Search results for: Hull recognition

Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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Authors: Rafael Carlos C. Aniceto, Bryce Abraham M. Anos, Don Christian A. Cornel, Marjerie Brianna S. Go, Samantha Nicole U. Roque, Earl Christian C. Te

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Indigenous peoples (IPs) in the Philippines are a vulnerable, marginalized group in terms of health and overall well-being due to social inequities and cultural differences. National standards regarding maternal healthcare are geared towards facility-based delivery with modern medicine, health services, and skilled birth attendants. Standards and procedures of care for pregnant mothers do not take into account cultural differences between indigenous people and the majority of the population. There do exist, however, numerous other factors that cause relatively poorer health outcomes among indigenous peoples (IPs). This analytic cross-sectional study sought to determine the association between social determinants of health (SDH), focusing on status as indigenous peoples, and maternal health-related knowledge and attitudes (KA), and health behavior of the Dumagat-Agta indigenous people of Barangay Catablingan and Barangay San Marcelino, General Nakar, Quezon Province, and their utilization of health facilities for antenatal care, facility-based delivery and postpartum care, which would affect their health outcomes (that were not within the scope of this study). To quantitatively measure the primary/secondary exposures and outcomes, a total of 90 face-to-face interviews with IP and non-IP mothers were done. For qualitative information, participant observation among 6 communities (5 IP and 1 non-IP), 11 key informant interviews (traditional and modern health providers) and 4 focused group discussions among IP mothers were conducted. Primary quantitative analyses included chi-squared, T-test and binary logistic regression, while secondary qualitative analyses involved thematic analysis and triangulation. The researchers spent a total of 15 days in the community to learn the culture and participate in the practices of the Dumagat-Agta more intensively and deeply. Overall, utilization of all MNCHN services measured in the study was lower for IP mothers compared to their non-IP counterparts. After controlling for confounders measured in the study, IP status (primary exposure) was found to be significantly correlated with utilization of and adherence to two MNCHN-prescribed services: number of antenatal care check-ups and place of delivery (secondary outcomes). Findings show that being an indigenous mother leads to unfavorable social determinants of health, and if compounded by a difference in knowledge and attitudes, would then lead to poor levels of utilization of MNCHN-prescribed services. Key themes from qualitative analyses show that factors that affected utilization were: culture, land alienation, social discrimination, socioeconomic status, and relations between IPs and non-IPs, specifically with non-IP healthcare providers. The findings of this study aim to be used to help and guide in policy-making, to provide healthcare that is not only adequate and of quality, but more importantly, that addresses inequities stemming from various social determinants, and which is socio-culturally acceptable to indigenous communities. To address the root causes of health problems of IPs, there must be full recognition and exercise of their collective rights to communal assets, specifically land, and self-determination. This would improve maternal and child health outcomes to one of the most vulnerable and neglected sectors in society today.

Keywords: child health, indigenous people, knowledge-attitudes-practices, maternal health, social determinants of health

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Authors: Amandeep Thakur, Yi-Hsuan Chu, Chun-Hsu Pan, Kunal Nepali

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The transfer of ADP-ribose residues onto target substrates from nicotinamide adenine dinucleotide (NAD) (PARylation) is catalyzed by Poly (ADP-ribose) polymerases (PARPs). Amongst the PARP family members, the DNA damage response in cancer is majorly regulated by PARP1 and PARP2. The blockade of DNA repair by PARP inhibitors leads to the progression of DNA single-strand breaks (induced by some triggering factors) to double-strand breaks. Notably, PARP inhibitors are remarkably effective in cancers with defective homologous recombination repair (HRR). In particular, cancer cells with BRCA mutations are responsive to therapy with PARP inhibitors. The aforementioned requirement for PARP inhibitors to be effective confers a narrow activity spectrum to PARP inhibitors, which hinders their clinical applicability. Thus, the quest to expand the application horizons of PARP inhibitors beyond BRCA mutations is the need of the hour. Literature precedents reveal that HDAC inhibition induces BRCAness in cancer cells and can broaden the therapeutic scope of PARP inhibitors. Driven by such disclosures, dual inhibitors targeting both PARP and HDAC enzymes were designed by our research group to extend the efficacy of PARP inhibitors beyond BRCA-mutated cancers to cancers with induced BRCAness. The design strategy involved the installation of Veliparib, an investigational PARP inhibitor, as a surface recognition part in the HDAC inhibitor pharmacophore model. The chemical architecture of veliparib was deemed appropriate as a starting point for the generation of dual inhibitors by virtue of its size and structural flexibility. A validatory docking study was conducted at the outset to predict the binding mode of the designed dual modulatory chemical architectures. Subsequently, the designed chemical architectures were synthesized via a multistep synthetic route and evaluated for antitumor efficacy. Delightfully, one compound manifested impressive anti-leukemic effects (HL-60 cell lines) mediated via dual inhibition of PARP and class I HDACs. The outcome of the western blot analysis revealed that the compound could downregulate the expression levels of PARP1 and PARP2 and the HDAC isoforms (HDAC1, 2, and 3). Also, the dual PARP-HDAC inhibitor upregulated the protein expression of the acetyl histone H3, confirming its abrogation potential for class I HDACs. In addition, the dual modulator could arrest the cell cycle at the G0/G1 phase and induce autophagy. Further, polymer-based nanoformulation of the dual inhibitor was furnished to afford targeted delivery of the dual inhibitor at the cancer site. Transmission electron microscopy (TEM) results indicate that the nanoparticles were monodispersed and spherical. Moreover, the polymeric nanoformulation exhibited an appropriate particle size. Delightfully, pH-sensitive behavior was manifested by the polymeric nanoformulation that led to selective antitumor effects towards the HL-60 cell lines. In light of the magnificent anti-leukemic profile of the identified dual PARP-HDAC inhibitor, in-vivo studies (pharmacokinetics and pharmacodynamics) are currently being conducted. Notably, the optimistic findings of the aforementioned study have spurred our research group to initiate several medicinal chemistry campaigns to create bifunctional small molecule inhibitors addressing PARP as the primary target.

Keywords: PARP inhibitors, HDAC inhibitors, BRCA mutations, leukemia

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Authors: Anjalika Fernando, Banuka Athuraliya

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This paper presents a comprehensive approach for converting Sinhala Sign Language (SSL) into grammatically correct sentences using Natural Language Processing (NLP) techniques in real-time. While previous studies have explored various aspects of SSL translation, the research gap lies in the absence of grammar checking for SSL. This work aims to bridge this gap by proposing a two-stage methodology that leverages deep learning models to detect signs and translate them into coherent sentences, ensuring grammatical accuracy. The first stage of the approach involves the utilization of a Long Short-Term Memory (LSTM) deep learning model to recognize and interpret SSL signs. By training the LSTM model on a dataset of SSL gestures, it learns to accurately classify and translate these signs into textual representations. The LSTM model achieves a commendable accuracy rate of 94%, demonstrating its effectiveness in accurately recognizing and translating SSL gestures. Building upon the successful recognition and translation of SSL signs, the second stage of the methodology focuses on improving the grammatical correctness of the translated sentences. The project employs a Neural Machine Translation (NMT) architecture, consisting of an encoder and decoder with LSTM components, to enhance the syntactical structure of the generated sentences. By training the NMT model on a parallel corpus of Sinhala wrong sentences and their corresponding grammatically correct translations, it learns to generate coherent and grammatically accurate sentences. The NMT model achieves an impressive accuracy rate of 98%, affirming its capability to produce linguistically sound translations. The proposed approach offers significant contributions to the field of SSL translation and grammar correction. Addressing the critical issue of grammar checking, it enhances the usability and reliability of SSL translation systems, facilitating effective communication between hearing-impaired and non-sign language users. Furthermore, the integration of deep learning techniques, such as LSTM and NMT, ensures the accuracy and robustness of the translation process. This research holds great potential for practical applications, including educational platforms, accessibility tools, and communication aids for the hearing-impaired. Furthermore, it lays the foundation for future advancements in SSL translation systems, fostering inclusive and equal opportunities for the deaf community. Future work includes expanding the existing datasets to further improve the accuracy and generalization of the SSL translation system. Additionally, the development of a dedicated mobile application would enhance the accessibility and convenience of SSL translation on handheld devices. Furthermore, efforts will be made to enhance the current application for educational purposes, enabling individuals to learn and practice SSL more effectively. Another area of future exploration involves enabling two-way communication, allowing seamless interaction between sign-language users and non-sign-language users.In conclusion, this paper presents a novel approach for converting Sinhala Sign Language gestures into grammatically correct sentences using NLP techniques in real time. The two-stage methodology, comprising an LSTM model for sign detection and translation and an NMT model for grammar correction, achieves high accuracy rates of 94% and 98%, respectively. By addressing the lack of grammar checking in existing SSL translation research, this work contributes significantly to the development of more accurate and reliable SSL translation systems, thereby fostering effective communication and inclusivity for the hearing-impaired community

Keywords: Sinhala sign language, sign Language, NLP, LSTM, NMT

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Authors: Oleg Shovkovyy

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This research conducted in response to one of the most pressing questions on the agenda of many public administration offices around the world: “What could be done for better integration and assimilation of immigrants into hosting communities?” In author’s view, the answer could be suggested by immigrants themselves. They, often ‘bogged down in the past,’ snared by own idols and demons, perceive things differently, which, in turn, may result in their inability to integrate smoothly into hosting communities. Brief literature review suggests that perceptions of immigrants are completely neglected or something unsought in the current research on migrants, which, often, based on opinion polls by members of hosting communities themselves or superficial research data by various research organizations. Even those specimens that include voices of immigrants, unlikely to shed any additional light onto the problem simply because certain things are not made to speak out loud, especially to those in whose hands immigrants’ fate is (authorities). In this regard, this qualitative study, conducted by an insider to a few Russian-speaking communities, represents a unique opportunity for all stakeholders to look at the question of integration through the eyes of immigrants, from a different perspective and thus, makes research findings especially valuable for better understanding of the problem. Case study research employed ethnographic methods of gathering data where, approximately 200 Russian-speaking immigrants of first and second generations were closely observed by the Russian-speaking researcher in their usual setting, for eight months, and at different venues. The number of informal interviews with 27 key informants, with whom the researcher managed to establish a good rapport and who were keen enough to share their experiences voluntarily, were conducted. The field notes were taken at 14 locations (study sites) within the Brisbane region of Queensland, Australia. Moreover, all this time, researcher lived in dwelling of one of the immigrants and was an active participant in the social life (worship, picnics, dinners, weekend schools, concerts, cultural events, social gathering, etc.) of observed communities, whose members, to a large extent, belong to various religious lines of the Russian and Protestant Church. It was found that the majority of immigrants had experienced some discrimination in matters of hiring, employment, recognition of educational qualifications from home countries, and simply felt a sort of dislike from society in various everyday situations. Many noted complete absences or very limited state assistance in terms of employment, training, education, and housing. For instance, the Australian Government Department of Human Services not only does not stimulate job search but, on the contrary, encourages to refuse short-term works and employment. On the other hand, offered free courses on adaptation, and the English language proved to be ineffective and unpopular amongst immigrants. Many interviewees have reported overstated requirements for English proficiency and local work experience, whereas it was not critical for the given task or job. Based on the result of long-term monitoring, the researcher also had the courage to assert the negative and decelerating roles of immigrants’ communities, particularly religious communities, on processes of integration and assimilation. The findings suggest that governments should either change current immigration policies in the direction of their toughening or to take more proactive and responsible role in dealing with immigrant-related issues; for instance, increasing assistance and support to all immigrants and probably, paying more attention to and taking stake in managing and organizing lives of immigrants’ communities rather, simply leaving it all to chance.

Keywords: Australia, immigration, integration, perceptions

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Authors: Ayla Hoeta

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In a post-colonial Aotearoa New Zealand, solutions by rangatahi (youth) for rangatahi are essential as is civic participation and building economic agency in an increasingly tough economic climate. Upsouth was an online community crowdsourcing platform developed by The Southern Initiative, in collaboration with Itsnoon that provides rangatahi and whānau (family) a safe space to share lived experience, thoughts and ideas about local kaupapa (issues/topics) of importance to them. The target participants were Māori indigenous peoples and Pacifica groups, aged 14 - 21 years. In the Aotearoa New Zealand context, this participant group is not likely to engage in traditional consultation processes despite being an essential constituent in helping shape better local communities, whānau and futures. The Upsouth platform was active for two years from 2018-2019 where it completed 42 callups with 4300+ participants. The web platform collates the ideas, voices, feedback, and content of users around a callup that has been commissioned by a sponsor, such as Auckland Council, Z Energy or Auckland Transport. A callup may be about a pressing challenge in a community such as climate change, a new housing development, homelessness etc. Each callup was funded by the sponsor with Upsouths main point of difference being that participants are given koha (money donation) through digital wallets for their ideas. Depending on the quality of what participants upload, the koha varies between small micropayments and larger payments. This encouraged participants to develop creative and critical thinking - upskilling for future focussed jobs, enterprise and democratic skills while earning pocket money at the same time. Upsouth enables youth-led action and voice, and empowers them to be a part of a reciprocal and creative economy. Rangatahi are encouraged to express themselves culturally, creatively, freely and in a way they are free to choose - for example, spoken word, song, dance, video, drawings, and/or poems. This challenges and changes what is considered acceptable as community engagement feedback by the local government. Many traditional engagement platforms are not as consultative, do not accept diverse types of feedback, nor incentivise this valuable expression of feedback. Upsouth is also empowering for rangatahi, since it allows them the opportunity to express their opinions directly to the government. Upsouth gained national and international recognition for the way it engages with youth: winning the Supreme Award and the Accessibility and Transparency Award at Auckland Council’s 2018 Engagement Awards, becoming a finalist in the 2018 Digital Equity and Accessibility category of International Data Corporation’s Smart City Asia and Pacific Awards. This paper will fully contextualize the challenges of rangatahi and whānau civic engagement in Aotearoa New Zealand and then present a reflective case study of the Upsouth project, with examples from some of the callups. This is intended to form part of the Divided Cities 22 conference New Ground sub-theme as a critical reflection on a design intervention, which was conceived and implemented by the lead author to overcome the post-colonial divisions of Māori, Pacifica and minority ethnic rangatahi in Aotearoa New Zealand.

Keywords: rangatahi, youth empowerment, civic engagement, enabling, relating, digital platform, participation

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Authors: Andreea Campu, Ilinica Muresan, Simona Cainap, Simion Astilean, Monica Focsan

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Acute myocardial infarction (AMI) is the most severe cardiovascular disease, which has threatened human lives for decades, thus a continuous interest is directed towards the detection of cardiac biomarkers such as cardiac troponin I (cTnI) in order to predict risk and, implicitly, fulfill the early diagnosis requirements in AMI settings. Microfluidics is a major technology involved in the development of efficient sensing devices with real-time fast responses and on-site applicability. Microfluidic devices have gathered a lot of attention recently due to their advantageous features such as high sensitivity and specificity, miniaturization and portability, ease-of-use, low-cost, facile fabrication, and reduced sample manipulation. The integration of gold nanoparticles into the structure of microfluidic sensors has led to the development of highly effective detection systems, considering the unique properties of the metallic nanostructures, specifically the Localized Surface Plasmon Resonance (LSPR), which makes them highly sensitive to their microenvironment. In this scientific context, herein, we propose the implementation of a novel detection device, which successfully combines the efficiency of gold bipyramids (AuBPs) as signal transducers and thermal generators with the sample-driven advantages of the microfluidic channels into a miniaturized, portable, low-cost, specific, and sensitive test for the dual LSPR-thermographic cTnI detection. Specifically, AuBPs with longitudinal LSPR response at 830 nm were chemically synthesized using the seed-mediated growth approach and characterized in terms of optical and morphological properties. Further, the colloidal AuBPs were deposited onto pre-treated silanized glass substrates thus, a uniform nanoparticle coverage of the substrate was obtained and confirmed by extinction measurements showing a 43 nm blue-shift of the LSPR response as a consequence of the refractive index change. The as-obtained plasmonic substrate was then integrated into a microfluidic “Y”-shaped polydimethylsiloxane (PDMS) channel, fabricated using a Laser Cutter system. Both plasmonic and microfluidic elements were plasma treated in order to achieve a permanent bond. The as-developed microfluidic plasmonic chip was further coupled to an automated syringe pump system. The proposed biosensing protocol implicates the successive injection inside the microfluidic channel as follows: p-aminothiophenol and glutaraldehyde, to achieve a covalent bond between the metallic surface and cTnI antibody, anti-cTnI, as a recognition element, and target cTnI biomarker. The successful functionalization and capture of cTnI was monitored by LSPR detection thus, after each step, a red-shift of the optical response was recorded. Furthermore, as an innovative detection technique, thermal determinations were made after each injection by exposing the microfluidic plasmonic chip to 785 nm laser excitation, considering that the AuBPs exhibit high light-to-heat conversion performances. By the analysis of the thermographic images, thermal curves were obtained, showing a decrease in the thermal efficiency after the anti-cTnI-cTnI reaction was realized. Thus, we developed a microfluidic plasmonic chip able to operate as both LSPR and thermal sensor for the detection of the cardiac troponin I biomarker, leading thus to the progress of diagnostic devices.

Keywords: gold nanobipyramids, microfluidic device, localized surface plasmon resonance detection, thermographic detection

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Authors: Maari Sugawara

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This study investigates the constructed notion of “motherhood” and queered forms of care in contemporary Japan, focusing on rental family services. In Japan, the concept of motherhood is often equated with womanhood, reflecting a pervasive ideology that views motherhood as an essential aspect of a woman's societal role, particularly amidst economic recovery and an aging population. This study interrogates these gendered expectations by linking rental family services, particularly the role of rental mothers, to traditional caregiving roles. It critiques the gendered construction of domestic labor and aims to expand conceptions of alternative family structures and caregiving roles beyond normative frameworks. Emerging in the 1980s to provide companionship for the elderly, rental family services have evolved to meet diverse social needs, with paid actors fulfilling familial roles at various social events. Despite their growing prevalence, academic exploration of this phenomenon remains limited. This research aims to fill that gap by investigating the cultural, social, and economic factors fueling the popularity of rental family services and analyzing their implications for contemporary understandings of family dynamics and care labor in Japan. Furthermore, this study underscores the disproportionate domestic labor burden women in Japan bear, often managing time-intensive household tasks, which creates a "double burden" for those in full-time employment. Care work, including elderly and disability support, is undervalued and typically compensated at near-minimum wage levels, with women predominantly filling these low-wage roles. This gender disparity in Japan's care industry contributes to labor shortages in caregiving and childcare, highlighting broader structural inequities in the labor market. Through semi-structured qualitative interviews with fifteen rental mothers, this study investigates their experiences, motivations, role dynamics, and emotional labor. It critically examines whether the labor performed by rental family actors constitutes a subversive practice deserving of appropriate compensation. Utilizing a role-playing method, the author engages with rental mothers as if they were her own, reflecting the dynamics of compensated labor. This interaction delves into the economic and emotional aspects of constructed motherhood, facilitating a broader inquiry into the value of both productive and reproductive labor in Japan. The study also investigates the relationship between sex work and rental family services within the socio-economic landscape, recognizing the links between the welfare sector and female employment in legal sex work. Although distinct, these sectors merit joint consideration due to the commonality of male clients in both industries. This research engages with theoretical perspectives framing mobile sex work as inherently queer, directly challenging the dominance of heteronormativity. The agency exercised by sex workers complicates narratives of conformity and deviance, underscoring the need to reevaluate caregiving labor in both paid and unpaid contexts. Ultimately, this research critiques the intersection of gender, care, and labor in contemporary Japan by examining the undervaluation of traditional caregiving roles alongside the labor involved in rental family services. It challenges Japanese policies that equate womanhood with motherhood and explores the potential of viewing outsourced care as queered maternal and non-reproductive labor, advocating for the recognition of alternative family structures and non-reproductive forms of motherhood.

Keywords: motherhood, alternative family structures, carework, Japan, queer studies

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Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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Authors: Hooshag Asadi Haroni, Maryam Veiskarami, Yongjun Lu

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The Dalli gold-rich porphyry deposit (17 Mt @ 0.5% Cu and 0.65 g/t Au) is located in the Urumieh-Dokhtar Magmatic Arc (UDMA), a small segment of the Tethyan metallogenic belt, hosting several porphyry Cu (Mo-Au) systems in Iran. This research characterizes the Dalli deposit to define exploration criteria in advanced exploration such as the drilling of possible blind porphyry centers. Geological map, trench/drill hole geochemical and ground magnetic data, and age dating and isotope trace element analyses, carried out at the John De Laeter Research Center of Curtin University, were used to characterize the Delli deposit. Mineralization at Dalli is hosted by NE-trending quartz-diorite porphyry stocks (~ 200m in diameter) intruded by a wall-rock andesite porphyry. Disseminated and stockwork Cu-Au mineralization is related to potassic alteration, comprising magnetite, late K-feldspar and biotite, and quartz-sericite-specularite overprint, surrounded by extensive barren argillic and propylitic alterations. In the peripheries of the porphyry centers, there are N-trending vuggy quartz veins, hosting epithermal Au-Ag-As-Sb mineralization. Geochemical analyses of drill core samples showed that the core of the porphyry stocks is low-grade, whereas the high-grade disseminated and stockwork mineralization (~ 1% Cu and ~ 1.2 g/t Au) occurred at the contact of the porphyry stocks and andesite porphyry. Geochemical studies of the drill hole and trench samples showed a strong correlation between Cu and Au and both show a second-order correlation with Fe and As. Magnetic survey revealed two significant magnetic anomalies, associated with intensive potassic alteration, in the reduced-to-the-pole magnetic map of the area. A relatively weaker magnetic anomaly, showing no surface porphyry expressions, is located on a lithocap, consisting of advanced argillic alteration, vuggy quartz veins, and surface expressions of epithermal geochemical signatures. The association of the lithocap and the weak magnetic anomaly could be indicative of a hidden mineralized porphyry center. Litho-geochemical analyses of the least altered Dalli intrusions and volcanic rocks indicated high Sr/Y (49-61) and Eu/Eu* (0.89-0.92), features typical of Cu porphyries. The U-Pb dating of zircons of the mineralized quartz diorite and andesite porphyry, carried out by laser ablation inductively coupled plasma mass spectrometry, yielded magmatic crystallization ages of 15.4-16.0 Ma (Middle Miocene). The zircon trace element concentrations of Dalli are characterized by high Eu/Eu* (0.3-0.8), (Ce/Nd)/Y (0.01-0.3), and 10000*(Eu/Eu*)/Y (2-15) ratios, similar to fertile porphyry suites such as the giant Sar-Cheshmeh and Qulong porphyry Cu deposits along the Tethyan belt. This suggests that the Middle Miocene Dalli intrusions are fertile and require extensive deep drillings to define their potential. Chondrite-normalized rare earth element (REE) patterns show no significant Eu anomalies, and are characterized by light-REE enrichments (La/Sm)n = 2.57–6.40). In normalized multi-element diagrams, analyzed rocks are characterized by enrichments in large ion lithophile elements (LILE) and depletions in high field strength elements (HFSE), and display typical features of subduction-related calc-alkaline magmas. The characteristics of the Dalli deposit provided several recognition criteria for detailed exploration of Cu-Au porphyry deposits and highlighted the importance of the UDMA as a potentially significant, economically important, but relatively underexplored porphyry province.

Keywords: porphyry, gold, geochronology, magnetic, exploration

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Authors: Gertraud Koch, Teresa Stumpf, Alejandra Tijerina García

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Discourse analysis research approaches belong to the central research strategies applied throughout the humanities; they focus on the countless forms and ways digital texts and images shape present-day notions of the world. Despite the constantly growing number of relevant digital, multimodal discourse resources, digital humanities (DH) methods are thus far not systematically developed and accessible for discourse analysis approaches. Specifically, the significance of multimodality and meaning plurality modelling are yet to be sufficiently addressed. In order to address this research gap, the D-WISE project aims to develop a prototypical working environment as digital support for the sociology of knowledge approach to discourse analysis and new IT-analysis approaches for the use of context-oriented embedding representations. Playing an essential role throughout our research endeavor is the constant optimization of hermeneutical methodology in the use of (semi)automated processes and their corresponding epistemological reflection. Among the discourse analyses, the sociology of knowledge approach to discourse analysis is characterised by the reconstructive and accompanying research into the formation of knowledge systems in social negotiation processes. The approach analyses how dominant understandings of a phenomenon develop, i.e., the way they are expressed and consolidated by various actors in specific arenas of discourse until a specific understanding of the phenomenon and its socially accepted structure are established. This article presents insights and initial findings from D-WISE, a joint research project running since 2021 between the Institute of Anthropological Studies in Culture and History and the Language Technology Group of the Department of Informatics at the University of Hamburg. As an interdisciplinary team, we develop central innovations with regard to the availability of relevant DH applications by building up a uniform working environment, which supports the procedure of the sociology of knowledge approach to discourse analysis within open corpora and heterogeneous, multimodal data sources for researchers in the humanities. We are hereby expanding the existing range of DH methods by developing contextualized embeddings for improved modelling of the plurality of meaning and the integrated processing of multimodal data. The alignment of this methodological and technical innovation is based on the epistemological working methods according to grounded theory as a hermeneutic methodology. In order to systematically relate, compare, and reflect the approaches of structural-IT and hermeneutic-interpretative analysis, the discourse analysis is carried out both manually and digitally. Using the example of current discourses on digitization in the healthcare sector and the associated issues regarding data protection, we have manually built an initial data corpus of which the relevant actors and discourse positions are analysed in conventional qualitative discourse analysis. At the same time, we are building an extensive digital corpus on the same topic based on the use and further development of entity-centered research tools such as topic crawlers and automated newsreaders. In addition to the text material, this consists of multimodal sources such as images, video sequences, and apps. In a blended reading process, the data material is filtered, annotated, and finally coded with the help of NLP tools such as dependency parsing, named entity recognition, co-reference resolution, entity linking, sentiment analysis, and other project-specific tools that are being adapted and developed. The coding process is carried out (semi-)automated by programs that propose coding paradigms based on the calculated entities and their relationships. Simultaneously, these can be specifically trained by manual coding in a closed reading process and specified according to the content issues. Overall, this approach enables purely qualitative, fully automated, and semi-automated analyses to be compared and reflected upon.

Keywords: entanglement of structural IT and hermeneutic-interpretative analysis, multimodality, plurality of meaning, sociology of knowledge approach to discourse analysis

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Authors: Fatima Saeed, Abdullah Mudassar

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Introduction: Patient safety remains a global priority in the ever-evolving healthcare landscape. At the forefront of this endeavor are the International Patient Safety Goals (IPSGs), a standardized framework designed to mitigate risks and elevate the quality of care. Doctors, positioned as primary caregivers, wield a pivotal role in upholding and adhering to IPSGs, underscoring the critical significance of their knowledge and understanding of these goals. This research embarks on a comprehensive exploration into the depth of Doctors ' comprehension of IPSGs, aiming to unearth potential gaps and provide insights for targeted educational interventions. Established by influential healthcare bodies, including the World Health Organization (WHO), IPSGs represent a universally applicable set of objectives spanning crucial domains such as medication safety, infection control, surgical site safety, and patient identification. Adherence to these goals has exhibited substantial reductions in adverse events, fostering an overall enhancement in the quality of care. This study operates on the fundamental premise that an informed Doctors workforce is indispensable for effectively implementing IPSGs. A nuanced understanding of these goals empowers Doctors to identify potential risks, advocate for necessary changes, and actively contribute to a safety-centric culture within healthcare institutions. Despite the acknowledged importance of IPSGs, there is a growing concern that nurses may need more knowledge to integrate these goals into their practice seamlessly. Methodology: A Comprehensive research methodology covering study design, setting, duration, sample size determination, sampling technique, and data analysis. It introduces the philosophical framework guiding the research and details material, methods, and the analysis framework. The descriptive quantitative cross-sectional study in teaching care hospitals utilized convenient sampling over six months. Data collection involved written informed consent and questionnaires, analyzed with SPSS version 23, presenting results graphically and descriptively. The chapter ensures a clear understanding of the study's design, execution, and analytical processes. Result: The survey results reveal a substantial distribution across hospitals, with 34.52% in MTIKTH and 65.48% in HMC MTI. There is a notable prevalence of patient safety incidents, emphasizing the significance of adherence to IPSGs. Positive trends are observed, including 77.0% affirming the "time-out" procedure, 81.6% acknowledging effective healthcare provider communication, and high recognition (82.7%) of the purpose of IPSGs to improve patient safety. While the survey reflects a good understanding of IPSGs, areas for improvement are identified, suggesting opportunities for targeted interventions. Discussion: The study underscores the need for tailored care approaches and highlights the bio-socio-cultural context of 'contagion,' suggesting areas for further research amid antimicrobial resistance. Shifting the focus to patient safety practices, the survey chapter provides a detailed overview of results, emphasizing workplace distribution, patient safety incidents, and positive reflections on IPSGs. The findings indicate a positive trend in patient safety practices with areas for improvement, emphasizing the ongoing need for reinforcing safety protocols and cultivating a safety-centric culture in healthcare. Conclusion: In summary, the survey indicates a positive trend in patient safety practices with a good understanding of IPSGs among participants. However, identifying areas for potential improvement suggests opportunities for targeted interventions to enhance patient safety further. Ongoing efforts to reinforce adherence to safety protocols, address identified gaps, and foster a safety culture will contribute to continuous improvements in patient care and outcomes.

Keywords: infection control, international patient safety, patient safety practices, proper medication

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Authors: C.Ardil

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Open Science translates the understanding and application of various theories and practices in open science philosophy, systems, paradigms and epistemology. Open Science originates with the premise that universal scientific knowledge is a product of a collective scholarly and social collaboration involving all stakeholders and knowledge belongs to the global society. Scientific outputs generated by public research are a public good that should be available to all at no cost and without barriers or restrictions. Open Science has the potential to increase the quality, impact and benefits of science and to accelerate advancement of knowledge by making it more reliable, more efficient and accurate, better understandable by society and responsive to societal challenges, and has the potential to enable growth and innovation through reuse of scientific results by all stakeholders at all levels of society, and ultimately contribute to growth and competitiveness of global society. Open Science is a global movement to improve accessibility to and reusability of research practices and outputs. In its broadest definition, it encompasses open access to publications, open research data and methods, open source, open educational resources, open evaluation, and citizen science. The implementation of open science provides an excellent opportunity to renegotiate the social roles and responsibilities of publicly funded research and to rethink the science system as a whole. Open Science is the practice of science in such a way that others can collaborate and contribute, where research data, lab notes and other research processes are freely available, under terms that enable reuse, redistribution and reproduction of the research and its underlying data and methods. Open Science represents a novel systematic approach to the scientific process, shifting from the standard practices of publishing research results in scientific publications towards sharing and using all available knowledge at an earlier stage in the research process, based on cooperative work and diffusing scholarly knowledge with no barriers and restrictions. Open Science refers to efforts to make the primary outputs of publicly funded research results (publications and the research data) publicly accessible in digital format with no limitations. Open Science is about extending the principles of openness to the whole research cycle, fostering, sharing and collaboration as early as possible, thus entailing a systemic change to the way science and research is done. Open Science is the ongoing transition in how open research is carried out, disseminated, deployed, and transformed to make scholarly research more open, global, collaborative, creative and closer to society. Open Science involves various movements aiming to remove the barriers for sharing any kind of output, resources, methods or tools, at any stage of the research process. Open Science embraces open access to publications, research data, source software, collaboration, peer review, notebooks, educational resources, monographs, citizen science, or research crowdfunding. The recognition and adoption of open science practices, including open science policies that increase open access to scientific literature and encourage data and code sharing, is increasing in the open science philosophy. Revolutionary open science policies are motivated by ethical, moral or utilitarian arguments, such as the right to access digital research literature for open source research or science data accumulation, research indicators, transparency in the field of academic practice, and reproducibility. Open science philosophy is adopted primarily to demonstrate the benefits of open science practices. Researchers use open science applications for their own advantage in order to get more offers, increase citations, attract media attention, potential collaborators, career opportunities, donations and funding opportunities. In open science philosophy, open data findings are evidence that open science practices provide significant benefits to researchers in scientific research creation, collaboration, communication, and evaluation according to more traditional closed science practices. Open science considers concerns such as the rigor of peer review, common research facts such as financing and career development, and the sacrifice of author rights. Therefore, researchers are recommended to implement open science research within the framework of existing academic evaluation and incentives. As a result, open science research issues are addressed in the areas of publishing, financing, collaboration, resource management and sharing, career development, discussion of open science questions and conclusions.

Keywords: Open Science, Open Science Philosophy, Open Science Research, Open Science Data

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