Search results for: Eric McConnel

Authors: Samira Mehrabi

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Geriatric depression is a common late-life mental health disorder that increases morbidity and mortality. It has been shown that exercise is effective in alleviating symptoms of geriatric depression. However, inconsistencies across studies and lack of optimal dose-response of exercise for improving geriatric depression have made it challenging to draw solid conclusions on the effectiveness of exercise in late-life depression. Purpose: To further investigate the moderators of the effectiveness of exercise on geriatric depression across the current body of evidence. Methods: Based on the Arksey and O’Malley framework, an extensive search strategy was performed by exploring PubMed, Scopus, Sport Discus, PsycInfo, ERIC, and IBSS without limitations in the time frame. Eight systematic reviews with empirical results that evaluated the effect of exercise on depression among people aged ≥ 60 years were identified and their individual studies were screened for inclusion. One additional study was found through the hand searching of reference lists. After full-text screening and applying inclusion and exclusion criteria, 21 studies were retained for inclusion. Results: The review revealed high variability in characteristics of the exercise interventions and outcome measures. Sample characteristics, nature of comparators, main outcome assessment, and baseline severity of depression also varied notably. Mind-body and aerobic exercises were found to significantly reduce geriatric depression. However, results on the relationship between resistance training and improvements in geriatric depression were inconsistent, and results of the intensity-related antidepressant effects of exercise interventions were mixed. Extensive use of self-reported questionnaires for the main outcome assessment and lack of evidence on the relationship between depression severity and observed effects were of the other important highlights of the review. Conclusion: Several literature gaps were found regarding the potential effect modifiers of exercise and geriatric depression. While acknowledging the complexity of establishing recommendations on the exercise variables and geriatric depression, future studies are required to understand the interplay and threshold effect of exercise for treating geriatric depression.

Keywords: exercise, geriatric depression, healthy aging, older adults, physical activity intervention, scoping review

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Authors: Emilienne Lardy, Eric Ballot, Mariam Lafkihi

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Efficient urban logistics requires a comprehensive understanding of traffic dynamics, particularly as it pertains to kinetic parameters influencing energy consumption and trip duration estimations. While real-time traffic information is increasingly accessible, current high-precision forecasting services embedded in route planning often function as opaque 'black boxes' for users. These services, typically relying on AI-processed counting data, fall short in accommodating open design parameters essential for management studies, notably within Supply Chain Management. This work revisits the modelling of traffic conditions in the context of city logistics, emphasizing its significance from the user’s point of view, with two focuses. Firstly, the focus is not on the vehicle flow but on the vehicles themselves and the impact of the traffic conditions on their driving behaviour. This means opening the range of studied indicators beyond vehicle speed, to describe extensively the kinetic and dynamic aspects of the driving behaviour. To achieve this, we leverage the Art. Kinema parameters are designed to characterize driving cycles. Secondly, this study examines how the driving context (i.e., exogenous factors to the traffic flow) determines the mentioned driving behaviour. Specifically, we explore how accurately the kinetic behaviour of a vehicle can be predicted based on a limited set of exogenous factors, such as time, day, road type, orientation, slope, and weather conditions. To answer this question, statistical analysis was conducted on real-world driving data, which includes high-frequency measurements of vehicle speed. A Factor Analysis and a Generalized Linear Model have been established to link kinetic parameters with independent categorical contextual variables. The results include an assessment of the adjustment quality and the robustness of the models, as well as an overview of the model’s outputs.

Keywords: factor analysis, generalised linear model, real world driving data, traffic congestion, urban logistics, vehicle kinematics

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Authors: Janet Modu, Jean-Francois Georgin, Laurent Briancon, Eric Antoinet

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The current practice during the repowering phase of wind turbines is deconstruction of existing foundations and construction of new foundations to accept larger wind loads or once the foundations have reached the end of their service lives. The ongoing research project FUI25 FEDRE (Fondations d’Eoliennes Durables et REpowering) therefore serves to propose scalable wind turbine foundation designs to allow reuse of the existing foundations. To undertake this research, numerical models and laboratory-scale models are currently being utilized and implemented in the GEOMAS laboratory at INSA Lyon following instrumentation of a reference wind turbine situated in the Northern part of France. Sensors placed within both the foundation and the underlying soil monitor the evolution of stresses from the foundation’s early age to stresses during service. The results from the instrumentation form the basis of validation for both the laboratory and numerical works conducted throughout the project duration. The study currently focuses on the effect of coupled mechanisms (Thermal-Hydro-Mechanical-Chemical) that induce stress during the early age of the reinforced concrete foundation, and scale factor considerations in the replication of the reference wind turbine foundation at laboratory-scale. Using THMC 3D models on COMSOL Multi-physics software, the numerical analysis performed on both the laboratory-scale and the full-scale foundations simulate the thermal deformation, hydration, shrinkage (desiccation and autogenous) and creep so as to predict the initial damage caused by internal processes during concrete setting and hardening. Results show a prominent effect of early age properties on the damage potential in full-scale wind turbine foundations. However, a prediction of the damage potential at laboratory scale shows significant differences in early age stresses in comparison to the full-scale model depending on the spatial position in the foundation. In addition to the well-known size effect phenomenon, these differences may contribute to inaccuracies encountered when predicting ultimate deformations of the on-site foundation using laboratory scale models.

Keywords: cement hydration, early age behavior, reinforced concrete, shrinkage, THMC 3D models, wind turbines

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Authors: Mariia Timofeeva, Andrew Ooi, Eric K. W. Poon, Peter Barlis

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Atherosclerotic plaque build-up, commonly known as stenosis, limits blood flow and hence oxygen and nutrient supplies to the heart muscle. Thus, assessment of its severity is of great interest to health professionals. Numerical simulation of the fractional flow reserve (FFR) has proved to be well correlated with invasively measured FFR used for physiological assessment of the severity of coronary stenosis in arteries. Atherosclerosis may impact the diseased artery in several locations causing serial stenoses, which is a complicated subset of coronary artery disease that requires careful treatment planning. However, hemodynamic of the serial sequential stenoses in coronary arteries has not been extensively studied. The hemodynamics of the serial stenoses is complex because the stenoses in the series interact and affect the flow through each other. To address this, serial stenoses in a 3.4 mm left anterior descending (LAD) artery are examined in this study. Two diameter stenoses (DS) are considered, 30 and 50 percent of the reference diameter. Serial stenoses configurations are divided into three groups based on the order of the stenoses in the series, spacing between them, and deviation of the stenoses’ symmetry (eccentricity). A patient-specific pulsatile waveform is used in the simulations. Blood flow within the stenotic artery is assumed to be laminar, Newtonian, and incompressible. Results for the FFR are reported. Based on the simulation results, it can be deduced that the larger drop in pressure (smaller value of the FFR) is expected when the percentage of the second stenosis in the series is bigger. Varying the distance between the stenoses affects the location of the maximum drop in the pressure, while the minimal FFR in the artery remains unchanged. Eccentric serial stenoses are characterized by a noticeably larger decrease in pressure through the stenoses and by the development of the chaotic flow downstream of the stenoses. The largest drop in the pressure (about 4% difference compared to the axisymmetric case) is obtained for the serial stenoses, where both the stenoses are highly eccentric with the centerlines deflected to the different sides of the LAD. In conclusion, varying configuration of the sequential serial stenoses results in a different distribution of FFR through the LAD. Results presented in this study provide insight into the clinical assessment of the severity of the coronary serial stenoses, which is proved to depend on the relative position of the stenoses and the deviation of the stenoses’ symmetry.

Keywords: computational fluid dynamics, coronary artery, fractional flow reserve, serial stenoses

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Authors: Ludivine Gueho, Sylvain Fleury, Eric Jamet

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Driver distraction is known to be a major contributing factor of car accidents. Since many years, constructors have been designing embedded technologies to face this problem and reduce distraction. Being able to predict user acceptance would further be helpful in the development process to build appropriate systems. The present research aims at modelling the acceptability of a specific system, an innovative personalized and contextualized embedded radio, through an online survey of 202 people in France that assessed the psychological variables determining intentions to use the system. The questionnaire instantiated the dimensions of the extended version of the UTAUT acceptability model. Because of the specific features of the system assessed, we added 4 dimensions: perceived security, anxiety, trust and privacy concerns. Results showed that hedonic motivation, i.e., the fun or pleasure derived from using a technology, and performance expectancy, i.e., the degree to which individuals believe that the characteristics of the system meet their needs, are the most important dimensions in determining behavioral intentions about the innovative radio. To a lesser extent, social influence, i.e., the degree to which individuals think they can use the system while respecting their social group’s norms and while giving a positive image of themselves, had an effect on behavioral intentions. Moreover, trust, that is, the positive belief about the perceived reliability of, dependability of, and confidence in a person, object or process, had a significant effect, mediated by performance expectancy. In an applicative way, the present research reveals that, to be accepted, in-car embedded new technology has to address individual needs, for instance by facilitating the driving activity or by providing useful information. If it shows hedonic qualities by being entertaining, pretty or comfortable, this may improve the intentions to use it. Therefore, it is clearly important to include reflection about user experience in the design process. Finally, the users have to be reassured on the system’s reliability. For example, improving the transparency of the system by providing information about the system functioning, could improve trust. These results bring some highlights on determinant of acceptance of an in-vehicle technology and are useful for constructors to design acceptable systems.

Keywords: acceptability, innovative embedded radio, structural equation, user-centric evaluation, UTAUT

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Authors: Paul Essel, Eric T. Glover, Gustav Gbeddy, Yaw Adjei-Kyereme, Abdallah M. A. Dawood, Evans M. Ameho, Emmanuel A. Aberikae

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Radioactive materials mainly in the form of Sealed Radioactive Sources are being used in various sectors (medicine, agriculture, industry, research, and teaching) for the socio-economic development of Ghana. The use of these beneficial radioactive materials has resulted in an inventory of Disused Sealed Radioactive Sources (DSRS) in storage. Most of the DSRS are legacy/historic sources which cannot be returned to their manufacturer or country of origin. Though small in volume, DSRS can be intensively radioactive and create a significant safety and security liability. They need to be managed in a safe and secure manner in accordance with the fundamental safety objective. The Radioactive Waste Management Center (RWMC) of the Ghana Atomic Energy Commission (GAEC) is currently storing a significant volume of DSRS. The initial activities of the DSRS range from 7.4E+5 Bq to 6.85E+14 Bq. If not managed properly, such DSRS can represent a potential hazard to human health and the environment. Storage is an important interim step, especially for DSRS containing very short-lived radionuclides, which can decay to exemption levels within a few years. Long-term storage, however, is considered an unsustainable option for DSRS with long half-lives hence the need for a disposal facility. The GAEC intends to use the International Atomic Energy Agency’s (IAEA’s) Borehole Disposal System (BDS) to provide a safe, secure, and cost-effective disposal option to dispose of its DSRS in storage. The proposed site for implementation of the BDS is on the GAEC premises at Kwabenya. The site has been characterized to gain a general understanding in terms of its regional setting, its past evolution and likely future natural evolution over the assessment time frame. Due to the long half-lives of some of the radionuclides to be disposed of (Ra-226 with half-life of 1600 years), the engineered barriers of the system must be robust to contain these radionuclides for this long period before they decay to harmless levels. There is the need to assess the safety related functions of the engineered barriers of this disposal system.

Keywords: radionuclides, disposal, radioactive waste, engineered barrier

Procedia PDF Downloads 82

Authors: Marizia Roberta Rasoanandrasana, Hery Lisy Tiana. Ranarijaona, Herintsitohaina Razakamanarivo, Eric Delaitre, Nandrianina Ramifehiarivo

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Madagascar is one of the producer’s countries of world's fine cocoa. Cocoa-based agroforestry systems (CBAS) plays a very important economic role for over 75% of the population in the north of Madagascar, the island's main cocoa-producing area. It is also viewed as a key factor in the deforestation of local protected areas. It is therefore urgent to establish a compromise between cocoa production and forest conservation in this region which is difficult due to a lack of accurate cocoa agro-systems data. In order to fill these gaps and to response to these socio-economic and environmental concerns, this study aims to describe CBAS by providing precise data on their characteristics and to establish a typology. To achieve this, 150 farms were surveyed and observed to characterize CBAS based on 11 agronomic and 6 socio-economic data. Also, 30 representative plots of CBAS among the 150 farms were inventoried for providing accurate ecological data (6 variables) as an additional data for the typology determination. The results showed that Madagascar’s CBAS systems are generally extensive and practiced by smallholders. Four types of cocoa-based agroforestry system were identified, with significant differences between the following variables: yield, planting age, cocoa density, density of associated trees, preceding crop, associated crops, Shannon-Wiener indices and species richness in the upper stratum. Type 1 is characterized by old systems (>45 years) with low crop density (425 cocoa trees/ha), installed after conversion of crops other than coffee (> 50%) and giving low yields (427 kg/ha/year). Type 2 consists of simple agroforestry systems (no associated crop 0%), fairly young (20 years) with low density of associated trees (77 trees/ha) and low species diversity (H'=1.17). Type 3 is characterized by high crop density (778 trees/ha and 175 trees/ha for cocoa and associated trees respectively) and a medium level of species diversity (H'=1.74, 8 species). Type 4 is particularly characterized by orchard regeneration method involving replanting and tree lopping (100%). Analysis of the potential of these four types has identified Type 4 as a promising practice for sustainable agriculture.

Keywords: conservation, practices, productivity, protect areas, smallholder, trade-off, typology

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Authors: Namasivayam Navaranjan, Eric Dimla

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The world needs more quality food, shelter and transportation to meet the demands of growing population and improving living standard of those who currently live below the poverty line. Materials are essential commodities for various applications including food and pharmaceutical packaging, building and automobile. Petroleum based plastics are widely used materials amongst others for these applications and their demand is expected to increase. Use of plastics has environment related issues because considerable amount of plastic used worldwide is disposed in landfills, where its resources are wasted, the material takes up valuable space and blights communities. Some countries have been implementing regulations and/or legislations to increase reuse, recycle, renew and remanufacture materials as well as to minimise the use of non-environmentally friendly materials such as petroleum plastics. However, issue of material waste is still a concern in the countries who have low environmental regulations. Development of materials, mostly bioplastics from renewable biomass resources has become popular in the last decade. It is widely believed that the potential for up to 90% substitution of total plastics consumption by bioplastics is technically possible. The global demand for bioplastics is estimated to be approximately six times larger than in 2010. Recently, standard polymers like polyethylene (PE), polypropylene (PP), Polyvinyl Chloride (PVC) or Polyethylene terephthalate (PET), but also high-performance polymers such as polyamides or polyesters have been totally or partially substituted by their renewable equivalents. An example is Polylactide (PLA) being used as a substitute in films and injection moulded products made of petroleum plastics, e.g. PET. The starting raw materials for bio-based materials are usually sugars or starches that are mostly derived from food resources, partially also recycled materials from food or wood processing. The risk in lower food availability by increasing price of basic grains as a result of competition with biomass-based product sectors for feedstock also needs to be considered for the future bioplastic production. Manufacturing of bioplastic materials is often still reliant upon petroleum as an energy and materials source. Life Cycle Assessment (LCA) of bioplastic products has being conducted to determine the sustainability of a production route. However, the accuracy of LCA depends on several factors and needs improvement. Low oil price and high production cost may also limit the technically possible growth of these plastics in the coming years.

Keywords: bioplastics, plastics, renewable resources, biomass

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Authors: Rapuane Eric Jan Pule

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Sport participation plays a significant role in learners’ well-being and lifestyle. Learners spend most of their time in the school environment, where they are monitored, guided and advised by teachers. Teachers have a good relationship with the learners, therefore they can play a major role in promoting and influencing learners to participate in physical activities, both competitive and recreational purposes. Their influence and involvement could assist in increasing the number learners' involvement in physical activities, sport and recreation at Township schools. The national sport and recreation plan in South Africa, recommends that promotion of sport and physical activities at primary and secondary schools should play an important role in helping learners commit to a live-long participation in sport, recreational and physical activities. Schoolteachers could play an influential role in ensuring that learners spent their leisure time productively through physical and recreational activities. However, the role and the influence of teachers in promoting physical and recreational activities have been previously overlooked in the literature. Part of this study focuses on the in-depth challenges encountered by primary and secondary school teachers at Township schools in promoting and influencing learners’ involvement in sport, recreation and physical activities. 109 primary and secondary teachers at Township schools agreed to participate in the study through the provision of informed consent. The participants consisted of 49 primary school teachers and 60 secondary school teachers. Quantitative approach was followed using validated structured questionnaire comprising 12 close-ended items were used. Findings indicated that teachers' can play a significant role in influencing and encouraging learners to participate in sport, recreation or physical activities. Teachers view physical activity as an important developmental component for learners. Primary school teachers believe that they have a significant role to play in encouraging and promoting physical activities, sport and recreation, as compared to the secondary school teachers. Both group of teachers at primary and secondary schools, believe that infrastructure development, financial support, and extra incentives could motivate them to promote physical, recreational and sporting activities at schools. Teachers also acknowledge that schools are facing challenges in implementing and coordinating physical activities and recreational programmes as required by the Department of sport and recreation South Africa. It is recommended that the Department of Basic Education and Sport and Recreation South Africa revise their policies regarding the role of teachers in promoting and administering physical and recreational activities at schools.

Keywords: township, physical activities, sport and recreation participation, learners, teachers, primary and secondary schools, physical education

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Authors: Deborah Eric, Abbas Ahmad Khan

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Lead halide perovskites quantum dots have attracted immense scientific and technological interest for successful photovoltaic applications because of their remarkable optoelectronic properties. In this paper, we have simulated CsMAPbI3-xBrx based quantum dots to implement their use in intermediate band solar cells (IBSC). These types of materials exhibit optical and electrical properties distinct from their bulk counterparts due to quantum confinement. The conceptual framework provides a route to analyze the electronic properties of quantum dots. This layer of quantum dots optimizes the position and bandwidth of IB that lies in the forbidden region of the conventional bandgap. A three-dimensional MAPbI3 quantum dot (QD) with geometries including spherical, cubic, and conical has been embedded in the CsPbBr3 matrix. Bound energy wavefunction gives rise to miniband, which results in the formation of IB. If there is more than one miniband, then there is a possibility of having more than one IB. The optimization of QD size results in more IBs in the forbidden region. One band time-independent Schrödinger equation using the effective mass approximation with step potential barrier is solved to compute the electronic states. Envelope function approximation with BenDaniel-Duke boundary condition is used in combination with the Schrödinger equation for the calculation of eigen energies and Eigen energies are solved for the quasi-bound states using an eigenvalue study. The transfer matrix method is used to study the quantum tunneling of MAPbI3 QD through neighbor barriers of CsPbI3. Electronic states are computed using Schrödinger equation with effective mass approximation by considering quantum dot and wetting layer assembly. Results have shown the varying the quantum dot size affects the energy pinning of QD. Changes in the ground, first, second state energies have been observed. The QD is non-zero at the center and decays exponentially to zero at boundaries. Quasi-bound states are characterized by envelope functions. It has been observed that conical quantum dots have maximum ground state energy at a small radius. Increasing the wetting layer thickness exhibits energy signatures similar to bulk material for each QD size.

Keywords: perovskite, intermediate bandgap, quantum dots, miniband formation

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Authors: Divyansh Goel, Varun Jain

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Classical economics works on the principle that people are rational and analytical in their decision making and their choices fall in line with the most suitable option according to the dominant strategy in a standard game theory model. This model has failed at many occasions in estimating the behavior and dealings of rational people, giving proof of some other underlying heuristics and cognitive biases at work. This paper probes into the study of these factors, which fall under the umbrella of behavioral economics and through their medium explore the solution to a problem which a lot of nations presently face. There has long been a wide disparity in the number of people holding favorable views on organ donation and the actual number of people signing up for the same. This paper, in its entirety, is an attempt to shape the public policy which leads to an increase the number of organ donations that take place and close the gap in the statistics of the people who believe in signing up for organ donation and the ones who actually do. The key assumption here is that in cases of cognitive dissonance, where people have an inconsistency due to conflicting views, people have a tendency to go with the default choice. This tendency is a well-documented cognitive bias known as the status quo bias. The research in this project involves an assay of mandated choice models of organ donation with two case studies. The first of an opt-in system of Germany (where people have to explicitly sign up for organ donation) and the second of an opt-out system of Austria (every citizen at the time of their birth is an organ donor and has to explicitly sign up for refusal). Additionally, there has also been presented a detailed analysis of the experiment performed by Eric J. Johnson and Daniel G. Goldstein. Their research as well as many other independent experiments such as that by Tsvetelina Yordanova of the University of Sofia, both of which yield similar results. The conclusion being that the general population has by and large no rigid stand on organ donation and are gullible to status quo bias, which in turn can determine whether a large majority of people will consent to organ donation or not. Thus, in our paper, we throw light on how governments can use status quo bias to drive positive social change by making policies in which everyone by default is marked an organ donor, which will, in turn, save the lives of people who succumb on organ transplantation waitlists and save the economy countless hours of economic productivity.

Keywords: behavioral economics, game theory, organ donation, status quo bias

Procedia PDF Downloads 300

Authors: A. Rezazadeh, B Damari, S. Riazi-Esfahani, M. Hajian

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The consumption of junk food in Iran is alarmingly increasing. This study aimed to investigate the influencing factors of junk food consumption and amendable interventions that are criticized and approved by stakeholders, in order to presented to health policy makers. The articles and documents related to the content of study were collected by using the appropriate key words such as junk food, carbonated beverage, chocolate, candy, sweets, industrial fruit juices, potato chips, French fries, puffed corn, cakes, biscuits, sandwiches, prepared foods and popsicles, ice cream, bar, chewing gum, pastilles and snack, in scholar.google.com, pubmed.com, eric.ed.gov, cochrane.org, magiran.com, medlib.ir, irandoc.ac.ir, who.int, iranmedex.com, sid.ir, pubmed.org and sciencedirect.com databases. The main key points were extracted and included in a checklist and qualitatively analyzed. Then a summarized abstract was prepared in a format of a questionnaire to be presented to stakeholders. The design of this was qualitative (Delphi). According to this method, a questionnaire was prepared based on reviewing the articles and documents and it was emailed to stakeholders, who were asked to prioritize and choose the main problems and effective interventions. After three rounds, consensus was obtained.            Studies revealed high consumption of junk foods in the Iranian population, especially in children and adolescents. The most important affecting factors include availability, low price, media advertisements, preference of fast foods taste, the variety of the packages and their attractiveness, low awareness and changing in lifestyle. Main interventions recommended by stakeholders include developing a protective environment, educational interventions, increasing healthy food access and controlling media advertisements and putting pressure from the Industry and Mining Ministry on producers to produce healthy snacks. According to the findings, the results of this study may be proposed to public health policymakers as an advocacy paper and to be integrated in the interventional programs of Health and Education ministries and the media. Also, implementation of supportive meetings with the producers of alternative healthy products is suggested.

Keywords: junk foods, situation, qualitative study, Iran

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Authors: Anne Lemnitzer, Eric Tavarez

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The academic rigor of the geotechnical engineering curriculum indicates strong institutional and geographical variations. Geotechnical engineering deals with the most challenging civil engineering material, as opposed to structural engineering, environmental studies, transportation engineering, and water resources. Yet, technical expectations posed by the practicing professional community do not necessarily consider the challenges inherent to the disparity in academic rigor and disciplinary differences. To recognize the skill shortages among current graduates as well as identify opportunities to better equip graduate students in specific fields of geotechnical engineering, a two-part survey was developed in collaboration with the Earth Retaining Structures (ERS) Committee of the American Society of Civil Engineers. Earth Retaining Structures are critical components of infrastructure systems and integral components to many major engineering projects. Within the geotechnical curriculum, Earth Retaining Structures is either taught as a separate course or major subject within a foundation design class. Part 1 of the survey investigated the breadth and depth of the curriculum with respect to ERS by requesting faculty across the United States to provide data on their curricular content, integration of practice-oriented course content, student preparation for professional licensing, and level of technical competency expected upon student graduation. Part 2 of the survey enables a comparison of training provided versus training needed. This second survey addressed practicing geotechnical engineers in all sectors of the profession (e.g., private engineering consulting, governmental agencies, contractors, suppliers/manufacturers) and collected data on the expectations with respect to technical and non-technical skills of engineering graduates entering the professional workforce. Results identified skill shortages in soft skills, critical thinking, analytical and language skills, familiarity with design codes and standards, and communication with various stakeholders. The data will be used to develop educational tools to advance the proficiency and expertise of geotechnical engineering students to meet and exceed the expectations of the profession and to stimulate a lifelong interest in advancing the field of geotechnical engineering.

Keywords: geotechnical engineering, academic training, industry requirements, earth retaining structures

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Authors: Florent Cerdan, Anne-Gaëlle Denay, Annette Roy, Jean-Claude Grandidier, Éric Laine

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The insulation of MarkIII membrane of the Liquid Natural Gas Carriers (LNGC) consists of a load- bearing system made of panels in reinforced polyurethane foam (R-PUF). During the shipping, the cargo containment shall be potentially subject to risk events which can be water leakage through the wall ballast tank. The aim of these present works is to further develop understanding of water transfer mechanisms and water effect on properties of R-PUF. This multi-scale approach contributes to improve the durability. Macroscale / Mesoscale Firstly, the use of the gravimetric technique has allowed to define, at room temperature, the water transfer mechanisms and kinetic diffusion, in the R-PUF. The solubility follows a first kinetic fast growing connected to the water absorption by the micro-porosity, and then evolves linearly slowly, this second stage is connected to molecular diffusion and dissolution of water in the dense membranes polyurethane. Secondly, in the purpose of improving the understanding of the transfer mechanism, the study of the evolution of the buoyant force has been established. It allowed to identify the effect of the balance of total and partial pressure of mixture gas contained in pores surface. Mesoscale / Microscale The differential scanning calorimetry (DSC) and Dynamical Mechanical Analysis (DMA), have been used to investigate the hydration of the hard and soft segments of the polyurethane matrix. The purpose was to identify the sensitivity of these two phases. It been shown that the glass transition temperatures shifts towards the low temperatures when the solubility of the water increases. These observations permit to conclude to a plasticization of the polymer matrix. Microscale The Fourier Transform Infrared (FTIR) study has been used to investigate the characterization of functional groups on the edge, the center and mid-way of the sample according the duration of submersion. More water there is in the material, more the water fix themselves on the urethanes groups and more specifically on amide groups. The pic of C=O urethane shifts at lower frequencies quickly before 24 hours of submersion then grows slowly. The intensity of the pic decreases more flatly after that.

Keywords: porous materials, water sorption, glass transition temperature, DSC, DMA, FTIR, transfer mechanisms

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Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

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Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

Procedia PDF Downloads 342

Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

Procedia PDF Downloads 123

Authors: Alexandra Emmanuelle Membangbi, Jacky Njiki Bikoï, Esther Del-florence Moni Ndedi, Marie Joseph Nkodo Mindimi, Donatien Serge Mbaga, Elsa Nguiffo Makue, André Chris Mikangue Mbongue, Martha Mesembe, George Ikomey Mondinde, Eric Walter Perfura-yone, Sara Honorine Riwom Essama

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Background: Tuberculosis (TB) is one of the top lethal infectious diseases worldwide. In recent years, interferon-γ (INF-γ) release assays (IGRAs) have been established as routine tests for diagnosing TB infection. However, produced INF-γ assessment failed to distinguish active TB (ATB) from latent TB infection (LTBI), especially in TB epidemic areas. In addition to IFN-γ, interleukin-2 (IL-2), another cytokine secreted by activated T cells, is also involved in immune response against Mycobacterium tuberculosis. The aim of the study was to assess the capacity of IFN-γ and IL2 to evaluate the therapeutic response of patients on anti-tuberculosis treatment. Material and Methods: We conducted a cross-sectional study in the Pneumonology Departments of the Jamot Hospital in Yaoundé between May and August 2021. After signed the informed consent, the sociodemographic data, as well as 5 mL of blood, were collected in the crook of the elbow of each participant. Sixty-one subjects were selected (n= 61) and divided into 4 groups as followed: group 1: resistant tuberculosis (n=13), group 2: active tuberculosis (n=19), group 3 cured tuberculosis (n=16), and group 4: presumed healthy persons (n=13). The cytokines of interest were determined using an indirect Enzyme-linked Immuno-Sorbent Assay (ELISA) according to the manufacturer's recommendations. P-values < 0.05 were interpreted as statistically significant. All statistical calculations were performed using SPSS version 22.0 Results: The results showed that men were more 14/61 infected (31,8%) with a high presence in active and resistant TB groups. The mean age was 41.3±13.1 years with a 95% CI = [38.2-44.7], the age group with the highest infection rate was ranged between 31 and 40 years. The IL-2 and INF-γ means were respectively 327.6±160.6 pg/mL and 26.6±13.0 pg/mL in active tuberculosis patients, 251.1±30.9 pg/mL and 21.4±9.2 pg/mL in patients with resistant tuberculosis, while it was 149.3±93.3 pg/mL and 17.9±9.4 pg/mL in cured patients, 15.1±8.4 pg/mL and 5.3±2.6 pg/mL in participants presumed healthy (p <0.0001). Significant differences in IFN-γ and IL-2 rates were observed between the different groups. Conclusion: Monitoring the serum levels of INF-γ and IL-2 would be useful to evaluate the therapeutic response of anti-tuberculosis patients, particularly in the both cytokines association case, that could improve the accuracy of routine examinations.

Keywords: antibiotic therapy, interferon gamma, interleukin 2, tuberculosis

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Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

Abstract:

Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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Authors: Eric Bates

Abstract:

Higher education is recognised as being of critical importance in Ireland and has been linked as a vital factor to national well-being. Statistics show that Ireland has one of the highest rates of higher education participation in Europe. However, student retention and progression, especially in Institutes of Technology, is becoming an issue as rates on non-completion rise. Both within Ireland and across Europe student retention is seen as a key performance indicator for higher education and with these increasing rates the Irish higher education system needs to be flexible and adapt to the situation it now faces. The author is a Programme Chair on a Level 6 full time undergraduate programme and experience to date has shown that the first year undergraduate students take some time to identify themselves as a group within the setting of a higher education institute. Despite being part of a distinct class on a specific programme some individuals can feel isolated as he or she take the first step into higher education. Such feelings can contribute to students eventually dropping out. This paper reports on an ongoing initiative that aims to accelerate the bonding experience of a distinct group of first year undergraduates on a programme which has a high rate of non-completion. This research sought to engage the students in dynamic interactions with their peers to quickly evolve a group sense of coherence. Two separate modules – a Research Module and a Communications module - delivered by the researcher were linked across two semesters. Students were allocated into random groups and each group was given a topic to be researched. There were six topics – essentially the six sub-headings on the DIT Graduate Attribute Statement. The research took place in a computer lab and students also used the library. The output from this was a document that formed part of the submission for the Research Module. In the second semester the groups then had to make a presentation of their findings where each student spoke for a minimum amount of time. Presentation workshops formed part of that module and students were given the opportunity to practice their presentation skills. These presentations were video recorded to enable feedback to be given. Although this was a small scale study preliminary results found a strong sense of coherence among this particular cohort and feedback from the students was very positive. Other findings indicate that spreading the initiative across two semesters may have been an inhibitor. Future challenges include spreading such Initiatives College wide and indeed sector wide.

Keywords: first year experience, student retention, group work, presentation workshops

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Authors: Eric Granholm, Christophe Delay, Jason Holden, Peter Link

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Negative symptoms are an important unmet treatment needed for schizophrenia. We conducted an open trial of a novel blended intervention called mobile-assisted cognitive behavior therapy for negative symptoms (mCBTn). mCBTn is a weekly group therapy intervention combining in-person and smartphone-based CBT (CBT2go app) to improve experiential negative symptoms in people with schizophrenia. Both the therapy group and CBT2go app included recovery goal setting, thought challenging, scheduling of pleasurable activities and social interactions, and pleasure savoring interventions to modify defeatist attitudes, a target mechanism associated with negative symptoms, and improve experiential negative symptoms. We tested whether participants with schizophrenia or schizoaffective disorder (N=31) who met prospective criteria for persistent negative symptoms showed improvement in experiential negative symptoms. Retention was excellent (87% at 18 weeks) and severity of defeatist attitudes and motivation and pleasure negative symptoms declined significantly in mCBTn with large effect sizes. We also tested whether pupillary responses, a measure of cognitive effort, predicted improvement in negative symptoms mCBTn. Pupillary responses were recorded at baseline using a Tobii pupillometer during the digit span task with 3-, 6- and 9-digit spans. Mixed models showed that greater dilation during the task at baseline significantly predicted a greater reduction in experiential negative symptoms. Pupillary responses may provide a much-needed prognostic biomarker of which patients are most likely to benefit from CBT. Greater pupil dilation during a cognitive task predicted greater improvement in experiential negative symptoms. Pupil dilation has been linked to motivation and engagement of executive control, so these factors may contribute to benefits in interventions that train cognitive skills to manage negative thoughts and emotions. The findings suggest mCBTn is a feasible and effective treatment for experiential negative symptoms and justify a larger randomized controlled clinical trial. The findings also provide support for the defeatist attitude model of experiential negative symptoms and suggest that mobile-assisted interventions like mCBTn can strengthen and shorten intensive psychosocial interventions for schizophrenia.

Keywords: cognitive-behavioral therapy, mobile interventions, negative symptoms, pupillometry schizophrenia

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Authors: Jessica Scher Lisa, Eric Shyman

Abstract:

Autism spectrum disorder (ASD) is a neuro-developmental disorder that is characterized by persistent deficits in social communication and social interaction (i.e. deficits in social-emotional reciprocity, nonverbal communicative behaviors, and establishing/maintaining social relationships), as well as by the presence of repetitive behaviors and perseverative areas of interest (i.e. stereotyped or receptive motor movements, use of objects, or speech, rigidity, restricted interests, and hypo or hyperactivity to sensory input or unusual interest in sensory aspects of the environment). Additionally, diagnoses of ASD require the presentation of symptoms in the early developmental period, marked impairments in adaptive functioning, and a lack of explanation by general intellectual impairment or global developmental delay (although these conditions may be co-occurring). Over the past several decades, many theories have been developed in an effort to explain the root cause of ASD in terms of atypical central cognitive processes. The field of neuroscience is increasingly finding structural and functional differences between autistic and neurotypical individuals using neuro-imaging technology. One main area this research has focused upon is in visuospatial processing, with specific attention to the notion of ‘weak central coherence’ (WCC). This paper offers an analysis of findings from selected studies in order to explore research that challenges the ‘deficit’ characterization of a weak central coherence theory as opposed to a ‘superiority’ characterization of strong local coherence. The weak central coherence theory has long been both supported and refuted in the ASD literature and has most recently been increasingly challenged by advances in neuroscience. The selected studies lend evidence to the notion of amplified localized perception rather than deficient global perception. In other words, WCC may represent superiority in ‘local processing’ rather than a deficit in global processing. Additionally, the right hemisphere and the specific area of the extrastriate appear to be key in both the visual and lexicosemantic process. Overactivity in the striate region seems to suggest inaccuracy in semantic language, which lends itself to support for the link between the striate region and the atypical organization of the lexicosemantic system in ASD.

Keywords: autism spectrum disorder, neurology, visual processing, weak coherence

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Authors: Hanwei Gao, Louis Jezequel, Eric Cabrol, Bernard Vitry

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The chassis system is composed of complex elements that take up all the loads from the tire-ground contact area and thus it plays an important role in numerous specifications such as durability, comfort, crash, etc. During the development of new vehicle projects in Renault, durability validation is always the main focus while deployment of comfort comes later in the project. Therefore, sometimes design choices have to be reconsidered because of the natural incompatibility between these two specifications. Besides, robustness is also an important point of concern as it is related to manufacturing costs as well as the performance after the ageing of components like shock absorbers. In this paper an approach is proposed aiming to realize a multi-objective optimization between chassis endurance and comfort while taking the random factors into consideration. The adaptive-sparse polynomial chaos expansion method (PCE) with Chebyshev polynomial series has been applied to predict responses’ uncertainty intervals of a system according to its uncertain-but-bounded parameters. The approach can be divided into three steps. First an initial design of experiments is realized to build the response surfaces which represent statistically a black-box system. Secondly within several iterations an optimum set is proposed and validated which will form a Pareto front. At the same time the robustness of each response, served as additional objectives, is calculated from the pre-defined parameter intervals and the response surfaces obtained in the first step. Finally an inverse strategy is carried out to determine the parameters’ tolerance combination with a maximally acceptable degradation of the responses in terms of manufacturing costs. A quarter car model has been tested as an example by applying the road excitations from the actual road measurements for both endurance and comfort calculations. One indicator based on the Basquin’s law is defined to compare the global chassis durability of different parameter settings. Another indicator related to comfort is obtained from the vertical acceleration of the sprung mass. An optimum set with best robustness has been finally obtained and the reference tests prove a good robustness prediction of Chebyshev PCE method. This example demonstrates the effectiveness and reliability of the approach, in particular its ability to save computational costs for a complex system.

Keywords: chassis durability, Chebyshev polynomials, multi-objective optimization, polynomial chaos expansion, ride comfort, robust design

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Authors: Ala’a F. Jaber, Bara’ah A. Bsharat, Noor T. Ismael

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Background: Sensory processing is a fundamental skill needed for the successful performance of daily living activities. These skills are impaired as parts of the neurodevelopmental process issues among children with autism spectrum disorder (ASD). This systematic review aimed to summarize the evidence on the differences in sensory processing and motor characteristic between children with ASD and children with TD. Method: This systematic review followed the guidelines of the preferred reporting items for systematic reviews and meta-analysis. The search terms included sensory, motor, condition, and child-related terms or phrases. The electronic search utilized Academic Search Ultimate, CINAHL Plus with Full Text, ERIC, MEDLINE, MEDLINE Complete, Psychology, and Behavioral Sciences Collection, and SocINDEX with full-text databases. The hand search included looking for potential studies in the references of related studies. The inclusion criteria included studies published in English between years 2009-2020 that included children aged 3-18 years with a confirmed ASD diagnosis, according to the DSM-V criteria, included a control group of typical children, included outcome measures related to the sensory processing and/or motor functions, and studies available in full-text. The review of included studies followed the Oxford Centre for Evidence-Based Medicine guidelines, and the Guidelines for Critical Review Form of Quantitative Studies, and the guidelines for conducting systematic reviews by the American Occupational Therapy Association. Results: Eighty-eight full-text studies related to the differences between children with ASD and children with TD in terms of sensory processing and motor characteristics were reviewed, of which eighteen articles were included in the quantitative synthesis. The results reveal that children with ASD had more extreme sensory processing patterns than children with TD, like hyper-responsiveness and hypo-responsiveness to sensory stimuli. Also, children with ASD had limited gross and fine motor abilities and lower strength, endurance, balance, eye-hand coordination, movement velocity, cadence, dexterity with a higher rate of gait abnormalities than children with TD. Conclusion: This systematic review provided preliminary evidence suggesting that motor functioning should be addressed in the evaluation and intervention for children with ASD, and sensory processing should be supported among children with TD. More future research should investigate whether how the performance and engagement in daily life activities are affected by sensory processing and motor skills.

Keywords: sensory processing, occupational therapy, children, motor skills

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Authors: Brock Liden, Eric Janowitz

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Introduction: Diabetic peripheral neuropathy (DPN) affects 70% of individuals with diabetes1. DPN causes a loss of protective sensation, which can lead to tissue damage and diabetic foot ulcer (DFU) formation2. These ulcers can result in infections and lower-extremity amputations of toes, the entire foot, and the lower leg. Even after a DFU is healed, recurrence is common, with 49% of DFU patients developing another ulcer within a year and 68% within 5 years3. This case series examines the use of sensory insoles and newly available plantar data (pressure, temperature, step count, adherence) and remote patient monitoring in patients at risk of DFU. Methods: Participants were provided with custom-made sensory insoles to monitor plantar pressure, temperature, step count, and daily use and were provided with real-time cues for pressure offloading as they went about their daily activities. The sensory insoles were used to track subject compliance, ulceration, and response to feedback from real-time alerts. Patients were remotely monitored by a qualified healthcare professional and were contacted when areas of concern were seen and provided coaching on reducing risk factors and overall support to improve foot health. Results: Of the 40 participants provided with the sensory insole system, 4 presented with a DFU. Based on flags generated from the available plantar data, patients were contacted by the remote monitor to address potential concerns. A standard clinical escalation protocol detailed when and how concerns should be escalated to the provider by the remote monitor. Upon escalation to the provider, patients were brought into the clinic as needed, allowing for any issues to be addressed before more serious complications might arise. Conclusion: This case series explores the use of innovative sensory technology to collect plantar data (pressure, temperature, step count, and adherence) for DFU detection and early intervention. The results from this case series suggest the importance of sensory technology and remote patient monitoring in providing proactive, preventative care for patients at risk of DFU. This robust plantar data, with the addition of remote patient monitoring, allow for patients to be seen in the clinic when concerns arise, giving providers the opportunity to intervene early and prevent more serious complications, such as wounds, from occurring.

Keywords: diabetic foot ulcer, DFU prevention, digital therapeutics, remote patient monitoring

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Authors: Faezeh Mosallat, Eric L. Bibeau, Tarek El Mekkawy

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Availability of a wide variety of renewable resources, such as large reserves of hydro, biomass, solar and wind in Canada provides significant potential to improve the sustainability of energy uses. As buildings represent a considerable portion of energy use in Canada, application of distributed solar energy systems for heating and cooling may increase the amount of renewable energy use. Parabolic solar trough systems have seen limited deployments in cold northern climates as they are more suitable for electricity production in southern latitudes. Heat production by concentrating solar rays using parabolic troughs can overcome the poor efficiencies of flat panels and evacuated tubes in cold climates. A numerical dynamic model is developed to simulate an installed parabolic solar trough facility in Winnipeg. The results of the numerical model are validated using the experimental data obtained from this system. The model is developed in Simulink and will be utilized to simulate a tri-generation system for heating, cooling and electricity generation in remote northern communities. The main objective of this simulation is to obtain operational data of solar troughs in cold climates as this is lacking in the literature. In this paper, the validated Simulink model is applied to simulate a solar assisted absorption cooling system along with electricity generation using organic Rankine cycle (ORC) and thermal storage. A control strategy is employed to distribute the heated oil from solar collectors among the above three systems considering the temperature requirements. This modeling provides dynamic performance results using real time minutely meteorological data which are collected at the same location the solar system is installed. This is a big step ahead of the current models by accurately calculating the available solar energy at each time step considering the solar radiation fluctuations due to passing clouds. The solar absorption cooling is modeled to use the generated heat from the solar trough system and provide cooling in summer for a greenhouse which is located next to the solar field. A natural gas water heater provides the required excess heat for the absorption cooling at low or no solar radiation periods. The results of the simulation are presented for a summer month in Winnipeg which includes the amount of generated electric power from ORC and contribution of solar energy in the cooling load provision

Keywords: absorption cooling, parabolic solar trough, remote community, validated model

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Authors: Allaire Eric, Hauet Pascal, Floresco Jean, Beley Sebastien, Sussman Helene, Virag Ronald

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Background: Caverno-venous leakage (CVL) is devastating, although barely known disease, the first cause of major physical impairment in men under 25, and responsible for 50% of resistances to phosphodiesterase 5-inhibitors (PDE5-I), affecting 30 to 40% of users in this medication class. In this condition, too early blood drainage from corpora cavernosa prevents penile rigidity and penetration during sexual intercourse. The role of conservative surgery in this disease remains controversial. Aim: Assess complications and results of combined open surgery and embolization for CVL. Method: Between June 2016 and September 2021, 133 consecutive patients underwent surgery in our institution for CVL, causing severe erectile dysfunction (ED) resistance to oral medical treatment. Procedures combined vein embolization and ligation with microsurgical techniques. We performed a pre-and post-operative clinical (Erection Harness Scale: EHS) hemodynamic evaluation by duplex sonography in all patients. Before surgery, the CVL network was visualized by computed tomography cavernography. Penile EMG was performed in case of diabetes or suspected other neurological conditions. All patients were optimized for hormonal status—data we prospectively recorded. Results: Clinical signs suggesting CVL were ED since age lower than 25, loss of erection when changing position, penile rigidity varying according to the position. Main complications were minor pulmonary embolism in 2 patients, one after airline travel, one with Factor V Leiden heterozygote mutation, one infection and three hematomas requiring reoperation, one decreased gland sensitivity lasting for more than one year. Mean pre-operative pharmacologic EHS was 2.37+/-0.64, mean pharmacologic post-operative EHS was 3.21+/-0.60, p<0.0001 (paired t-test). The mean EHS variation was 0.87+/-0.74. After surgery, 81.5% of patients had a pharmacologic EHS equal to or over 3, allowing for intercourse with penetration. Three patients (2.2%) experienced lower post-operative EHS. The main cause of failure was leakage from the deep dorsal aspect of the corpus cavernosa. In a 14 months follow-up, 83.2% of patients had a clinical EHS equal to or over 3, allowing for sexual intercourse with penetration, one-third of them without any medication. 5 patients had a penile implant after unsuccessful conservative surgery. Conclusion: Open surgery combined with embolization for CVL is an efficient approach to CVL causing severe erectile dysfunction.

Keywords: erectile dysfunction, cavernovenous leakage, surgery, embolization, treatment, result, complications, penile duplex sonography

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Authors: Shazia Ali, Yves Mard, Éric Severin

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To the best of our knowledge, this is the first study to have analyzed the impact of a) firm-specific product-market power and b) industry competition on earnings management behavior of European firms in distress versus healthy years while controlling for firm-level characteristics. We predicted a significant relationship between firms’ product market power and earnings management tools and their trade-off under the moderation effect of financial distress. We found that the firm-level market power hereinafter referred to as MP (proxied by the industry-adjusted Lerner Index) is positively associated with both real and accrual earnings management. However, MP is associated with a higher level of real earnings management compared to accrual earnings management in distress years compared to healthy years. On the other hand, industry product market power (representing low competition and proxied by the inverse of the total number of firms in an industry hereinafter referred to as NUMB) and firms product market power (proxied by firm market share hereinafter referred to as MS) are associated with lower inflationary accruals and higher deflationary accruals respectively. On the other hand, they are found to be linked with higher real earnings management in distress versus healthy years. When we divided the sample into small and big firms based on their respective industry-year median total assets, we found that all three measures of industry competition (Industry Median Lerner Index (hereinafter referred to as IMLI), NUMB, and Herfindahl–Hirschman Index (hereinafter referred to as HHI) indicate that small firms in low-competitive industries in financial distress are more likely to inflate their earnings through discretionary accruals. While big firms in this situation are more likely to lower the use of both inflationary and deflationary discretionary accruals as indicated by IMLI and HHI and trade-off accruals earnings management for real earnings management as indicated by NUMB. Moreover, IMLI and HHI did not show any interesting results when we divided the sample based on the firm Lerner Index/Market Power. However, the distressed firms with high market power (MP>industry median) are found to engage in income-decreasing discretionary accruals in low-competitive industries (high NUMB). Whereas firms with low market power in the same industry use downward discretionary accruals but inflate income using real activities (abnCFO). Our findings are robust across alternate measures of discretionary accruals and financial distress, such as the Altman Z-Score. The finding of the study is valuable for accounting standard setters, competition authorities, policymakers, and investors alike to help in informed decision-making.

Keywords: financial distress, earnings management, market competition

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Authors: Iulianna Taritsa, Kuldeep Neote, Eric Fossel

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Lysosome-induced immunogenic cell death (LIICD) is a powerful mechanism of targeting cancer cells that kills circulating malignant cells and primes the host’s immune cells against future remission. Current immunotherapies for cancer are limited in preventing recurrence – a gap that can be bridged by training the immune system to recognize cancer neoantigens. Lysosomal leakage can be induced therapeutically to traffic antigens from dying cells to dendritic cells, which can later present those tumorigenic antigens to T cells. Previous research has shown that oxidative agents administered in the tumor microenvironment can initiate LIICD. We generated a fusion protein between an oxidative agent known as xanthine oxidase (XO) and a mini-antibody specific for EGFR/HER2-sensitive breast tumor cells. The anti-EGFR single domain antibody fragment is uniquely sourced from llama, which is functional without the presence of a light chain. These llama micro-antibodies have been shown to be better able to penetrate tissues and have improved physicochemical stability as compared to traditional monoclonal antibodies. We demonstrate that the fusion protein created is stable and can induce early markers of immunogenic cell death in an in vitro human breast cancer cell line (SkBr3). Specifically, we measured overall cell death, as well as surface-expressed calreticulin, extracellular ATP release, and HMGB1 production. These markers are consensus indicators of ICD. Flow cytometry, luminescence assays, and ELISA were used respectively to quantify biomarker levels between treated versus untreated cells. We also included a positive control group of SkBr3 cells dosed with doxorubicin (a known inducer of LIICD) and a negative control dosed with cisplatin (a known inducer of cell death, but not of the immunogenic variety). We looked at each marker at various time points after cancer cells were treated with the XO/antibody fusion protein, doxorubicin, and cisplatin. Upregulated biomarkers after treatment with the fusion protein indicate an immunogenic response. We thus show the potential for this fusion protein to induce an anticancer effect paired with an adaptive immune response against EGFR/HER2+ cells. Our research in human cell lines here provides evidence for the success of the same therapeutic method for patients and serves as the gateway to developing a new treatment approach against breast cancer.

Keywords: apoptosis, breast cancer, immunogenic cell death, lysosome

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

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

Keywords: chain shot, timber harvesters, safety, testing

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Authors: Sabrina Servot, Annick St-Amand, Michel Rousseau, Valerie Simard, Evelyne Touchette

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Child maltreatment has a profound impact on children’s development. In its victims, internalizing and externalizing problems are highly prevalent, and sleep problems are common. Furthermore, the environment they live in is often disorganized, lacking routine and consistency. In non-maltreated children, several studies documented the important role of sleep regulation and sleep ecology. A poor sleep ecology (e.g., lack of sleep hygiene and bedtime routine, inappropriate sleeping location) may lead to sleep regulation problems (e.g., short sleep duration, nocturnal awakenings), and sleep regulation problems may increase the risk of behavior problems. Therefore, this scoping review aims to map evidence about sleep ecology and sleep regulation and the associations between sleep ecology, sleep regulation, and behavior problems in maltreated preschoolers. Literature from 1993 was searched in PsycInfo, Pubmed, Medline, Eric, and Proquest Dissertations and Theses. Articles and thesis were comprehensively reviewed based upon inclusion/exclusion criteria: 1) it concerns maltreated children aged 1-5 years, and 2) it addresses at least one of the following: sleep ecology, sleep regulation, and/or their associations with behavior problems in maltreated preschoolers. From the 650 studies screened, nine of them were included. Data were charted according to study characteristics, nature of variable documented, measures, analyses performed, and results of each study, then synthesized in a narrative summary. The main results show all included articles were quantitative. Foster children samples were used in four studies, children experienced different types of maltreatment in six studies, while one was specifically about sexually abused children. Regarding sleep ecology, only one study describing maltreated preschoolers’ sleep ecology was found, while seven studies documented sleep regulation. Among these seven studies, 17 different sleep variables (e.g., parasomnia, dyssomnia, total 24-h sleep duration) were used, each study documenting from one to nine of them. Actigraphic measures were employed in three studies, the others used parent-reported questionnaires or sleep diaries. Maltreated children’s sleep was described and/or compared to non-maltreated children’s sleep, or an intervention group, showing mild differences. As for associations between sleep regulation and behavior problems, five studies investigated it and performed correlational or linear regression analyses between sleep and behavior problems, revealing some significant associations. No study was found about associations between sleep ecology and sleep regulation, between sleep ecology and behavior problems, or between these three variables. In conclusion, literature about sleep ecology, sleep regulation, and their associations with behavior problems are far more scarce in maltreated preschoolers than in non-maltreated ones. At present, there is especially a paucity of research about sleep ecology and the association between sleep ecology and sleep regulation in maltreated preschoolers, while studies on non-maltreated children showed sleep ecology plays a major role in sleep regulation. In addition, as sleep regulation is measured in many different ways among the studies, it is difficult to compare their findings. Finally, it seems necessary that research fill these gaps, as recommendations could be made to clinicians working with maltreated preschoolers regarding the use of sleep ecology and sleep regulation as intervention tools.

Keywords: maltreated preschoolers, sleep ecology, sleep regulation, behavior problems

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