presented model, different data sources, such as known infections, wastewater virus load, blood donor antibodies, circulating virus variants and the used capacity for hospitalization, as well as the availability of medical materials like ventilators, were integrated with a database system and used. The simulation result of the model was used for predicting the dynamics and the possible outcomes and was used by the health authorities to decide on the measures to be taken in order to control the pandemic situation. The survival package was implemented in the programming language Java and the analytics were performed with R Studio. During the first run in March 2020, the simulation showed that without measures other than individual personal behavior and appropriate medication, the death toll would have been about 27 million people worldwide within the first year. The model predicted the hospitalization rates (standard and intensive care) for Tyrol and South Tyrol with an accuracy of about 1.5% average error. They were calculated to provide 10-days forecasts. The state government and the hospitals were provided with the 10-days models to support their decision-making. This ensured that standard care was maintained for as long as possible without restrictions. Furthermore, various measures were estimated and thereafter enforced. Among other things, communities were quarantined based on the calculations while, in accordance with the calculations, the curfews for the entire population were reduced. With this framework, which is used in the national crisis team of the Austrian province of Tyrol, a very accurate model could be created on the federal state level as well as on the district and municipal level, which was able to provide decision-makers with a solid information basis. This framework can be transferred to various infectious diseases and thus can be used as a basis for future monitoring.

Keywords: modelling, simulation, agent-based, SARS-Cov-2, COVID-19

Procedia PDF Downloads 174

Authors: Eric Bang

Abstract:

Interactions between receptors and ligands are crucial for many essential biological processes, including neurotransmission and metabolism. Ligand-receptor analyses that examine cell behavior and interactions often utilize cell type-specific RNA expressions from single-cell RNA sequencing (scRNA-seq) data. Using CellPhoneDB, a public repository consisting of ligands, receptors, and ligand-receptor interactions, the cell-cell interactions were explored in a specific scRNA-seq dataset from kidney tissue and portrayed the results with dot plots and heat maps. Depending on the type of cell, each ligand-receptor pair was aligned with the interacting cell type and calculated the positori probabilities of these associations, with corresponding P values reflecting average expression values between the triads and their significance. Using single-cell data (sample kidney cell references), genes in the dataset were cross-referenced with ones in the existing CellPhoneDB dataset. For example, a gene such as Pleiotrophin (PTN) present in the single-cell data also needed to be present in the CellPhoneDB dataset. Using the single-cell transcriptomics data via slide-seq and reference data, the CellPhoneDB program defines cell types and plots them in different formats, with the two main ones being dot plots and heat map plots. The dot plot displays derived measures of the cell to cell interaction scores and p values. For the dot plot, each row shows a ligand-receptor pair, and each column shows the two interacting cell types. CellPhoneDB defines interactions and interaction levels from the gene expression level, so since the p-value is on a -log10 scale, the larger dots represent more significant interactions. By performing an interaction analysis, a significant interaction was discovered for myeloid and T-cell ligand-receptor pairs, including those between Secreted Phosphoprotein 1 (SPP1) and Fibronectin 1 (FN1), which is consistent with previous findings. It was proposed that an effective protocol would involve a filtration step where cell types would be filtered out, depending on which ligand-receptor pair is activated in that part of the tissue, as well as the incorporation of the CellPhoneDB data in a streamlined workflow pipeline. The filtration step would be in the form of a Python script that expedites the manual process necessary for dataset filtration. Being in Python allows it to be integrated with the CellPhoneDB dataset for future workflow analysis. The manual process involves filtering cell types based on what ligand/receptor pair is activated in kidney cells. One limitation of this would be the fact that some pairings are activated in multiple cells at a time, so the manual manipulation of the data is reflected prior to analysis. Using the filtration script, accurate sorting is incorporated into the CellPhoneDB database rather than waiting until the output is produced and then subsequently applying spatial data. It was envisioned that this would reveal wherein the cell various ligands and receptors are interacting with different cell types, allowing for easier identification of which cells are being impacted and why, for the purpose of disease treatment. The hope is this new computational method utilizing spatially explicit ligand-receptor association data can be used to uncover previously unknown specific interactions within kidney tissue.

Keywords: bioinformatics, Ligands, kidney tissue, receptors, spatial transcriptome

Procedia PDF Downloads 139

Authors: B. Godefroy, D. Beladjine, K. Beddiar

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In France, construction BIM actors commonly evoke the BIM gains for exploitation by integrating of the life cycle of a building. The standardization of level 7 of development would achieve this stage of the digital model. The householders include local public authorities, social landlords, public institutions (health and education), enterprises, facilities management companies. They have a dual role: owner and manager of their housing complex. In a context of financial constraint, the BIM of exploitation aims to control costs, make long-term investment choices, renew the portfolio and enable environmental standards to be met. It assumes a knowledge of the existing buildings, marked by its size and complexity. The information sought must be synthetic and structured, it concerns, in general, a real estate complex. We conducted a study with professionals about their concerns and ways to use it to see how householders could benefit from this development. To obtain results, we had in mind the recurring interrogation of the project management, on the needs of the operators, we tested the following stages: 1) Inculcate a minimal culture of BIM with multidisciplinary teams of the operator then by business, 2) Learn by BIM tools, the adaptation of their trade in operations, 3) Understand the place and creation of a graphic and technical database management system, determine the components of its library so their needs, 4) Identify the cross-functional interventions of its managers by business (operations, technical, information system, purchasing and legal aspects), 5) Set an internal protocol and define the BIM impact in their digital strategy. In addition, continuity of management by the integration of construction models in the operation phase raises the question of interoperability in the control of the production of IFC files in the operator’s proprietary format and the export and import processes, a solution rivaled by the traditional method of vectorization of paper plans. Companies that digitize housing complex and those in FM produce a file IFC, directly, according to their needs without recourse to the model of construction, they produce models business for the exploitation. They standardize components, equipment that are useful for coding. We observed the consequences resulting from the use of the BIM in the property industry and, made the following observations: a) The value of data prevail over the graphics, 3D is little used b) The owner must, through his organization, promote the feedback of technical management information during the design phase c) The operator's reflection on outsourcing concerns the acquisition of its information system and these services, observing the risks and costs related to their internal or external developments. This study allows us to highlight: i) The need for an internal organization of operators prior to a response to the construction management ii) The evolution towards automated methods for creating models dedicated to the exploitation, a specialization would be required iii) A review of the communication of the project management, management continuity not articulating around his building model, it must take into account the environment of the operator and reflect on its scope of action.

Keywords: information system, interoperability, models for exploitation, property industry

Procedia PDF Downloads 144

Authors: Nadia Belu, Laurenţiu Mihai Ionescu, Agnieszka Misztal

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The automotive industry is one of the most important industries in the world that concerns not only the economy, but also the world culture. In the present financial and economic context, this field faces new challenges posed by the current crisis, companies must maintain product quality, deliver on time and at a competitive price in order to achieve customer satisfaction. Two of the most recommended techniques of quality management by specific standards of the automotive industry, in the product development, are Failure Mode and Effects Analysis (FMEA) and Control Plan. FMEA is a methodology for risk management and quality improvement aimed at identifying potential causes of failure of products and processes, their quantification by risk assessment, ranking of the problems identified according to their importance, to the determination and implementation of corrective actions related. The companies use Control Plans realized using the results from FMEA to evaluate a process or product for strengths and weaknesses and to prevent problems before they occur. The Control Plans represent written descriptions of the systems used to control and minimize product and process variation. In addition Control Plans specify the process monitoring and control methods (for example Special Controls) used to control Special Characteristics. In this paper we propose a computer-aided solution with Genetic Algorithms in order to reduce the drafting of reports: FMEA analysis and Control Plan required in the manufacture of the product launch and improved knowledge development teams for future projects. The solution allows to the design team to introduce data entry required to FMEA. The actual analysis is performed using Genetic Algorithms to find optimum between RPN risk factor and cost of production. A feature of Genetic Algorithms is that they are used as a means of finding solutions for multi criteria optimization problems. In our case, along with three specific FMEA risk factors is considered and reduce production cost. Analysis tool will generate final reports for all FMEA processes. The data obtained in FMEA reports are automatically integrated with other entered parameters in Control Plan. Implementation of the solution is in the form of an application running in an intranet on two servers: one containing analysis and plan generation engine and the other containing the database where the initial parameters and results are stored. The results can then be used as starting solutions in the synthesis of other projects. The solution was applied to welding processes, laser cutting and bending to manufacture chassis for buses. Advantages of the solution are efficient elaboration of documents in the current project by automatically generating reports FMEA and Control Plan using multiple criteria optimization of production and build a solid knowledge base for future projects. The solution which we propose is a cheap alternative to other solutions on the market using Open Source tools in implementation.

Keywords: automotive industry, FMEA, control plan, automotive technology

Procedia PDF Downloads 406

Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students. 

Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant

Procedia PDF Downloads 125

Authors: Nadia Obaed, Lexi Frankel, Amalia Ardeljan, Denis Nigel, Anniki Witter, Omar Rashid

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Breast cancer is the most common cancer among women, with a lifetime risk of one in eight of all women in the United States. Although breast cancer is prevalent throughout the world, the uneven distribution in incidence and mortality rates is shaped by the variation in population structure, environment, genetics and known lifestyle risk factors. Furthermore, the bacterial profile in healthy and cancerous breast tissue differs with a higher relative abundance of bacteria capable of causing DNA damage in breast cancer patients. Previous bacterial infections may change the composition of the microbiome and partially account for the environmental factors promoting breast cancer. One study found that higher amounts of Staphylococcus, Bacillus, and Enterobacteriaceae, of which Escherichia coli (E. coli) is a part, were present in breast tumor tissue. Based on E. coli’s ability to damage DNA, it is hypothesized that there is an increased risk of breast cancer associated with previous E. coli infection. Therefore, the purpose of this study was to evaluate the correlation between E. coli infection and the incidence of breast cancer. Holy Cross Health, Fort Lauderdale, provided access to the Health Insurance Portability and Accountability (HIPAA) compliant national database for the purpose of academic research. International Classification of Disease 9th and 10th Codes (ICD-9, ICD-10) was then used to conduct a retrospective analysis using data from January 2010 to December 2019. All breast cancer diagnoses and all patients infected versus not infected with E. coli that underwent typical E. coli treatment were investigated. The obtained data were matched for age, Charlson Comorbidity Score (CCI score), and antibiotic treatment. Standard statistical methods were applied to determine statistical significance and an odds ratio was used to estimate the relative risk. A total of 81286 patients were identified and analyzed from the initial query and then reduced to 31894 antibiotic-specific treated patients in both the infected and control group, respectively. The incidence of breast cancer was 2.51% and present in 2043 patients in the E. coli group compared to 5.996% and present in 4874 patients in the control group. The incidence of breast cancer was 3.84% and present in 1223 patients in the treated E. coli group compared to 6.38% and present in 2034 patients in the treated control group. The decreased incidence of breast cancer in the E. coli and treated E. coli groups was statistically significant with a p-value of 2.2x10-16 and 2.264x10-16, respectively. The odds ratio in the E. coli and treated E. coli groups was 0.784 and 0.787 with a 95% confidence interval, respectively (0.756-0.813; 0.743-0.833). The current study shows a statistically significant decrease in breast cancer incidence in association with previous Escherichia coli infection. Researching the relationship between single bacterial species is important as only up to 10% of breast cancer risk is attributable to genetics, while the contribution of environmental factors including previous infections potentially accounts for a majority of the preventable risk. Further evaluation is recommended to assess the potential and mechanism of E. coli in decreasing the risk of breast cancer.

Keywords: breast cancer, escherichia coli, incidence, infection, microbiome, risk

Procedia PDF Downloads 253

Authors: U.K. Sarkar, G. Karnatak, P. Mishal, Lianthuamluaia, S. Kumari, S.K. Das, B.K. Das

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Inland open water fisheries provide food, income, livelihood and nutritional security to millions of fishers across the globe. However, the open water ecosystem and fisheries are threatened due to climate change and anthropogenic pressures, which are more visible in the recent six decades, making the resources vulnerable. Understanding the interaction between meteorological parameters and inland fisheries is imperative to develop mitigation and adaptation strategies. As per IPCC 5th assessment report, the earth is warming at a faster rate in recent decades. Global mean surface temperature (GMST) for the decade 2006–2015 (0.87°C) was 6 times higher than the average over the 1850–1900 period. The direct and indirect impacts of climatic parameters on the ecology of fisheries ecosystem have a great bearing on fisheries due to alterations in fish physiology. The impact of meteorological factors on ecosystem health and fish food organisms brings about changes in fish diversity, assemblage, reproduction and natural recruitment. India’s average temperature has risen by around 0.7°C during 1901–2018. The studies show that the mean air temperature in the Ganga basin has increased in the range of 0.20 - 0.47 °C and annual rainfall decreased in the range of 257-580 mm during the last three decades. The studies clearly indicate visible impacts of climatic and environmental factors on inland open water fisheries. Besides, a significant reduction in-depth and area (37.20–57.68% reduction), diversity of natural indigenous fish fauna (ranging from 22.85 to 54%) in wetlands and progression of trophic state from mesotrophic to eutrophic were recorded. In this communication, different applications of biometeorology in inland fisheries management with special reference to the assessment of ecosystem and species vulnerability to climatic variability and change have been discussed. Further, the paper discusses the impact of climate anomaly and extreme climatic events on inland fisheries and emphasizes novel modeling approaches for understanding the impact of climatic and environmental factors on reproductive phenology for identification of climate-sensitive/resilient fish species for the adoption of climate-smart fisheries in the future. Adaptation and mitigation strategies to enhance fish production and the role of culture-based fisheries and enclosure culture in converting sequestered carbon into blue carbon have also been discussed. In general, the type and direction of influence of meteorological parameters on fish biology in open water fisheries ecosystems are not adequately understood. The optimum range of meteorological parameters for sustaining inland open water fisheries is yet to be established. Therefore, the application of biometeorology in inland fisheries offers ample scope for understanding the dynamics in changing climate, which would help to develop a database on such least, addressed research frontier area. This would further help to project fisheries scenarios in changing climate regimes and develop adaptation and mitigation strategies to cope up with adverse meteorological factors to sustain fisheries and to conserve aquatic ecosystem and biodiversity.

Keywords: biometeorology, inland fisheries, aquatic ecosystem, modeling, India

Procedia PDF Downloads 195

Authors: Nishimwe Clemence, Mchunu Gugu, Mukamusoni Dariya

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Background: Community health workers and extension workers can play an important role in supporting families to adopt health practices, encourage delivery in a health care facility, and ensure time referral of mothers and newborns if needed. Saving the lives of neonates should, therefore, be a significant health outcome in any maternal and newborn health program that is being implemented. Furthermore, about half of a million mothers die from pregnancy-related causes. Maternal and newborn deaths related to the period of postnatal care are neglected. Some authors emphasized that in developing countries, newborn mortality rates have been reduced much more slowly because of the lack of many necessary facility-based and outreach service. The aim of this review was to critically analyze the implementation and integration process of the maternal and newborn health care program by maternal community health workers, into the health care system, in Africa. Furthermore, it aims to reduce maternal and newborn mortality. We addressed the following review question: (1) what process is involved in the implementation and integration of the maternal and newborn health care program by maternal community health workers during antenatal, delivery and postnatal care into health system care in Africa? Methods: The database searched was from Health Source: Nursing/Academic Edition through academic search complete via EBSCO Host. An iterative approach was used to go through Google scholarly papers. The reviewers considered adapted Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance, and the Mixed Methods Appraisal Tool (MMAT) was used. Synthesis method in integrative review following elements of noting patterns and themes, seeing plausibility, clustering, counting, making contrasts and comparisons, discerning commons and unusual patterns, subsuming particulars into general, noting relations between variability, finding intervening factors and building a logical chain of evidence, using data–based convergent synthesis design. Results: From the seventeen of studies included, results focused on three dimensions inspired by the literature on antenatal, delivery, and postnatal interventions. From this, further conceptual framework was elaborated. The conceptual framework process of implementation and integration of maternal and newborn health care program by maternal community health workers was elaborated in order to ensure the sustainability of community based intervention. Conclusions: the review revealed that the implementation and integration of maternal and newborn health care program require planning. We call upon governments, non-government organizations, the global health community, all stakeholders including policy makers, program managers, evaluators, educators, and providers to be involved in implementation and integration of maternal and newborn health program in updated policy and community-based intervention. Furthermore, emphasis should be placed on competence, responsibility, and accountability of maternal community health workers, their training and payment, collaboration with health professionals in health facilities, and reinforcement of outreach service. However, the review was limited in focus to the African context, where the process of maternal and newborn health care program has been poorly implemented.

Keywords: Africa, implementation of integration, maternal, newborn

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Authors: Sandra Regina Cavalcante, Rodolfo A. G. Vilela

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Introduction: Work accidents and occupational diseases are a big problem for public health around the world and the main health problem of workers with high social and economic costs. Brazil has shown progress over the last years, with the development of the regulatory system to improve safety and quality of life in the workplace. However, the situation is far from acceptable, because the occurrences remain high and there is a great gap between legislation and reality, generated by the low level of voluntary compliance with the law. Brazilian laws provide procedural legal instruments for both, to compensate the damage caused to the worker's health and to prevent future injuries. In the Judiciary, the prevention idea is in the collective action, effected through Brazilian Class Actions. Inhibitory guardianships may impose both, improvements to the working environment, as well as determine the interruption of activity or a ban on the machine that put workers at risk. Both the Labor Prosecution and trade unions have to stand to promote this type of action, providing payment of compensation for collective moral damage. Objectives: To verify how class actions (known as ‘public civil actions’), regulated in Brazilian legal system to protect diffuse, collective and homogeneous rights, are being used to protect workers' health and safety. Methods: The author identified and evaluated decisions of Brazilian Superior Court of Labor involving collective actions and work accidents. The timeframe chosen was December 2015. The online jurisprudence database was consulted in page available for public consultation on the court website. The categorization of the data was made considering the result (court application was rejected or accepted), the request type, the amount of compensation and the author of the cause, besides knowing the reasoning used by the judges. Results: The High Court issued 21,948 decisions in December 2015, with 1448 judgments (6.6%) about work accidents and only 20 (0.09%) on collective action. After analyzing these 20 decisions, it was found that the judgments granted compensation for collective moral damage (85%) and/or obligation to make, that is, changes to improve prevention and safety (71%). The processes have been filed mainly by the Labor Prosecutor (83%), and also appeared lawsuits filed by unions (17%). The compensation for collective moral damage had average of 250,000 reais (about US$65,000), but it should be noted that there is a great range of values found, also are several situations repaired by this compensation. This is the last instance resource for this kind of lawsuit and all decisions were well founded and received partially the request made for working environment protection. Conclusions: When triggered, the labor court system provides the requested collective protection in class action. The values of convictions arbitrated in collective actions are significant and indicate that it creates social and economic repercussions, stimulating employers to improve the working environment conditions of their companies. It is necessary to intensify the use of collective actions, however, because they are more efficient for prevention than reparatory individual lawsuits, but it has been underutilized, mainly by Unions.

Keywords: Brazilian Class Action, collective action, work accident penalization, workplace accident prevention, workplace protection law

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Authors: Francesco Pandolfi, Georgios Baltzopoulos, Iunio Iervolino

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The impact of extreme winds on industrial assets and the built environment is gaining increasing attention from stakeholders, including the corporate insurance industry. This has led to a progressively more in-depth study of building vulnerability and fragility to wind. Wind vulnerability models are used in probabilistic risk assessment to relate a loss metric to an intensity measure of the natural event, usually a gust or a mean wind speed. In fact, vulnerability models can be integrated with the wind hazard, which consists of associating a probability to each intensity level in a time interval (e.g., by means of return periods) to provide an assessment of future losses due to extreme wind. This has also given impulse to the world- and regional-scale wind hazard studies.Another approach often adopted for the probabilistic description of building vulnerability to the wind is the use of fragility functions, which provide the conditional probability that selected building components will exceed certain damage states, given wind intensity. In fact, in wind engineering literature, it is more common to find structural system- or component-level fragility functions rather than wind vulnerability models for an entire building. Loss assessment based on component fragilities requires some logical combination rules that define the building’s damage state given the damage state of each component and the availability of a consequence model that provides the losses associated with each damage state. When risk calculations are based on numerical simulation of a structure’s behavior during extreme wind scenarios, the interaction of component fragilities is intertwined with the computational procedure. However, simulation-based approaches are usually computationally demanding and case-specific. In this context, the present work introduces the ExtReMe wind risk assESsment prototype Software, ERMESS, which is being developed at the University of Naples Federico II. ERMESS is a wind risk assessment tool for insurance applications to industrial facilities, collecting a wide assortment of available wind vulnerability models and fragility functions to facilitate their incorporation into risk calculations based on in-built or user-defined wind hazard data. This software implements an alternative method for building-specific risk assessment based on existing component-level fragility functions and on a number of simplifying assumptions for their interactions. The applicability of this alternative procedure is explored by means of an illustrative proof-of-concept example, which considers four main building components, namely: the roof covering, roof structure, envelope wall and envelope openings. The application shows that, despite the simplifying assumptions, the procedure can yield risk evaluations that are comparable to those obtained via more rigorous building-level simulation-based methods, at least in the considered example. The advantage of this approach is shown to lie in the fact that a database of building component fragility curves can be put to use for the development of new wind vulnerability models to cover building typologies not yet adequately covered by existing works and whose rigorous development is usually beyond the budget of portfolio-related industrial applications.

Keywords: component wind fragility, probabilistic risk assessment, vulnerability model, wind-induced losses

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Authors: Sun-Hee Lee, Amanda Kraley

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The “MeToo” movement is a social movement against sexual abuse and harassment. Though the hashtag went viral in 2017 following different cultural flashpoints in different countries, the initial response was quiet in South Korea. This radically changed in January 2018, when a high-ranking senior prosecutor, Seo Ji-hyun, gave a televised interview discussing being sexually assaulted by a colleague. Acknowledging public anger, particularly among women, on the long-existing problems of sexual harassment and abuse, the South Korean media have focused on several high-profile cases. Analyzing the media representation of these cases is a window into the evolving South Korean discourse around “MeToo.” This study presents a linguistic analysis of “MeToo” discourse in South Korea by utilizing a corpus-based approach. The term corpus (pl. corpora) is used to refer to electronic language data, that is, any collection of recorded instances of spoken or written language. A “MeToo” corpus has been collected by extracting newspaper articles containing the keyword “MeToo” from BIGKinds, big data analysis, and service and Nexis Uni, an online academic database search engine, to conduct this language analysis. The corpus analysis explores how Korean media represent accusers and the accused, victims and perpetrators. The extracted data includes 5,885 articles from four broadsheet newspapers (Chosun, JoongAng, Hangyore, and Kyunghyang) and 88 articles from two Korea-based English newspapers (Korea Times and Korea Herald) between January 2017 and November 2020. The information includes basic data analysis with respect to keyword frequency and network analysis and adds refined examinations of select corpus samples through naming strategies, semantic relations, and pragmatic properties. Along with the exponential increase of the number of articles containing the keyword “MeToo” from 104 articles in 2017 to 3,546 articles in 2018, the network and keyword analysis highlights ‘US,’ ‘Harvey Weinstein’, and ‘Hollywood,’ as keywords for 2017, with articles in 2018 highlighting ‘Seo Ji-Hyun, ‘politics,’ ‘President Moon,’ ‘An Ui-Jeong, ‘Lee Yoon-taek’ (the names of perpetrators), and ‘(Korean) society.’ This outcome demonstrates the shift of media focus from international affairs to domestic cases. Another crucial finding is that word ‘defamation’ is widely distributed in the “MeToo” corpus. This relates to the South Korean legal system, in which a person who defames another by publicly alleging information detrimental to their reputation—factual or fabricated—is punishable by law (Article 307 of the Criminal Act of Korea). If the defamation occurs on the internet, it is subject to aggravated punishment under the Act on Promotion of Information and Communications Network Utilization and Information Protection. These laws, in particular, have been used against accusers who have publicly come forward in the wake of “MeToo” in South Korea, adding an extra dimension of risk. This corpus analysis of “MeToo” newspaper articles contributes to the analysis of the media representation of the “MeToo” movement and sheds light on the shifting landscape of gender relations in the public sphere in South Korea.

Keywords: corpus linguistics, MeToo, newspapers, South Korea

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Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz

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Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.

Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting

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Authors: Yujie Yuan, Yiyang Fan, Hong Fan

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Objective: The RNA methylation recognition protein Aly/REF export factor (ALYREF) is considered one type of “reader” protein acting as a recognition protein of m5C, has been reported involved in several biological progresses including cancer initiation and progression. 5-methylcytosine (m5C) is a conserved and prevalent RNA modification in all species, as accumulating evidence suggests its role in the promotion of tumorigenesis. It has been claimed that ALYREF mediates nuclear export of mRNA with m5C modification and regulates biological effects of cancer cells. However, the systematical regulatory pathways of ALYREF in cancer tissues have not been clarified, yet. Methods: The expression level of ALYREF in pan-cancer and their normal tissues was compared through the data acquired from The Cancer Genome Atlas (TCGA). The University of Alabama at Birmingham Cancer data analysis Portal UALCAN was used to analyze the relationship between ALYREF and clinical pathological features. The relationship between the expression level of ALYREF and prognosis of pan-cancer, and the correlation genes of ALYREF were figured out by using Gene Expression Correlation Analysis database GEPIA. Immune related genes were obtained from TISIDB (an integrated repository portal for tumor-immune system interactions). Immune-related research was conducted by using Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) and TIMER. Results: Based on the data acquired from TCGA, ALYREF has an obviously higher-level expression in various types of cancers compared with relevant normal tissues excluding thyroid carcinoma and kidney chromophobe. The immunohistochemical images on The Human Protein Atlas showed that ALYREF can be detected in cytoplasm, membrane, but mainly located in nuclear. In addition, a higher expression level of ALYREF in tumor tissue generates a poor prognosis in majority of cancers. According to the above results, cancers with a higher expression level of ALYREF compared with normal tissues and a significant correlation between ALYREF and prognosis were selected for further analysis. By using TISIDB, we found that portion of ALYREF co-expression genes (such as BIRC5, H2AFZ, CCDC137, TK1, and PPM1G) with high Pearson correlation coefficient (PCC) were involved in anti-tumor immunity or affect resistance or sensitivity to T cell-mediated killing. Furthermore, based on the results acquired from GEPIA, there was significant correlation between ALYREF and PD-L1. It was exposed that there is a negative correlation between the expression level of ALYREF and ESTIMATE score. Conclusion: The present study indicated that ALYREF plays a vital and universal role in cancer initiation and progression of pan-cancer through regulating mitotic progression, DNA synthesis and metabolic process, and RNA processing. The correlation between ALYREF and PD-L1 implied ALYREF may affect the therapeutic effect of immunotherapy of tumor. More evidence revealed that ALYREF may play an important role in tumor immunomodulation. The correlation between ALYREF and immune cell infiltration level indicated that ALYREF can be a potential therapeutic target. Exploring the regulatory mechanism of ALYREF in tumor tissues may expose the reason for poor efficacy of immunotherapy and offer more directions of tumor treatment.

Keywords: ALYREF, pan-cancer, immunotherapy, PD-L1

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