Search results for: sensor node placement

Authors: Wenjun Zhang, Yunqing Du, Steven W. Cranford, Ming L. Wang

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The beginning of 21st century has witnessed new advancements in the design and use of new materials for biosensing applications, from nano to macro, protein to tissue. Traditional analytical methods lack a complete toolset to describe the complexities introduced by living systems, pathological relations, discrete hierarchical materials, cross-phase interactions, and structure-property dependencies. Materiomics – via systematic molecular dynamics (MD) simulation – can provide structure-process-property relations by using a materials science approach linking mechanisms across scales and enables oriented biosensor design. With this approach, DNA biosensors can be utilized to detect disease biomarkers present in individuals’ breath such as acetone for diabetes. Our wireless sensor array based on single-stranded DNA (ssDNA)-decorated single-walled carbon nanotubes (SWNT) has successfully detected trace amount of various chemicals in vapor differentiated by pattern recognition. Here, we present how MD simulation can revolutionize the way of design and screening of DNA aptamers for targeting biomarkers related to oral diseases and oral health monitoring. It demonstrates great potential to be utilized to build a library of DNDA sequences for reliable detection of several biomarkers of one specific disease, and as well provides a new methodology of creating, designing, and applying of biosensors.

Keywords: biosensor, DNA, biomarker, molecular dynamics simulation

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Authors: C. Yin, B. Zhang, Y. Liu, J. Cai

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Airborne EM (AEM) is an effective geophysical exploration tool, especially suitable for ridged mountain areas. In these areas, topography will have serious effects on AEM system responses. However, until now little study has been reported on topographic effect on airborne EM systems. In this paper, an edge-based unstructured finite-element (FE) method is developed for 3D topographic modeling for both frequency and time-domain airborne EM systems. Starting from the frequency-domain Maxwell equations, a vector Helmholtz equation is derived to obtain a stable and accurate solution. Considering that the AEM transmitter and receiver are both located in the air, the scattered field method is used in our modeling. The Galerkin method is applied to discretize the Helmholtz equation for the final FE equations. Solving the FE equations, the frequency-domain AEM responses are obtained. To accelerate the calculation speed, the response of source in free-space is used as the primary field and the PARDISO direct solver is used to deal with the problem with multiple transmitting sources. After calculating the frequency-domain AEM responses, a Hankel’s transform is applied to obtain the time-domain AEM responses. To check the accuracy of present algorithm and to analyze the characteristic of topographic effect on airborne EM systems, both the frequency- and time-domain AEM responses for 3 model groups are simulated: 1) a flat half-space model that has a semi-analytical solution of EM response; 2) a valley or hill earth model; 3) a valley or hill earth with an abnormal body embedded. Numerical experiments show that close to the node points of the topography, AEM responses demonstrate sharp changes. Special attentions need to be paid to the topographic effects when interpreting AEM survey data over rugged topographic areas. Besides, the profile of the AEM responses presents a mirror relation with the topographic earth surface. In comparison to the topographic effect that mainly occurs at the high-frequency end and early time channels, the EM responses of underground conductors mainly occur at low frequencies and later time channels. For the signal of the same time channel, the dB/dt field reflects the change of conductivity better than the B-field. The research of this paper will serve airborne EM in the identification and correction of the topographic effects.

Keywords: 3D, Airborne EM, forward modeling, topographic effect

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Authors: Yang Yang, Lu Xin

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The study of extant musical sites can provide a side-by-side picture of historical ethnomusicological information. In their data collection on Chinese opera houses, researchers found that one Ming Dynasty opera house reached a width of nearly 18 meters, while all opera houses of the same period and after it was far from such a width, being significantly smaller than 18 meters. The historical transient fluctuations in the data dimension of width that caused Chinese theatres to fluctuate in the absence of construction scale constraints have piqued the interest of researchers as to why there is data variation in width. What factors have contributed to the lack of further expansion in the width of theatres? To address this question, this study used a comparative approach to conduct a venue experiment between this theater stage and another theater stage for non-heritage opera performances, collecting the subjective perceptions of performers and audiences at different theater stages, as well as combining BK Connect platform software to measure data such as echo and delay. From the subjective and objective results, it is inferred that the Chinese ancients discovered and understood the acoustical phenomenon of the Haas effect by exploring the effect of stage width on musical performance and appreciation of listening states during the Ming Dynasty and utilized this discovery to serve music in subsequent stage construction. This discovery marked a node of evolution in Chinese architectural acoustics technology driven by musical demands. It is also instructive to note that, in contrast to many of the world's "unsuccessful civilizations," China can use a combination of heritage and intangible cultural research to chart a clear, demand-driven course for the evolution of human music technology, and that the findings of such research will complete the course of human exploration of music acoustics. The findings of such research will complete the journey of human exploration of music acoustics, and this practical experience can be applied to the exploration and understanding of other musical heritage base data.

Keywords: Haas effect, musical acoustics, history of acoustical technology, Chinese opera stage, structure

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Authors: Leonie Laskowitz

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A self-confident appearance is a basic prerequisite for success in the world of work 4.0. Within a few seconds, people convey a first impression that usually lasts. Artificial intelligence is making it increasingly important how our virtual selves appear and communicate (nonverbally) in digital worlds such as the metaverse. In addition to the modified creation of an avatar, the field of photogrammetry is developing fast, creating exact likenesses of ourselves in virtual environments. Given the importance of self-representation in virtual space for future collaborations, it is important to investigate the impact of phenotype in virtual worlds and how an avatar type can profitably be used situationally. We analyzed the effect of self-similar versus desirable self-presentation as an avatar on one's self-awareness, considering various theoretical constructs in the area of self-awareness and stress stimuli. The avatars were arbitrarily created on the one hand and scanned on the other hand with the help of a lidar sensor, the state-of-the-art photogrammetry method. All subjects were exposed to the established Trier Social Stress Test. The results showed that especially insecure people prefer to create rather than be scanned when confronted with a stressful work situation. (1) If they are in a casual work environment and a relaxed situation, they prefer a 3D photorealistic avatar that reflects them in detail. (2) Confident people will give their avatar their true appearance in any situation, while insecure people would only do so for honesty and authenticity. (3) Thus, the choice of avatar type has considerable impact on self-confidence in different situations.

Keywords: avatar, virtual identity, self-presentation, metaverse, virtual reality, self-awareness

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Authors: Panupong Makvichian

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Global Navigation Satellite System (GNSS) is nowadays a common technology that improves navigation functions in our life. Additionally, GNSS is also being employed on behalf of an accurate atmospheric sensor these times. Meteorology is a practical application of GNSS, which is unnoticeable in the background of people’s life. GNSS Precise Point Positioning (PPP) is a positioning method that requires data from a single dual-frequency receiver and precise information about satellite positions and satellite clocks. In addition, careful attention to mitigate various error sources is required. All the above data are combined in a sophisticated mathematical algorithm. At this point, the research is going to demonstrate how GNSS and PPP method is capable to provide high-precision estimates, such as 3D positions or Zenith tropospheric delays (ZTDs). ZTDs combined with pressure and temperature information allows us to estimate the water vapor in the atmosphere as precipitable water vapor (PWV). If the process is replicated for a network of GNSS sensors, we can create thematic maps that allow extract water content information in any location within the network area. All of the above are possible thanks to the advances in GNSS data processing. Therefore, we are able to use GNSS data for climatic trend analysis and acquisition of the further knowledge about the atmospheric water content.

Keywords: GNSS, precise point positioning, Zenith tropospheric delays, precipitable water vapor

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Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan

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We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.

Keywords: daily activity recognition, healthcare, IoT sensors, transfer learning

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Authors: Ya-Chu May Tsai, Ibrahim Yacoub, Eoin Casey

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The Australian and New Zealand College of Anaesthetists (ANZCA) advises that smoking should not be permitted within 12 hours of surgery. There is little information in the medical literature regarding patients awareness of perioperative smoking cessation recommendations nor their appreciation of how smoking might negatively impact their perioperative course. The aim of the study is to assess the prevalence of current smokers presenting to Werribee Mercy Hospital (WMH) and to evaluate if pre-operative provision of both written and verbal pre-operative advice was, 1: Effective in improving patient awareness of the benefits of pre-operative smoking cessation, 2: Associated with an increase in the number of elective surgical patients who stop smoking at least 12 hours pre-operatively. Methods: The initial survey included all patients who presented to WMH for elective surgical procedures from 19 – 30 September 2016 using a standardized questionnaire focused on patients’ smoking history and their awareness of smoking cessation preoperatively. The intervention consisted of a standard pre-operative phone call to all patients advising them of the increased perioperative risks associated with smoking, and advised patients to cease 12 hours prior. In addition, written information on smoking cessation strategies were sent out in mail at least 1 week prior to planned procedure date to all patients. Questionnaire-based study after the intervention was conducted on day of elective procedure from 10 – 21 October 2016 inclusive. Primary outcomes measured were patient’s awareness of smoking cessation and proportion of smokers who quit >12 hours, considered a clinically meaning duration to reduce anaesthetics complications. Comparison of pre and post intervention results were made using SPSS 21.0. Results: In the pre-intervention group (n=156), 36 (22.4%) patients were current smokers, 46 were ex-smokers (29.5%) and 74 were non-smokers (48.1%). Of the smokers, 12 (33%) reported having been informed of smoking cessation prior to operation and 8 (22%) were aware of increased intra- and perioperative adverse events associated with smoking. In the post-intervention group n= 177, 38 (21.5%) patients were current smokers, 39 were ex-smokers (22.0%) and 100 were non-smokers (56.5%). Of the smokers, 32 (88.9%) reported having been informed of smoking cessation prior to operation and 35 (97.2%) reported being aware of increased intra- and perioperative adverse events associated with smoking. The median time since last smoke in the pre-intervention group was 5.5 hours (Q1-Q3 = 2-14) compared with 13 hours (Q1-Q3 = 5-24) in post intervention group. Amongst the smokers, smoking cessation at least 12 hours prior to surgery significantly increased from 27.8% pre-intervention to 52.6% post intervention (P=0.03). Conclusion: A standard preoperative phone call and written instruction on smoking cessation guidelines at time of waitlist placement increase preoperative smoking cessation rates by almost 2-fold.

Keywords: anaesthesia, audit, perioperative medicine, smoking cessation

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Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Yuen Shan Ho, Tim Man Ho Li, Andy Choi-Yeung Tse, Cheng-Ta Li, Calvin Pak-Wing Cheng, Roland Beisteiner

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Transcranial pulse stimulation (TPS) is a non-intrusive brain stimulation technology that has been proven effective in older adults with mild neurocognitive disorders and adults with major depressive disorder. Given these robust evidences, TPS might be an adjunct treatment options in neuropsychiatric disorders, for example, autism spectrum disorder (ASD) – which is a common neurodevelopmental disorder in children. This trial aimed to investigate the effects of TPS on right temporoparietal junction, a key node for social cognition for Autism Spectrum Disorder (ASD), and to examine the association between TPS, executive functions and social functions. Design: This trial adopted a two-armed (verum TPS group vs. sham TPS group), double-blinded, randomized, sham-controlled design. Sampling: 32 subjects aged between 12 and 17, diagnosed with ASD were recruited. All subjects were computerized randomized into either verum TPS group or the sham TPS group on a 1:1 ratio. All subjects undertook functional MRI before and after the TPS interventions. Intervention: Six 30-min TPS sessions were administered to subjects in 2 weeks’ time on alternate days assessing neural connectivity changes. Baseline measurements and post-TPS evaluation of the ASD symptoms, executive functions, and social functions were conducted. Participants were followed up at 2-weeks, at 1-month and 3-month, assessing the short-and long-term sustainability of the TPS intervention. Data analysis: Generalized Estimating Equations with repeated measures were used to analyze the group and time difference. Missing data were managed by multiple imputations. The level of significance was set at p < 0.05. To our best knowledge, this is the first study evaluating the efficacy and safety of TPS among adolescents with ASD in Hong Kong and nationwide. Results emerging from this study will develop insight on whether TPS can be used as an adjunct treatment on ASD in neuroscience and clinical psychiatry. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT05408793.

Keywords: adolescents, autism spectrum disorder, neuromodulation, rct, transcranial pulse stimulation

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Authors: Wann-Yun Shieh, Hsin-Yi Kathy Cheng, Yan-Ying Ju, Yu-Chun Yu, Ya-Cheng Shieh

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Adolescents who have intellectual disabilities often demonstrate maladaptive behaviors in their daily activities due to either physical abnormalities or neurological disorders. These adolescents commonly struggle with their cognition and movement coordination when it comes to executing tasks such as throwing or catching objects smoothly, quickly, and gracefully, in contrast to their typically developing peers. Simply measuring movement time and distance doesn't provide a comprehensive view of their performance challenges. In this study, a ball-playing approach was proposed to assess the cognition and movement coordination of adolescents with intellectual disabilities using a smart ball equipped with an embedded inertial sensor. Four distinct ball games were specifically designed for this smart ball: two focusing on lower limb activities (dribbling along a straight line and navigating a zigzag path) and two centered around upper limb tasks (picking up and throwing and catching the ball). The cognition and movement coordination of 25 adolescents with intellectual disabilities (average age 18.36 ± 2.46 years) with that of 25 typically developing adolescents (average age 18.36 ± 0.49 years) were compared in these four tests. The results clearly revealed significant differences in the cognition and movement coordination between the adolescents with intellectual disabilities and the typically developing adolescents. These differences encompassed aspects such as movement speed, hand-eye coordination, and control over objects across all the tests conducted.

Keywords: cognition, intellectual disabilities, movement coordination, smart ball

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Authors: Temesgen Geremew

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ZnS/glass and CdS/glass single layers and ZnS/CdS and CdS/ZnS heterojunction thin films were deposited by the chemical bath deposition method using zinc acetate and cadmium acetate as the metal ion sources and thioacetamide as a nonmetallic ion source in acidic medium. Na2EDTA was used as a complexing agent to control the free cation concentration. +e single layer and heterojunction thin films were characterized with X-ray diffraction (XRD), a scanning electron microscope (SEM), energy dispersive X-ray (EDX), and a UV-VIS spectrometer. +e XRD patterns of the CdS/glass thin film deposited on the soda lime glass substrate crystalized in the cubic structure with a single peak along the (111) plane. +e ZnS/CdS heterojunction and ZnS/glass single layer thin films were crystalized in the hexagonal ZnS structure. +e CdS/ZnS heterojunction thin film is nearly amorphous.The optical analysis results confirmed single band gap values of 2.75 eV and 2.5 eV for ZnS/CdS and CdS/ZnS heterojunction thin films, respectively. +e CdS/glass and CdS/ZnS thin films have more imaginary dielectric components than the real part. The optical conductivity of the single layer and heterojunction films is in the order of 1015 1/s. +e optical study also confirmed refractive index values between 2 and 2.7 for ZnS/glass, ZnS/CdS, and CdS/ZnS thin films for incident photon energies between 1.2 eV and 3.8 eV. +e surface morphology studies revealed compacted spherical grains covering the substrate surfaces with few cracks on ZnS/glass, ZnS/CdS, and CdS/glass and voids on CdS/ZnS thin films. +e EDX result confirmed nearly 1 :1 metallic to nonmetallic ion ratio in the single-layered thin films and the dominance of Zn ion over Cd ion in both ZnS/CdS and CdS/ZnS heterojunction thin films.

Keywords: SERS, sensor, Hg2+, water detection, polythiophene

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Authors: Samantha Meyerholz

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MSKCC offers patients cutting edge cancer care with the highest quality standards. However, many patients and industry members do not realize that the operations of the Immunology Histology Lab (IHC) are the backbone for carrying out this mission. The IHC lab manufactures blocks and slides containing critical tissue samples that will be read by a Pathologist to diagnose and dictate a patient’s treatment course. The lab processes 200 requests daily, leading to the generation of approximately 2,000 slides and 1,100 blocks each day. Lab material is transported through labeling, cutting, staining and sorting manufacturing stations, while being managed by multiple techs throughout the space. The quality of the stain as well as wait times associated with processing requests, is directly associated with patients receiving rapid treatments and having a wider range of care options. This project aims to improve slide request turnaround time for rush and non-rush cases, while increasing the quality of each request filled (no missing slides or poorly stained items). Rush cases are to be filled in less than 24 hours, while standard cases are allotted a 48 hour time period. Reducing turnaround times enable patients to communicate sooner with their clinical team regarding their diagnosis, ultimately leading faster treatments and potentially better outcomes. Additional project goals included streamlining tech and material workflow, while reducing waste and increasing efficiency. This project followed a DMAIC structure with emphasis on lean and ergonomic principles that could be integrated into an evolving lab culture. Load times and batching processes were analyzed using process mapping, FMEA analysis, waste analysis, engineering observation, 5S and spaghetti diagramming. Reduction of lab technician movement as well as their body position at each workstation was of top concern to pathology leadership. With new equipment being brought into the lab to carry out workflow improvements, screen and tool placement was discussed with the techs in focus groups, to reduce variation and increase comfort throughout the workspace. 5S analysis was completed in two phases in the IHC lab, helping to drive solutions that reduced rework and tech motion. The IHC lab plans to continue utilizing these techniques to further reduce the time gap between tissue analysis and cancer care.

Keywords: engineering, ergonomics, healthcare, lean

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Authors: Nurul Aini Abdul Wahab, Nor Syamim Halidin, Sayidatina Aisah Masnan, Nur Izzati Romli

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There are many applications of principle component method for reducing the large set of variables in various fields. Fisher’s Discriminant function is also a popular tool for classification. In this research, the researcher focuses on studying the performance of Principle Component-Fisher’s Discriminant function in helping to classify rice kernels to their defined classes. The data were collected on the smells or odour of the rice kernel using odour-detection sensor, Cyranose. 32 variables were captured by this electronic nose (e-nose). The objective of this research is to measure how well a combination model, between principle component and linear discriminant, to be as a classification model. Principle component method was used to reduce all 32 variables to a smaller and manageable set of components. Then, the reduced components were used to develop the Fisher’s Discriminant function. In this research, there are 4 defined classes of rice kernel which are Aromatic, Brown, Ordinary and Others. Based on the output from principle component method, the 32 variables were reduced to only 2 components. Based on the output of classification table from the discriminant analysis, 40.76% from the total observations were correctly classified into their classes by the PC-Discriminant function. Indirectly, it gives an idea that the classification model developed has committed to more than 50% of misclassifying the observations. As a conclusion, the Fisher’s Discriminant function that was built on a 2-component from PCA (2-PC-D) is not satisfying to classify the rice kernels into its defined classes.

Keywords: classification model, discriminant function, principle component analysis, variable reduction

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Authors: Jason Hoellwarth, Atiya Oomatia, Anuj Chavan, Kevin Tetsworth, Munjed Al Muderis

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Introduction: Percutaneous EndoProsthetic Osseointegration for Limbs (PEPOL) facilitates improved quality of life (QOL) and objective mobility for most amputees discontent with their traditional socket prosthesis (TSP) experience. Some amputees desiring PEPOL have residual bone much shorter than the currently marketed press-fit implant lengths of 14-16 cm, potentially a risk for failure to integrate. We report on the techniques used, complications experienced, the management of those complications, and the overall mobility outcomes of seven patients who had femur distraction osteogenesis (DO) with a Freedom nail followed by PEPOL. Method: Retrospective evaluation of a prospectively maintained database identified nine patients (5 females) who had transfemoral DO in preparation for PEPOL with two years of follow-up after PEPOL. Six patients had traumatic causes of amputation, one had perinatal complications, one was performed to manage necrotizing fasciitis and one was performed as a result of osteosarcoma. Result: The average age at which DO commenced was 39.4±15.9 years, and seven patients had their amputation more than ten years prior (average 25.5±18.8 years). The residual femurs, on average, started at 102.2±39.7 mm and were lengthened 58.1±20.7 mm, 98±45% of the goal (99±161% of the original bone length). Five patients (56%) had a complication requiring additional surgery: four events of inadequate regeneration were managed with continued lengthening to the desired goal followed by autograft placement harvested from contralateral femur reaming; one patient had the cerclage wires break, which required operative replacement. All patients had osseointegration performed at 355±123 days after the initial lengthening nail surgery. One patient had K-level >2 before DO, at a mean of 3.4±0.6 (2.6-4.4) years following osseointegration. Six patients had K-level >2. The 6-Minute Walk Test remained unchanged (267±56 vs. 308 ± 117 meters). Patient self-rating of prosthesis function, problems, and amputee situation did not significantly change from before DO to after osseointegration. Six patients required additional surgery following osseointegration: six to remove fixation plates placed to maintain distraction osteogenesis length at osseointegration; two required irritation and debridement for infection. Conclusion: Extremely short residual femurs, which make TSP use troublesome, can be lengthened with externally controlled telescoping nails and successfully achieve osseointegration. However, it is imperative to counsel patients that additional surgery to address inadequate regeneration or to remove painful hardware used to maintain fixation may be necessary. This may improve the amputee’s expectations before beginning a potentially arduous process.

Keywords: osseointegration, limb lengthening, quality of life, amputation

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Authors: Rohit Semwal, Shivam Arora, Saurav, Sangita Roy

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This work proposes a supervised framework with deep convolutional neural networks (CNNs) for vision-based sign language recognition of static gestures. Our approach addresses the acquisition and segmentation of correct inputs for the CNN-based classifier. Microsoft Kinect™ sensor, despite complex environmental conditions, can track hands efficiently. Skin Colour based segmentation is applied on cropped images of hands in different poses, used to depict different sign language gestures. The segmented hand images are used as an input for our classifier. The CNN classifier proposed in the paper is able to classify the input images with a high degree of accuracy. The system was trained and tested on 39 static sign language gestures, including 26 letters of the alphabet and 13 commonly used words. This paper includes a problem definition for building the proposed system, which acts as a sign language translator between deaf/mute and the rest of the society. It is then followed by a focus on reviewing existing knowledge in the area and work done by other researchers. It also describes the working principles behind different components of CNNs in brief. The architecture and system design specifications of the proposed system are discussed in the subsequent sections of the paper to give the reader a clear picture of the system in terms of the capability required. The design then gives the top-level details of how the proposed system meets the requirements.

Keywords: sign language, CNN, HCI, segmentation

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Authors: Gubiani Rino, Nicola Zucchiatti, Da Broi Ugo, Bietresato Marco

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The problem of vibrations in agriculture is very important due to the different types of machinery used for the different types of soil in which work is carried out. One of the most commonly used machines is the tractor, where the phenomenon has been studied for a long time by measuring the whole body and placing the sensor on the seat. However, this measurement system does not take into account the characteristics of the drivers, such as their body index (BMI), their gender (male, female) or the muscle fatigue they are subjected to, which is highly dependent on their age for example. The aim of the research was therefore to place sensors not only on the seat but along the spinal column to check the transmission of vibration on drivers with different BMI on different tractors and at different travel speeds and of different genders. The test was also done using wearable sensors such as a dynamometer applied to the muscles, the data of which was correlated with the vibrations produced by the tractor. Initial data show that even on new tractors with pneumatic seats, the vibrations attenuate little and are still correlated with the roughness of the track travelled and the forward speed. Another important piece of data are the root-mean square values referred to 8 hours (A(8)x,y,z) and the maximum transient vibration values (MTVVx,y,z) and, the latter, the MTVVz values were problematic (limiting factor in most cases) and always aggravated by the speed. The MTVVx values can be lowered by having a tyre-pressure adjustment system, able to properly adjust the tire pressure according to the specific situation (ground, speed) in which a tractor is operating.

Keywords: fatigue, effect vibration on health, tractor driver vibrations, vibration, muscle skeleton disorders

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Authors: Jianfang Wang, Xianzhe Chen, Zhuoliang Liu, Cheng-An Tao, Yujiao Li

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Organophosphorus (OPs) pesticide used as insecticides are widely used in agricultural pest control, household and storage deworming. The detection of pesticides needs more simple and efficient methods. One of the best ways is to make electrochemical biosensors. In this paper, an electrochemical enzyme biosensor based on acetylcholine esterase (AChE) was constructed, and its sensing properties and sensing mechanisms were studied. Reduced graphene oxide-polydopamine complexes (RGO-PDA), gold nanoparticles (AuNPs) and silver nanoparticles (AgNPs) were prepared firstly and composited with AChE and chitosan (CS), then fixed on the glassy carbon electrode (GCE) surface to construct the biosensor GCE/RGO-PDA-AuNPs-AgNPs-AChE-CS by one-pot method. The results show that graphene oxide (GO) can be reduced by dopamine (DA) and dispersed well in RGO-PDA complexes. And the composites have a synergistic catalysis effect and can improve the surface resistance of GCE. The biosensor selectively can detect acetylcholine (ACh) and OPs pesticide with good linear range and high sensitivity. The performance of the biosensor is affected by the ratio and adding ways of AChE and the adding of AuNPs and AChE. And the biosensor can achieve a detection limit of 2.4 ng/L for methyl parathion and a wide linear detection range of 0.02 ng/L ~ 80 ng/L, and has excellent stability, good anti-interference ability, and excellent preservation performance, indicating that the sensor has practical value.

Keywords: acetylcholine esterase, electrochemical biosensor, nanoparticles, organophosphates, reduced graphene oxide

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Authors: Ankita Wadhawan, Parteek Kumar, Umesh Kumar

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Gesture is any body movement that expresses some attitude or any sentiment. Gestures as a sign language are used by deaf people for conveying messages which helps in eliminating the communication barrier between deaf people and normal persons. Nowadays, everybody is using mobile phone and computer as a very important gadget in their life. But there are some physically challenged people who are blind/deaf and the use of mobile phone or computer like device is very difficult for them. So, there is an immense need of a system which works on body gesture or sign language as input. In this research, Microsoft Kinect Sensor, SDK V2 and Hidden Markov Toolkit (HTK) are used to recognize the object, motion of object and human body joints through Touch less NUI (Natural User Interface) in real-time. The depth data collected from Microsoft Kinect has been used to recognize gestures of Indian Sign Language (ISL). The recorded clips are analyzed using depth, IR and skeletal data at different angles and positions. The proposed system has an average accuracy of 85%. The developed Touch less NUI provides an interface to recognize gestures and controls the cursor and click operation in computer just by waving hand gesture. This research will help deaf people to make use of mobile phones, computers and socialize among other persons in the society.

Keywords: gesture recognition, Indian sign language, Microsoft Kinect, natural user interface, sign language

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Authors: Gurjeet Singh, Rabindra K. Panda

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Soil moisture is a key hydrologic state variable and is intrinsically linked to the Earth's water, climate and carbon cycles. On ecological point of view, the soil moisture is a fundamental natural resource providing the transpirable water for plants. Soil moisture varies both temporally and spatially due to spatiotemporal variation in rainfall, vegetation cover, soil properties and topography. Satellite derived soil moisture provides spatio-temporal extensive data. However, the spatial resolution of a typical satellite (L-band radiometry) is of the order of tens of kilometers, which is not good enough for developing efficient agricultural water management schemes at the field scale. In the present study, the soil moisture from radiometer data has been disaggregated using blending approach to achieve higher resolution soil moisture data. The radiometer estimates of soil moisture at a 40 km resolution have been disaggregated to 10 km, 5 km and 1 km resolutions. The disaggregated soil moisture was compared with the observed data, consisting of continuous sensor based soil moisture profile measurements, at three monitoring sites and extensive spatial near-surface soil moisture measurements, concurrent with satellite monitoring in the 500 km2 study watershed in the Eastern India. The estimated soil moisture status at different spatial scales can help in developing efficient agricultural water management schemes to increase the crop production and water use efficiency.

Keywords: disaggregation, eastern India, radiometers, soil moisture, water use efficiency

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Authors: Mary Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Exposure to violence not only has negative psychological impact on children but is a risk factor for children becoming recurrent victims of violence. However, little is known regarding the degree to which child victims of violence are exposed to trauma at home and in their community, or its association with specific psychological diagnoses. Objective: The aims of this study were to perform in-depth characterizations of family, community and psychological wellness amongst pediatric victims of interpersonal violence. Methods: As standard of care at the Saint Louis Children’s Hospital pediatric emergency department (ED), social workers perform in-depth interviews with all children presenting due to violent interpersonal encounters. In this retrospective cross-sectional study, we collected data from social work interviews on family structure, exposure to violence in the community and the home, as well as history of psychological diagnoses amongst children ages 8-19 years who presented to the ED for injuries related to interpersonal violence from 2014-2017. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed. The average age of studied youths was 14.7 years (SD 2.5). Youths were 97.5% African American ethnicity and 66.6% male. 67.8% described their home having a nonnuclear family structure, 50% of which reported living with a single mother. Of the 21% who reported having incarcerated family members, 56.3% reported their father being incarcerated, 15% reported their mother being incarcerated, and 12.5% reported multiple family members being incarcerated. 11.3% reported witnessing domestic violence in their home. 12.8% of youths reported some form of child abuse. The type of child abuse was not specified in 29.3% of cases, but physical abuse (32.8%) followed by sexual abuse (22.4%) were the most commonly reported. 14.5% had history of placement in foster care and/or adoption. 64% reported having witnessed violence in their community. 30.2% reported having lost friends or family due to violence, and of those, 26.4% reported the loss of a cousin, 18.9% the loss of a friend, 16% the loss of their father, and 12.3% the loss of their brother due to violence. Of the 22.4% youths with psychiatric diagnose(s), 48.4% had multiple diagnoses, the most common of which were ADD/ADHD (62.6%), followed by depression (31.9%), bipolar disorder (27.5%) and anxiety (15.4%). Conclusions: A remarkable proportion of children presenting to EDs due to interpersonal violence have a history of exposure to instability and violence in their homes and communities. Additionally, psychological diagnoses are frequent among pediatric victims of violence. More research is needed to better understand the association between trauma exposure, psychological health and violent victimization amongst children.

Keywords: community violence, emergency department, pediatric interpersonal violence, pediatric trauma, psychological effects of trauma

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Authors: Yan-Shiang Chiou, Yi-Huang Hsueh

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Bacillus cereus is a foodborne pathogen that causes two types of foodborne illness, the emetic and diarrheal syndromes. B. cereus consistently ranks among the top three among bacterial foodborne outbreaks in the ten years of 2001 to 2010 in Taiwan. Foodborne outbreak caused by B. cereus has been increased, and recently it ranks second foodborne pathogen after Vibrio parahaemolyticus. This pathogen is difficult to control due to its ubiquitousness in the environment, the psychrotrophic nature of many strains, and the heat resistance of their spores. Because complete elimination of biofilms is difficult, a better understanding of the molecular mechanisms of biofilm formation by B. cereus will help to develop better strategies to control this pathogen. Surface translocation can be an important factor in biofilm formation. In B. cereus, NprR is a quorum sensor, and its apo NprR is a dimer and changes to a tetramer in the presence of NprX. The small peptide NprX may induce conformational change allowing the apo dimer to switch to an active tetramer specifically recognizing target DNA sequences. Our result showed that mutation of nprRX causes surface spreading deficiency. Mutation of flagella, pili and surfactant genes (flgAB, bcpAB, krsABC), did not abolish spreading motility. Under nprRX mutant, mutation of spo0A restored the spreading deficiency. This suggests that spreading motility is not related surfactant, pili and flagella but other unknown mechanism and Spo0A, a sporulation initiation protein, inhibits spreading motility.

Keywords: Bacillus cereus, nprRX, spo0A, spreading motility

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Authors: Ojin Kwon, Yong-Jin Yoon, Liu Xin, Zhang Hongbao

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Wireless Body Area Network (WBAN) is a short-range wireless communication around human body for various applications such as wearable devices, entertainment, military, and especially medical devices. WBAN attracts the attention of continuous health monitoring system including diagnostic procedure, early detection of abnormal conditions, and prevention of emergency situations. Compared to cellular network, WBAN system is more difficult to control inter- and inner-cell interference due to the limited power, limited calculation capability, mobility of patient, and non-cooperation among WBANs. In this paper, we compare the performance of resource allocation scheme based on several Pseudo Orthogonal Codewords (POCs) to mitigate inter-WBAN interference. Previously, the POCs are widely exploited for a protocol sequence and optical orthogonal code. Each POCs have different properties of auto- and cross-correlation and spectral efficiency according to its construction of POCs. To identify different WBANs, several different pseudo orthogonal patterns based on POCs exploits for resource allocation of WBANs. By simulating these pseudo orthogonal resource allocations of WBANs on MATLAB, we obtain the performance of WBANs according to different POCs and can analyze and evaluate the suitability of POCs for the resource allocation in the WBANs system.

Keywords: wireless body area network, body sensor network, resource allocation without feedback, interference mitigation, pseudo orthogonal pattern

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Authors: Atish Bagchi, Siva Chandrasekaran

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Background: According to World Bank national accounts data, the estimated global manufacturing value-added output in 2020 was 13.74 trillion USD. These manufacturing processes are monitored, modelled, and controlled by advanced, real-time, computer-based systems, e.g., Industrial IoT, PLC, SCADA, etc. These systems measure and manipulate a set of physical variables, e.g., temperature, pressure, etc. Despite the use of IoT, SCADA etc., in manufacturing, studies suggest that unplanned downtime leads to economic losses of approximately 864 billion USD each year. Therefore, real-time, accurate detection, classification and prediction of machine behaviour are needed to minimise financial losses. Although vast literature exists on time-series data processing using machine learning, the challenges faced by the industries that lead to unplanned downtimes are: The current algorithms do not efficiently handle the high-volume streaming data from industrial IoTsensors and were tested on static and simulated datasets. While the existing algorithms can detect significant 'point' outliers, most do not handle contextual outliers (e.g., values within normal range but happening at an unexpected time of day) or subtle changes in machine behaviour. Machines are revamped periodically as part of planned maintenance programmes, which change the assumptions on which original AI models were created and trained. Aim: This research study aims to deliver a Graph Neural Network(GNN)based hybrid forecasting model that interfaces with the real-time machine control systemand can detect, predict machine behaviour and behavioural changes (anomalies) in real-time. This research will help manufacturing industries and utilities, e.g., water, electricity etc., reduce unplanned downtimes and consequential financial losses. Method: The data stored within a process control system, e.g., Industrial-IoT, Data Historian, is generally sampled during data acquisition from the sensor (source) and whenpersistingin the Data Historian to optimise storage and query performance. The sampling may inadvertently discard values that might contain subtle aspects of behavioural changes in machines. This research proposed a hybrid forecasting and classification model which combines the expressive and extrapolation capability of GNN enhanced with the estimates of entropy and spectral changes in the sampled data and additional temporal contexts to reconstruct the likely temporal trajectory of machine behavioural changes. The proposed real-time model belongs to the Deep Learning category of machine learning and interfaces with the sensors directly or through 'Process Data Historian', SCADA etc., to perform forecasting and classification tasks. Results: The model was interfaced with a Data Historianholding time-series data from 4flow sensors within a water treatment plantfor45 days. The recorded sampling interval for a sensor varied from 10 sec to 30 min. Approximately 65% of the available data was used for training the model, 20% for validation, and the rest for testing. The model identified the anomalies within the water treatment plant and predicted the plant's performance. These results were compared with the data reported by the plant SCADA-Historian system and the official data reported by the plant authorities. The model's accuracy was much higher (20%) than that reported by the SCADA-Historian system and matched the validated results declared by the plant auditors. Conclusions: The research demonstrates that a hybrid GNN based approach enhanced with entropy calculation and spectral information can effectively detect and predict a machine's behavioural changes. The model can interface with a plant's 'process control system' in real-time to perform forecasting and classification tasks to aid the asset management engineers to operate their machines more efficiently and reduce unplanned downtimes. A series of trialsare planned for this model in the future in other manufacturing industries.

Keywords: GNN, Entropy, anomaly detection, industrial time-series, AI, IoT, Industry 4.0, Machine Learning

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Authors: Badawia Ibrahim, Iman Hussein, Samar El Sheikh, Fatma Abou Elkasem, Hazem Abo Ismael

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Background: Response of breast carcinoma to neoadjuvant chemotherapy (NAC) varies regarding many factors including hormonal receptor status. Breast cancer is a heterogenous disease with different outcomes, hence a need arises for new markers predicting the outcome of NAC especially for the triple negative group when estrogen, progesterone receptors and Her2/neu are negative. FOXP3 is a promising target with unclear role. Aim: To examine the value of FOXP3 expression in locally advanced triple negative breast cancer tumoral cells as well as tumor infiltrating lymphocytes (TILs) and to elucidate its relation to the extent of NAC response. Material and Methods: Forty five cases of immunohistochemically confirmed to be triple negative breast carcinoma were evaluated for NAC (Doxorubicin, Cyclophosphamide AC x 4 cycles + Paclitaxel x 12 weeks, patients with ejection fraction less than 60% received Taxotere or Cyclophosphamide, Methotrexate, Fluorouracil CMF) response in both tumour and lymph nodes status according to Miller & Payne's and Sataloff's systems. FOXP3 expression in tumor as well as TILs evaluated in the pretherapy biopsies was correlated with NAC response in breast tumor and lymph nodes as well as other clinicopathological factors. Results: Breast tumour cells showed FOXP3 positive cytoplasmic expression in (42%) of cases. High FOXP3 expression percentage was detected in (47%) of cases. High infiltration by FOXP3+TILs was detected in (49%) of cases. Positive FOXP3 expression was associated with negative lymph node metastasis. High FOXP3 expression percentage and high infiltration by FOXP3+TILs were significantly associated with complete therapy response in axillary lymph nodes. High FOXP3 expression in tumour cells was associated with high infiltration by FOXP3+TILs. Conclusion: This result may provide evidence that FOXP3 marker is a good prognostic and predictive marker for triple negative breast cancer (TNBC) indicated for neoadjuvant chemotherapy and can be used for stratifications of TNBC cases indicated for NAC. As well, this study confirmed the fact that the tumour cells and the surrounding microenvironment interact with each other and the tumour microenvironment can influence the treatment outcomes of TNBC.

Keywords: breast cancer, FOXP3 expression, prediction of neoadjuvant chemotherapy effect, triple negative

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Authors: I. S. Gandhi, D. N. Patel, M. Johnson, A. R. Hirsch

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Although distortion of taste perception following a cerebrovascular event may seem to be a frivolous consequence of a classic stroke presentation, altered taste perception places patients at an increased risk for malnutrition, weight loss, and depression, all of which negatively impact the quality of life. Impaired taste perception can result from a wide variety of cerebrovascular lesions to various locations, including pons, insular cortices, and ventral posteromedial nucleus of the thalamus. Wallenberg syndrome, also known as a lateral medullary syndrome, has been described to impact taste; however, specific sweet to bitter taste dysgeusia from a territory infarction is an infrequent event; as such, a case is presented. One year prior to presentation, this 64-year-old right-handed woman, suffered a right posterior inferior cerebellar artery aneurysm rupture with resultant infarction, culminating in a ventriculoperitoneal shunt placement. One and half months after this event, she noticed the gradual onset of lack of ability to taste sweet, to eventually all sweet food tasting bitter. Since the onset of her chemosensory problems, the patient has lost 60-pounds. Upon gustatory testing, the patient's taste threshold showed ageusia to sucrose and hydrochloric acid, while normogeusia to sodium chloride, urea, and phenylthiocarbamide. The gustatory cortex is made in part by the right insular cortex as well as the right anterior operculum, which are primarily involved in the sensory taste modalities. In this model, sweet is localized in the posterior-most along with the rostral aspect of the right insular cortex, notably adjacent to the region responsible for bitter taste. The sweet to bitter dysgeusia in our patient suggests the presence of a lesion in this localization. Although the primary lesion in this patient was located in the right medulla of the brainstem, neurodegeneration in the rostal and posterior-most aspect, of the right insular cortex may have occurred due to diaschisis. Diaschisis has been described as neurophysiological changes that occur in remote regions to a focal brain lesion. Although hydrocephalus and vasospasm due to aneurysmal rupture may explain the distal foci of impairment, the gradual onset of dysgeusia is more indicative of diaschisis. The perception of sweet, now tasting bitter, suggests that in the absence of sweet taste reception, the intrinsic bitter taste of food is now being stimulated rather than sweet. In the evaluation and treatment of taste parageusia secondary to cerebrovascular injury, prophylactic neuroprotective measures may be worthwhile. Further investigation is warranted.

Keywords: diaschisis, dysgeusia, stroke, taste

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Authors: S. Padma, D. H. Tejavathi

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Somatic embryogenesis is a remarkable illustration of the dictum of plant totipotency where developmental reconstruction of somatic cells takes place towards the embryogenic pathway. It recapitulates the morphological and developmental process that occurs in zygotic embryogenesis. S. androgynous commonly called as multivitamin plant. The leaves are consumed as green leafy vegetable by the Southeast Asian communities due to their rich nutritional profile. Despite being a good nutritional vegetable with proteins, vitamins, minerals, amino acids, it is warned for excessive intake due to the presence of alkoloid called papaverine. Papaverine at higher concentrations is toxic and leads to a syndrome called Bronchiolitis Obliterans. In the present study, morphogenetic potential of shoot tip, leaf and nodal explants of Sauropus androgynous was investigated to develop and enhance the reliable plant regeneration protocol via somatic embryogenesis. Somatic embryos were derived directly from the embryogenic callus derived from shoot tip, node and leaf cultures on Phillips and Collins (L2) medium supplemented with NAA at various concentrations ranging from 5.3 µM/l to 26.85 µM/l within two months of inoculation. Thus obtained embryos were sub cultured to modified L2 media supplemented with increased vitamin level for the further growth. Somatic embryos with well-developed cotyledons were transferred to normal and modified L2 basal medium for conversion. The plantlets thus obtained were subjected to brief acclimatization before transferring them to land. About 95% of survival rate was recorded. The augmentation process of culturing various explants through somatic embryogenesis using synthetic medium with various plant growth regulators under controlled conditions have aggrandized the commercial production of Sauropus making it easily available over the conventional propagation methods. In addition, regeneration process through somatic embryogenesis has ameliorated the development of desired character in Sauropus with low papaverine content thereby providing a valuable resource to the food and pharmaceutical industry. Based on this research, plant tissue culture techniques have shown promise for economical and convenient application in Sauropus androgynous breeding.

Keywords: L2 medium, multivitamin plant, NAA, papaverine

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Authors: Zohreh Derikvand

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One new 2D metal-organic coordination polymer of Ni(II) namely [Ni2(ndc)2(DMSO)4(H2O)]n, where ndc = naphthalene-1,4-dicarboxylic acid and DMSO= dimethyl sulfoxide has been synthesized and characterized by elemental analysis, spectral (IR, UV-Vis), thermal (TG/DTG) analysis and single crystal X-ray diffraction. Compound 1 possesses a 2D layer structure constructed from dinuclear nickel(II) building blocks in which two crystallographically independent Ni2+ ions are bridged by ndc2– ligands and water molecule. The ndc2– ligands adopt μ3 bridging modes, linking the metal centers into a two-dimensional coordination framework. The two independent NiII cations are surrounded by dimethyl sulfoxide and naphthalene-1,4-dicarboxylate molecules in distorted octahedron geometry. In the crystal structures of 1 there are non-classical hydrogen bonding arrangements and C-H–π stacking interactions. Electrochemical behavior of [Ni2(ndc)2(DMSO)4(H2O)]n, (Ni-NDA) on the surface of carbon nanotube (CNTs) glassy carbon electrode (GCE) was described. The surface structure and composition of the sensor were characterized by scanning electron microscopy (SEM). Oxidation of fructose on the surface of modified electrode was investigated with cyclic voltammetry and electrochemical impedance spectroscopy (EIS) and the results showed that the Ni-NDA/CNTs film displays excellent electrochemical catalytic activities towards fructose oxidation.

Keywords: naphthalene-1, 4-dicarboxylic acid, crystal structure, coordination polymer, electrocatalysis, impedance spectroscopy

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Authors: Zeyu Zhou, Xiaojun Bi

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Due to the limited environmental parameters and the limited resolution of the sensor, the universal existence of the mixed pixels in the process of remote sensing images restricts the spatial resolution of the remote sensing images. Sub-pixel mapping technology can effectively improve the spatial resolution. As the bilinear interpolation algorithm inevitably produces the edge blur effect, which leads to the inaccurate sub-pixel mapping results. In order to avoid the edge blur effect that affects the sub-pixel mapping results in the interpolation process, this paper presents a new edge-directed interpolation algorithm which uses the covariance adaptive interpolation algorithm on the edge of the low-resolution image and uses bilinear interpolation algorithm in the low-resolution image smooth area. By using the edge-directed interpolation algorithm, the super-resolution of the image with low resolution is obtained, and we get the percentage of each sub-pixel under a certain type of high-resolution image. Then we rely on the probability value as a soft attribute estimate and carry out sub-pixel scale under the ‘hard classification’. Finally, we get the result of sub-pixel mapping. Through the experiment, we compare the algorithm and the bilinear algorithm given in this paper to the results of the sub-pixel mapping method. It is found that the sub-pixel mapping method based on the edge-directed interpolation algorithm has better edge effect and higher mapping accuracy. The results of the paper meet our original intention of the question. At the same time, the method does not require iterative computation and training of samples, making it easier to implement.

Keywords: remote sensing images, sub-pixel mapping, bilinear interpolation, edge-directed interpolation

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Authors: Auday Al-Mayyahi, Phil Birch, William Wang

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A vision system-based navigation for autonomous ground vehicle (AGV) equipped with a single camera in an indoor environment is presented. A proposed navigation algorithm has been utilized to detect obstacles represented by coloured mini- cones placed in different positions inside a corridor. For the recognition of the relative position and orientation of the AGV to the coloured mini cones, the features of the corridor structure are extracted using a single camera vision system. The relative position, the offset distance and steering angle of the AGV from the coloured mini-cones are derived from the simple corridor geometry to obtain a mapped environment in real world coordinates. The corridor is first captured as an image using the single camera. Hence, image processing functions are then performed to identify the existence of the cones within the environment. Using a bounding box surrounding each cone allows to identify the locations of cones in a pixel coordinate system. Thus, by matching the mapped and pixel coordinates using a projection transformation matrix, the real offset distances between the camera and obstacles are obtained. Real time experiments in an indoor environment are carried out with a wheeled AGV in order to demonstrate the validity and the effectiveness of the proposed algorithm.

Keywords: autonomous ground vehicle, navigation, obstacle avoidance, vision system, single camera, image processing, ultrasonic sensor

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Authors: Xinwen Zhu, Xingguang Li, Sun Yi

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Crack is one of the most common damages in buildings, bridges, roads and so on, which may pose safety hazards. However, cracks frequently happen in structures of various materials. Traditional methods of manual detection and measurement, which are known as subjective, time-consuming, and labor-intensive, are gradually unable to meet the needs of modern development. In addition, crack detection and measurement need be safe considering space limitations and danger. Intelligent crack detection has become necessary research. In this paper, an efficient method for crack detection and quantification using a 3D sensor, LiDAR, and depth camera is proposed. This method works even in a dark environment, which is usual in real-world applications. The LiDAR rapidly spins to scan the surrounding environment and discover cracks through lasers thousands of times per second, providing a rich, 3D point cloud in real-time. The LiDAR provides quite accurate depth information. The precision of the distance of each point can be determined within around  ±3 cm accuracy, and not only it is good for getting a precise distance, but it also allows us to see far of over 100m going with the top range models. But the accuracy is still large for some high precision structures of material. To make the depth of crack is much more accurate, the depth camera is in need. The cracks are scanned by the depth camera at the same time. Finally, all data from LiDAR and Depth cameras are analyzed, and the size of the cracks can be quantified successfully. The comparison shows that the minimum and mean absolute percentage error between measured and calculated width are about 2.22% and 6.27%, respectively. The experiments and results are presented in this paper.

Keywords: LiDAR, depth camera, real-time, detection and measurement

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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