Search results for: Matthew Shiu
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 189

Search results for: Matthew Shiu

39 Stratafix Barbed Suture Versus Polydioxanone Suture on the Rate of Pancreatic Fistula After Pancreaticoduodenectomy

Authors: Saniya Ablatt, Matthew Jacobsson, Jamie Whisler, Austin Forbes

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Postoperative pancreatic fistula (POPF) is a complication that occurs in up to 41% of patients after pancreaticoduodenectomy. Although certain characteristics such as individual patient anatomy are known risk factors for POPF, the effect of barbed suture techniques remains underexplored. This study examines whether the use of Stratafix barbed suture versus PDS impacts the risk of developing POPF. After obtaining IRB exemption, a retrospective chart review was initiated involving patients who underwent pancreaticoduodenectomy for the treatment of malignant or premalignant lesions of the pancreas at our institution between April 1st 2020 and April 30th 2022. Patients were stratified into 2 groups respective to the technique used to suture the pancreatico-jejunal anastomosis: Group 1 was composed to patients in which 4.0 Stratafix® suture was used n=41. Group 1 was composed to patients in which 4.0 PDS suture was used n=42. Data regarding patient age, sex, BMI, presence or absence of biochemical leak, presence or absence of grade B & C postoperative pancreatic fistulas, rate and type of in hospital complication, rate of reoperation, 30 day readmission rate, 90 day mortality, and total mortality were compared between groups. 83 patients were included in our study with 42 receiving Stratafix and 41 receiving PDS (50.6% vs 49.4%). Stratafix patients had less biochemical leaks (0.0% vs 4.8%, p=0.19) and higher rates of POPF but this was not statistically significant (7.2% vs 2.4%, p=0.26). Additionally, there was no difference between the use of stratafix versus PDS on the risk of clinically relevant grade B or C POPF (p=0.26, OR=3.25 [CI= 0.74-16.43]). Of the independent variables including age, race, sex, BMI, and ASA class, BMI greater than 25 increased the risk of clinically relevant POPF by 7.7 times compared to patients with BMI less than 25 (p=0.03, OR=7.79 [1.04-88.51]). Despite no significant difference in primary outcomes, the Stratafix group had lower rates of secondary outcomes including 90-day mortality; bleeding, cardiac, and infectious complications; reoperation; and 30-day readmission. On statistical analysis, Stratafix decreased the risk of 30-day readmission (p=0.04, OR=0.21, CI=0.04-0.97) and had a marginally significant effect on the risk of reoperation (p=0.08, OR=0.24, CI=0.04-1.26). There was no difference between the use of Stratafix versus PDS on the risk of POPF (p=0.26). However, Stratafix decreased the risk of 30-day readmission (p=0.04) and BMI greater than 25 increased the risk of clinically relevant POPF (p=0.03).

Keywords: pancreas, hepatobiliary surgery, hepatobiliary, pancreatic leak, biochemical leak, fistula, pancreatic fistula

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38 Transforming Breast Density Measurement with Artificial Intelligence: Population-Level Insights from BreastScreen NSW

Authors: Douglas Dunn, Ricahrd Walton, Matthew Warner-Smith, Chirag Mistry, Kan Ren, David Roder

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Introduction: Breast density is a risk factor for breast cancer, both due to increased fibro glandular tissue that can harbor malignancy and the masking of lesions on mammography. Therefore, evaluation of breast density measurement is useful for risk stratification on an individual and population level. This study investigates the performance of Lunit INSIGHT MMG for automated breast density measurement. We analyze the reliability of Lunit compared to breast radiologists, explore density variations across the BreastScreen NSW population, and examine the impact of breast implants on density measurements. Methods: 15,518 mammograms were utilized for a comparative analysis of intra- and inter-reader reliability between Lunit INSIGHT MMG and breast radiologists. Subsequently, Lunit was used to evaluate 624,113 mammograms for investigation of density variations according to age and birth country, providing insights into diverse population subgroups. Finally, we compared breast density in 4,047 clients with implants to clients without implants, controlling for age and birth country. Results: Inter-reader variability between Lunit and Breast Radiologists weighted kappa coefficient was 0.72 (95%CI 0.71-0.73). Highest breast densities were seen in women with a North-East Asia background, whilst those of Aboriginal background had the lowest density. Across all backgrounds, density was demonstrated to reduce with age, though at different rates according to country of birth. Clients with implants had higher density relative to the age-matched no-implant strata. Conclusion: Lunit INSIGHT MMG demonstrates reasonable inter- and intra-observer reliability for automated breast density measurement. The scale of this study is significantly larger than any previous study assessing breast density due to the ability to process large volumes of data using AI. As a result, it provides valuable insights into population-level density variations. Our findings highlight the influence of age, birth country, and breast implants on density, emphasizing the need for personalized risk assessment and screening approaches. The large-scale and diverse nature of this study enhances the generalisability of our results, offering valuable information for breast cancer screening programs internationally.

Keywords: breast cancer, screening, breast density, artificial intelligence, mammography

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37 Treating Voxels as Words: Word-to-Vector Methods for fMRI Meta-Analyses

Authors: Matthew Baucum

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With the increasing popularity of fMRI as an experimental method, psychology and neuroscience can greatly benefit from advanced techniques for summarizing and synthesizing large amounts of data from brain imaging studies. One promising avenue is automated meta-analyses, in which natural language processing methods are used to identify the brain regions consistently associated with certain semantic concepts (e.g. “social”, “reward’) across large corpora of studies. This study builds on this approach by demonstrating how, in fMRI meta-analyses, individual voxels can be treated as vectors in a semantic space and evaluated for their “proximity” to terms of interest. In this technique, a low-dimensional semantic space is built from brain imaging study texts, allowing words in each text to be represented as vectors (where words that frequently appear together are near each other in the semantic space). Consequently, each voxel in a brain mask can be represented as a normalized vector sum of all of the words in the studies that showed activation in that voxel. The entire brain mask can then be visualized in terms of each voxel’s proximity to a given term of interest (e.g., “vision”, “decision making”) or collection of terms (e.g., “theory of mind”, “social”, “agent”), as measured by the cosine similarity between the voxel’s vector and the term vector (or the average of multiple term vectors). Analysis can also proceed in the opposite direction, allowing word cloud visualizations of the nearest semantic neighbors for a given brain region. This approach allows for continuous, fine-grained metrics of voxel-term associations, and relies on state-of-the-art “open vocabulary” methods that go beyond mere word-counts. An analysis of over 11,000 neuroimaging studies from an existing meta-analytic fMRI database demonstrates that this technique can be used to recover known neural bases for multiple psychological functions, suggesting this method’s utility for efficient, high-level meta-analyses of localized brain function. While automated text analytic methods are no replacement for deliberate, manual meta-analyses, they seem to show promise for the efficient aggregation of large bodies of scientific knowledge, at least on a relatively general level.

Keywords: FMRI, machine learning, meta-analysis, text analysis

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36 A Holistic Analysis of the Emergency Call: From in Situ Negotiation to Policy Frameworks and Back

Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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35 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures

Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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34 Standardizing and Achieving Protocol Objectives for ChestWall Radiotherapy Treatment Planning Process using an O-ring Linac in High-, Low- and Middle-income Countries

Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun

Abstract:

Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.

Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning

Procedia PDF Downloads 119
33 Library Support for the Intellectually Disabled: Book Clubs and Universal Design

Authors: Matthew Conner, Leah Plocharczyk

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This study examines the role of academic libraries in support of the intellectually disabled (ID) in post-secondary education. With the growing public awareness of the ID, there has been recognition of their need for post-secondary educational opportunities. This was an unforeseen result for a population that has been associated with elementary levels of education, yet the reasons are compelling. After aging out of the school system, the ID need and deserve educational and social support as much as anyone. Moreover, the commitment to diversity in higher education rings hollow if this group is excluded. Yet, challenges remain to integrating the ID into a college curriculum. This presentation focuses on the role of academic libraries. Neglecting this vital resource for the support of the ID is not to be thought of, yet the library’s contribution is not clear. Library collections presume reading ability and libraries already struggle to meet their traditional goals with the resources available. This presentation examines how academic libraries can support post-secondary ID. For context, the presentation first examines the state of post-secondary education for the ID with an analysis of data on the United States compiled by the ThinkCollege! Project. Geographic Information Systems (GIS) and statistical analysis will show regional and methodological trends in post-secondary support of the ID which currently lack any significant involvement by college libraries. Then, the presentation analyzes a case study of a book club at the Florida Atlantic University (FAU) libraries which has run for several years. Issues such as the selection of books, effective pedagogies, and evaluation procedures will be examined. The study has found that the instruction pedagogies used by libraries can be extended through concepts of Universal Learning Design (ULD) to effectively engage the ID. In particular, student-centered, participatory methodologies that accommodate different learning styles have proven to be especially useful. The choice of text is complex and determined not only by reading ability but familiarity of subject and features of the ID’s developmental trajectory. The selection of text is not only a necessity but also promises to give insight into the ID. Assessment remains a complex and unresolved subject, but the voluntary, sustained, and enthusiastic attendance of the ID is an undeniable indicator. The study finds that, through the traditional library vehicle of the book club, academic libraries can support ID students through training in both reading and socialization, two major goals of their post-secondary education.

Keywords: academic libraries, intellectual disability, literacy, post-secondary education

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32 Effect of Methanol Root Extracts of Moringa Oleifera on Lipid Profile Parameters, Atherogenic Indices and HMG – CoA Reductase Activities of Poloxamer 407-Induced Hyperlipidemic Rats

Authors: Matthew Ocheleka Itodo, Ogo Agbo Ogo, Agnes Ogbene Abutu, Bawa Inalegwu

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Hyperlipidemia is characterised by elevated serum total cholesterol and low density and very low-density lipoprotein cholesterol and decreased high-density lipoprotein are the risk factor for coronary heart diseases. There are claims by traditional medicine practitioners in Nigeria that Moringa oleifera plants are used for the treatment of cardiovascular diseases, but it appears there is no scientific research and, publication or documented work to verify these claims. This study aimed to determine the effect of methanol root extracts of Moringa oleifera on Lipid profile, Atherogenic indices and 3 hydroxyl 3 methylglutaryl Coenzyme A reductase activity of poloxamer 407-induced hyperlipidemic rats. The animals were grouped into 8; Group 1: Normal control, Group 2: Hyperlipidemic control. Groups 2 to 8 were induced with Poloxamer 407 1000 mg/Kg body weight. However, group 3 were treated with standard drugs (atorvastatin). Group 4 was treated with crude extract, and groups 5 to 8 were treated with purified fractions from column chromatography. The preliminary antihyperlipidemic study showed Methanol root extract at 200 mg/kg body weight significantly (p≤0.05) decreased total cholesterol, low-density lipoprotein, triacylglyceride, 3 hydroxyls 3 methylglutaryl Coenzyme A reductase, and increase high-density lipoprotein of hyperlipidemic treated groups. Screening the extracts for the most potent anti-hyperlipidemic activity reveals that fraction 1 of Total Cholesterol and Fraction 3 of Triacylglyceride have the highest percentage reduction of 56% and 51%, respectively. The atherogenic risk factor of all induced treated rats shows a significant (p<0.05) decrease in levels of Castelli’s risk index II, atherogenic index of plasma and a significant (p<0.05) higher level of Castelli’s risk index I ratio. The study shows that the methanol extract of root possesses antihyperlipidemic effects and may explain why it has been found to be useful in the management of cardiovascular diseases by traditional medicine practitioners.

Keywords: hyperlipidemia, moringa oleifera, poloxamer 407, lipid profile

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31 Reaching New Levels: Using Systems Thinking to Analyse a Major Incident Investigation

Authors: Matthew J. I. Woolley, Gemma J. M. Read, Paul M. Salmon, Natassia Goode

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The significance of high consequence, workplace failures within construction continues to resonate with a combined average of 12 fatal incidents occurring daily throughout Australia, the United Kingdom, and the United States. Within the Australian construction domain, more than 35 serious, compensable injury incidents are reported daily. These alarming figures, in conjunction with the continued occurrence of fatal and serious, occupational injury incidents globally suggest existing approaches to incident analysis may not be achieving required injury prevention outcomes. One reason may be that, incident analysis methods used in construction have not kept pace with advances in the field of safety science and are not uncovering the full range system-wide contributory factors that are required to achieve optimal levels of construction safety performance. Another reason underpinning this global issue may also be the absence of information surrounding the construction operating and project delivery system. For example, it is not clear who shares the responsibility for construction safety in different contexts. To respond to this issue, to the author’s best knowledge, a first of its kind, control structure model of the construction industry is presented and then used to analyse a fatal construction incident. The model was developed by applying and extending the Systems Theoretic and Incident Model and Process method to hierarchically represent the actors, constraints, feedback mechanisms, and relationships that are involved in managing construction safety performance. The Causal Analysis based on Systems Theory (CAST) method was then used to identify the control and feedback failures involved in the fatal incident. The conclusions from the Coronial investigation into the event are compared with the findings stemming from the CAST analysis. The CAST analysis highlighted additional issues across the construction system that were not identified in the coroner’s recommendations, suggested there is a potential benefit in applying a systems theory approach to incident analysis in construction. The findings demonstrate the utility applying systems theory-based methods to the analysis of construction incidents. Specifically, this study shows the utility of the construction control structure and the potential benefits for project leaders, construction entities, regulators, and construction clients in controlling construction performance.

Keywords: construction project management, construction performance, incident analysis, systems thinking

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30 Experimental Study Analyzing the Similarity Theory Formulations for the Effect of Aerodynamic Roughness Length on Turbulence Length Scales in the Atmospheric Surface Layer

Authors: Matthew J. Emes, Azadeh Jafari, Maziar Arjomandi

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Velocity fluctuations of shear-generated turbulence are largest in the atmospheric surface layer (ASL) of nominal 100 m depth, which can lead to dynamic effects such as galloping and flutter on small physical structures on the ground when the turbulence length scales and characteristic length of the physical structure are the same order of magnitude. Turbulence length scales are a measure of the average sizes of the energy-containing eddies that are widely estimated using two-point cross-correlation analysis to convert the temporal lag to a separation distance using Taylor’s hypothesis that the convection velocity is equal to the mean velocity at the corresponding height. Profiles of turbulence length scales in the neutrally-stratified ASL, as predicted by Monin-Obukhov similarity theory in Engineering Sciences Data Unit (ESDU) 85020 for single-point data and ESDU 86010 for two-point correlations, are largely dependent on the aerodynamic roughness length. Field measurements have shown that longitudinal turbulence length scales show significant regional variation, whereas length scales of the vertical component show consistent Obukhov scaling from site to site because of the absence of low-frequency components. Hence, the objective of this experimental study is to compare the similarity theory relationships between the turbulence length scales and aerodynamic roughness length with those calculated using the autocorrelations and cross-correlations of field measurement velocity data at two sites: the Surface Layer Turbulence and Environmental Science Test (SLTEST) facility in a desert ASL in Dugway, Utah, USA and the Commonwealth Scientific and Industrial Research Organisation (CSIRO) wind tower in a rural ASL in Jemalong, NSW, Australia. The results indicate that the longitudinal turbulence length scales increase with increasing aerodynamic roughness length, as opposed to the relationships derived by similarity theory correlations in ESDU models. However, the ratio of the turbulence length scales in the lateral and vertical directions to the longitudinal length scales is relatively independent of surface roughness, showing consistent inner-scaling between the two sites and the ESDU correlations. Further, the diurnal variation of wind velocity due to changes in atmospheric stability conditions has a significant effect on the turbulence structure of the energy-containing eddies in the lower ASL.

Keywords: aerodynamic roughness length, atmospheric surface layer, similarity theory, turbulence length scales

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29 Improving Engagement: Dental Veneers, a Qualitative Analysis of Posts on Instagram

Authors: Matthew Sedgwick

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Introduction: Social media continues to grow in popularity and Instagram is one of the largest platforms available. It provides an invaluable method of communication between health care professionals and patients. Both patients and dentists can benefit from seeing clinical cases posted by other members of the profession. It can prompt discussion about how the outcome was achieved and showcases what is possible with the right techniques and planning. This study aimed to identify what people were posting about the topic ‘veneers’ and inform health care professionals as to what content had the most engagement and make recommendations as to how to improve the quality of social media posts. Design: 150 consecutive posts for the search term ‘veneers’ were analyzed retrospectively between 21st October 2021 to 31st October 2021. Non-English language posts duplicated posts, and posts not about dental veneers were excluded. After exclusions were applied, 80 posts were included in the study for analysis. The content of the posts was analyzed and coded and the main themes were identified. The number of comments, likes and views were also recorded for each post. Results: The themes were: before and after treatment, cost, dental training courses, treatment process and trial smiles. Dentists were the most common posters of content (82.5%) and it was interesting to note that there were no patients who posted about treatment in this sample. The main type of media was photographs (93.75%) compared to video (6.25%). Videos had an average of 45,541 views and more comments and likes than the average for photographs. The average number of comments and likes per post were 20.88 and 761.58, respectively. Conclusion: Before and after photographs were the most common finding as this is how dentists showcase their work. The study showed that videos showing the treatment process had more engagement than photographs. Dentists should consider making video posts showing the patient journey, including before and after veneer treatment, as this can result in more potential patients and colleagues viewing the content. Video content could help dentists distinguish their posts from others as it can also be used across other platforms such as TikTok or Facebook reaching a wider audience. More informative posts about how the result has shown are achieved required, including potential costs. This will help increase transparency regarding this treatment method, including the financial and potential biological cost to teeth. As a result, this will improve patient understanding and become an invaluable adjunct in informed consent.

Keywords: content analysis, dental veneers, Instagram, social media

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28 Connectivity: Connecting ActivityRethinking Streets as Public Space under the Six Dimensions of Urban Space Design in the Context of Bangladesh

Authors: Manal Anis, Bin Bakhti Sayeed

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With the encroachment of automobile upon our communities for decades and the concomitant urban sprawl resulting in a loss of public place, it was only a matter of time before people, realizing the role of streets in stimulating urban prosperity, would start reclaiming them to rebuild their communities. In order for this restoration of communities to take effect it is imperative that streets be freed from the dominance of motor vehicles. A holistic approach to pedestrian-friendly street environment can help build communities that embody the cities in which they are found. While the developed countries are finding more and more innovative ways to integrate walkable streets to foster communal living, the developing countries still have a long way to go. Since Dhaka is still struggling to balance the growing needs of accommodating automobiles for increased population with the loss of urban community life that comes with it, it is high time that alternate approaches are looked into. This study aims to understand streets as a living corridor through which one discovers and identifies with the city. The research area is chosen to be Manik Mia Avenue, overlooking the South Plaza of the National Parliament Building in Dhaka city. Being the site of supreme power, it is precisely this symbolic importance that the National Parliament Building has in the psyche of Bangladeshis, which has given Manik Mia Avenue a significant place in the country’s history. Above all, being an avenue it is essentially a neutral territory, universally accessible, inclusive and pluralist. The needs of the Avenue’s frequent users are analyzed with the help of a multi-method approach to survey consisting of an empirical study, a questionnaire survey and interview with relevant users. The research then tries to understand the concept of walkability by exploring the different ways in which the built environment influences walking. For this analysis, the six dimensions of Matthew Carmona are taken as a guideline for a holistic approach toward the different interacting facets of an urban public space. Based on the studies, a set of criteria is proposed to evaluate, plan and design streets that are more contextual in nature. The study concludes with how the existing street patterns of Dhaka city can be rethought and redesigned to cater to peoples’ need for a public place. The proposal is meant to be an inspiration for further studies in this respect in the context of Bangladesh.

Keywords: public space, six dimensions, street, urban, walkability

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27 University Students' Perspectives on a Mindfulness-Based App for Weight, Weight Related Behaviors, and Stress: A Qualitative Focus Group Study

Authors: Lynnette Lyzwinski, Liam Caffery, Matthew Bambling, Sisira Edirippulige

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Introduction: A novel method of delivering mindfulness interventions for populations at risk of weight gain and stress-related eating, in particular, college students, is through mHealth. While there have been qualitative studies on mHealth for weight loss, there has not been a study on mHealth for weight loss using mindfulness that has explored student perspectives on a student centred mindfulness app and mindfulness-based text messages for eating and stress. Student perspective data will provide valuable information for creating a specific purpose weight management app and mindfulness-based text messages (for the Mindfulness App study). Methods: A qualitative focus group study was undertaken at St Lucia campus at the University of Queensland in March 2017. Students over the age of 18 were eligible to participate. Interviews were audiotaped and transcribed. One week following the focus group, students were sent sample mindfulness-based text messages based on their responses. Students provided written feedback via email. Data were analysed using N Vivo software. Results: The key themes in a future mindfulness-based app are a simple design interface, a focus on education/practical tips, and real-life practical exercises. Social media should be avoided. Key themes surrounding barriers include the perceived difficulty of mindfulness and a lack of proper guidance or knowledge. The mindfulness-based text messages were received positively. Key themes were creating messages with practical tips about how to be mindful and how to integrate mindful reflection of both one’s body and environment while on campus. Other themes including creating positive, inspirational messages. There was lack of agreement on the ideal timing for messages. Discussion: This is the first study that explored student perspectives on a mindfulness-app and mindfulness-based text messages for stress and weight management as a pre-trial study for the Mindfulness App trial for stress, lifestyle, and weight in students. It is important to consider maximizing the potential facilitators of use and minimize potential identified barriers when developing and designing a future mHealth mindfulness-based intervention tailored to the student consumer. Conclusion: Future mHealth studies may consider integrating mindfulness-based text messages in their interventions for weight and stress as this is a novel feature that appears to be acceptable for participants. The results of this focus group provide the basis to develop content for a specific purpose student app for weight management.

Keywords: mindfulness, college students, mHealth, weight loss

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26 The Impact of AI on Consumers’ Morality: An Empirical Evidence

Authors: Mingxia Zhu, Matthew Tingchi Liu

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AI grows gradually in the market with its efficiency and accuracy, influencing people’s perceptions, attitude, and even consequential behaviors. Current study extends prior research by focusing on AI’s impact on consumers’ morality. First, study 1 tested individuals’ believes about AI and human’s moral perceptions and people’s attribution of moral worth to AI and human. Moral perception refers to a computational system an entity maintains to detect and identify moral violations, while moral worth here denotes whether individual regard an entity as worthy of moral treatment. To identify the effect of AI on consumers’ morality, two studies were employed. Study 1 is a within-subjects survey, while study 2 is an experimental study. In the study 1, one hundred and forty participants were recruited through online survey company in China (M_age = 27.31 years, SD = 7.12 years; 65% female). The participants were asked to assign moral perception and moral worth to AI and human. A paired samples t-test reveals that people generally regard that human has higher moral perception (M_Human = 6.03, SD = .86) than AI (M_AI = 2.79, SD = 1.19; t(139) = 27.07, p < .001; Cohen’s d = 1.41). In addition, another paired samples t-test results showed that people attributed higher moral worth to the human personnel (M_Human = 6.39, SD = .56) compared with AIs (M_AI = 5.43, SD = .85; t(139) = 12.96, p < .001; d = .88). In the next study, two hundred valid samples were recruited from survey company in China (M_age = 27.87 years, SD = 6.68 years; 55% female) and the participants were randomly assigned to two conditions (AI vs. human). After viewing the stimuli of human versus AI, participants are informed that one insurance company would determine the price purely based on their declaration. Therefore, their open-ended answers were coded into ethical, honest behavior and unethical, dishonest behavior according to the design of prior literature. A Chi-square analysis revealed that 64% of the participants would immorally lie towards AI insurance inspector while 42% of participants reported deliberately lower mileage facing with human inspector (χ^2 (1) = 9.71, p = .002). Similarly, the logistic regression results suggested that people would significantly more likely to report fraudulent answer when facing with AI (β = .89, odds ratio = 2.45, Wald = 9.56, p = .002). It is demonstrated that people would be more likely to behave unethically in front of non-human agents, such as AI agent, rather than human. The research findings shed light on new practical ethical issues in human-AI interaction and address the important role of human employees during the process of service delivery in the new era of AI.

Keywords: AI agent, consumer morality, ethical behavior, human-AI interaction

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25 Identification, Synthesis, and Biological Evaluation of the Major Human Metabolite of NLRP3 Inflammasome Inhibitor MCC950

Authors: Manohar Salla, Mark S. Butler, Ruby Pelingon, Geraldine Kaeslin, Daniel E. Croker, Janet C. Reid, Jong Min Baek, Paul V. Bernhardt, Elizabeth M. J. Gillam, Matthew A. Cooper, Avril A. B. Robertson

Abstract:

MCC950 is a potent and selective inhibitor of the NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome that shows early promise for treatment of inflammatory diseases. The identification of major metabolites of lead molecule is an important step during drug development process. It provides an information about the metabolically labile sites in the molecule and thereby helping medicinal chemists to design metabolically stable molecules. To identify major metabolites of MCC950, the compound was incubated with human liver microsomes and subsequent analysis by (+)- and (−)-QTOF-ESI-MS/MS revealed a major metabolite formed due to hydroxylation on 1,2,3,5,6,7-hexahydro-s-indacene moiety of MCC950. This major metabolite can lose two water molecules and three possible regioisomers were synthesized. Co-elution of major metabolite with each of the synthesized compounds using HPLC-ESI-SRM-MS/MS revealed the structure of the metabolite (±) N-((1-hydroxy-1,2,3,5,6,7-hexahydro-s-indacen-4-yl)carbamoyl)-4-(2-hydroxypropan-2-yl)furan-2-sulfonamide. Subsequent synthesis of individual enantiomers and coelution in HPLC-ESI-SRM-MS/MS using a chiral column revealed the metabolite was R-(+)- N-((1-hydroxy-1,2,3,5,6,7-hexahydro-s-indacen-4-yl)carbamoyl)-4-(2-hydroxypropan-2-yl)furan-2-sulfonamide. To study the possible cytochrome P450 enzyme(s) responsible for the formation of major metabolite, MCC950 was incubated with a panel of cytochrome P450 enzymes. The result indicated that CYP1A2, CYP2A6, CYP2B6, CYP2C9, CYP2C18, CYP2C19, CYP2J2 and CYP3A4 are most likely responsible for the formation of the major metabolite. The biological activity of the major metabolite and the other synthesized regioisomers was also investigated by screening for for NLRP3 inflammasome inhibitory activity and cytotoxicity. The major metabolite had 170-fold less inhibitory activity (IC50-1238 nM) than MCC950 (IC50-7.5 nM). Interestingly, one regioisomer had shown nanomolar inhibitory activity (IC50-232 nM). However, no evidence of cytotoxicity was observed with any of these synthesized compounds when tested in human embryonic kidney 293 cells (HEK293) and human liver hepatocellular carcinoma G2 cells (HepG2). These key findings give an insight into the SAR of the hexahydroindacene moiety of MCC950 and reveal a metabolic soft spot which could be blocked by chemical modification.

Keywords: Cytochrome P450, inflammasome, MCC950, metabolite, microsome, NLRP3

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24 Increases in Serum Erythropoietin Hormone in Recreational Breath-Hold Divers Following a Series of Repeated Apnoeas: Apnoea beyond Freediving

Authors: Antonis Elia, Theo Loizou, Gladys Onambele-Pearson, Matthew Barlow, Georgina Stebbings

Abstract:

Hypoxic conditions have been reported to enhance red blood cell production in both acclimatised low-landers and altitude adapted populations. This process is mediated by the erythropoietin hormone, which is released predominantly by the hypoxic kidney. A higher haemoglobin concentration was previously reported in elite breath-hold divers when compared to elite-skiers and untrained individuals. Therefore, the present study aimed to investigate whether apnoea induced hypoxia could induce a significant increase in serum erythropoietin concentration in recreational breath-hold divers which would provide an explanation to the higher haemoglobin levels observed in elite breath-hold divers. Identifying whether apnoea induced hypoxia induces a significant increase in serum erythropoietin might suggest that apnoea can be used as an alternative acclimatisation method to high altitude exposure. Seven healthy, recreational male breath-hold divers performed two sets of five 180 second breath-holds with a ten-minute supine rest between each set and a two-minute seated rest between each apnoea. During each breath-hold, participant’s heart rate and peripheral oxygen saturation levels were recorded every subsequent 10 seconds until the end of the 180 second breath-hold. After each 180 second breath-hold a capillary blood sample was collected from the finger to identify circulating haemoglobin levels. Following completion of the apnoeic protocol, three blood samples were collected at 30, 90 and 180 minutes to measure circulating erythropoietin levels. A significant interaction between erythropoietin and time was observed (F(3,18)= 4.72, p < 0.001), with significant increases in erythropoietin evident at 30 (t(6)= -5.035, p < 0.0590 (t(6)= -6.162, p < 0.05) and 180 (t(6)= - 7.232, p < 0.001) minutes post the last apnoea when compared to baseline. Corresponding average increases when compared to baseline were 16% at 30, 23% at 90 and 40% at 180 minutes post the last apnoea. A significant interaction between haemoglobin and time was observed (F(78,84)= 20.814, p < 0.001), with significant increases in haemoglobin evident at the fifth (t(29)= -1.124, p < 0.001), ninth (t(29)= -1.357, p < 0.001) and tenth (t(29)= -1.211, p < 0.05) apnoeas when compared to baseline. A significant interaction between peripheral oxygen saturation and time was observed (F(10,60)= 408.23, p < 0.001). The present study demonstrates that a series of ten 180 second breath-holds is sufficient to induce a significant increase in the circulating erythropoietin concentration of recreational breath hold divers. These observations may suggest that apnoea induced hypoxia may be used as an alternative acclimatisation method to high altitude exposure.

Keywords: apnoea, breath-holding, diving reflex, erythropoietin, haemoglobin

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23 Incidence of Breast Cancer and Enterococcus Infection: A Retrospective Analysis

Authors: Matthew Cardeiro, Amalia D. Ardeljan, Lexi Frankel, Dianela Prado Escobar, Catalina Molnar, Omar M. Rashid

Abstract:

Introduction: Enterococci comprise the natural flora of nearly all animals and are ubiquitous in food manufacturing and probiotics. However, its role in the microbiome remains controversial. The gut microbiome has shown to play an important role in immunology and cancer. Further, recent data has suggested a relationship between gut microbiota and breast cancer. These studies have shown that the gut microbiome of patients with breast cancer differs from that of healthy patients. Research regarding enterococcus infection and its sequala is limited, and further research is needed in order to understand the relationship between infection and cancer. Enterococcus may prevent the development of breast cancer (BC) through complex immunologic and microbiotic adaptations following an enterococcus infection. This study investigated the effect of enterococcus infection and the incidence of BC. Methods: A retrospective study (January 2010- December 2019) was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using a Humans Health Insurance Database. International Classification of Disease (ICD) 9th and 10th codes, Current Procedural Terminology (CPT), and National Drug Codes were used to identify BC diagnosis and enterococcus infection. Patients were matched for age, sex, Charlson Comorbidity Index (CCI), antibiotic treatment, and region of residence. Chi-squared, logistic regression, and odds ratio were implemented to assess the significance and estimate relative risk. Results: 671 out of 28,518 (2.35%) patients with a prior enterococcus infection and 1,459 out of 28,518 (5.12%) patients without enterococcus infection subsequently developed BC, and the difference was statistically significant (p<2.2x10⁻¹⁶). Logistic regression also indicated enterococcus infection was associated with a decreased incidence of BC (RR=0.60, 95% CI [0.57, 0.63]). Treatment for enterococcus infection was analyzed and controlled for in both enterococcus infected and noninfected populations. 398 out of 11,523 (3.34%) patients with a prior enterococcus infection and treated with antibiotics were compared to 624 out of 11,523 (5.41%) patients with no history of enterococcus infection (control) and received antibiotic treatment. Both populations subsequently developed BC. Results remained statistically significant (p<2.2x10-16) with a relative risk of 0.57 (95% CI [0.54, 0.60]). Conclusion & Discussion: This study shows a statistically significant correlation between enterococcus infection and a decrease incidence of breast cancer. Further exploration is needed to identify and understand not only the role of enterococcus in the microbiome but also the protective mechanism(s) and impact enterococcus infection may have on breast cancer development. Ultimately, further research is needed in order to understand the complex and intricate relationship between the microbiome, immunology, bacterial infections, and carcinogenesis.

Keywords: breast cancer, enterococcus, immunology, infection, microbiome

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22 Improving Screening and Treatment of Binge Eating Disorders in Pediatric Weight Management Clinic through a Quality Improvement Framework

Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

Abstract:

Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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21 Implementation of an Accessible State-Wide Trauma Education Program

Authors: Christine Lassen, Elizabeth Leonard, Matthew Oliver

Abstract:

The management of trauma is often complex and outcomes dependent on clinical expertise, effective teamwork, and a supported trauma system. The implementation of a statewide trauma education program should be accessible to all clinicians who manage trauma, but this can be challenging due to diverse individual needs, trauma service needs and geography. The NSW Institute of Trauma and Injury Management (ITIM) is a government funded body, responsible for coordinating and supporting the NSW Trauma System. The aim of this presentation is to describe how education initiatives have been implemented across the state. Simulation: In 2006, ITIM developed a Trauma Team Training Course - aimed to educate clinicians on the technical and non-technical skills required to manage trauma. The course is now independently coordinated by trauma services across the state at major trauma centres as well as in regional and rural hospitals. ITIM is currently in the process of re-evaluating and updating the Trauma Team Training Course to allow for the development of new resources and simulation scenarios. Trauma Education Evenings: In 2013, ITIM supported major trauma services to develop trauma education evenings which allowed the provision of free education to staff within the area health service and local area. The success of these local events expanded to regional hospitals. A total of 75 trauma education evenings have been conducted within NSW, with over 10,000 attendees. Wed-Based Resources: Recently, ITIM commenced free live streaming of the trauma education evenings which have now had over 3000 live views. The Trauma App developed in 2015 provides trauma clinicians with a centralised portal for trauma information and works on smartphones and tablets that integrate with the ITIM website. This supports pre-hospital and bedside clinical decisions and allows for trauma care to be more standardised, evidence-based, timely, and appropriate. Online e-Learning modules have been developed to assist clinicians, reduce unwarranted clinical variation and provide up to date evidence based education. The modules incorporate clinically focused education content with summative and formative assessments. Conclusion: Since 2005, ITIM has helped to facilitate the development of trauma education programs for doctors, nurses, pre-hospital and allied health clinicians. ITIM has been actively involved in more than 100 specialized trauma education programs, seminars and clinical workshops - attended by over 12,000 staff. The provision of state-wide trauma education is a challenging task requiring collaboration amongst numerous agencies working towards a common goal – to provide easily accessible trauma education.

Keywords: education, simulation, team-training, trauma

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20 A Research Study of the Inclusiveness of VR Headsets for Higher Education

Authors: Fredrick Forster, Gareth Ward, Matthew Tubby, Pamela Lithgow, Anne Nortcliffe

Abstract:

This paper presents the results from a research study of random adult participants accessing one of four different commercially available Virtual Reality (VR) Head Mounted Displays (HMDs) and completing a post user experience reflection questionnaire. The research sort to understand how inclusive commercially available VR HMDs are and identify any associated barriers that could impact the widespread adoption of the devices, specifically in Higher Education (HE). In the UK, education providers are legally required under the Equality Act 2010 to ensure all education facilities are inclusive and reasonable adjustments can be applied appropriately. The research specifically aimed to identify the considerations that academics and learning technologists need to make when adopting the use of commercial VR HMDs in HE classrooms, namely cybersickness, user comfort, Interpupillary Distance, inclusiveness, and user perceptions of VR. The research approach was designed to build upon previously published research on user reflections on presence, usability, and overall HMD comfort, using quantitative and qualitative research methods by way of a questionnaire. The quantitative data included the recording of physical characteristics such as the distance between eye pupils, known as Interpupillary Distance (IPD). VR HMDs require each user’s IPD measurement to enable the focusing of the VR HMDs virtual camera output to the right position in front of the eyes of the user. In addition, the questionnaire captured users’ qualitative reflections and evaluations of the broader accessibility characteristics of the VR HMDs. The initial research activity was accomplished by enabling a random sample of visitors, staff, and students at Canterbury Christ Church University, Kent to use a VR HMD for a set period of time and asking them to complete the post user experience questionnaire. The study identified that there is little correlation between users who experience cyber sickness and car sickness. Also, users with a smaller IPD than average (typically associated with females) were able to use the VR HMDs successfully; however, users with a larger than average IPD reported an impeded experience. This indicates that there is reduced inclusiveness for the tested VR HMDs for users with a higher-than-average IPD which is typically associated with males of certain ethnicities. As action education research, these initial findings will be used to refine the research method and conduct further investigations with the aim to provide verification and validation of the accessibility of current commercial VR HMDs. The conference presentation will report on the research results of the initial study and subsequent follow up studies with a larger variety of adult volunteers.

Keywords: virtual reality, education technology, inclusive technology, higher education

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19 Designing Metal Organic Frameworks for Sustainable CO₂ Utilization

Authors: Matthew E. Potter, Daniel J. Stewart, Lindsay M. Armstrong, Pier J. A. Sazio, Robert R. Raja

Abstract:

Rising CO₂ levels in the atmosphere means that CO₂ is a highly desirable feedstock. This requires specific catalysts to be designed to activate this inert molecule, combining a catalytic site tailored for CO₂ transformations with a support that can readily adsorb CO₂. Metal organic frameworks (MOFs) are regularly used as CO₂ sorbents. The organic nature of the linker molecules, connecting the metal nodes, offers many post-synthesis modifications to introduce catalytic active sites into the frameworks. However, the metal nodes may be coordinatively unsaturated, allowing them to bind to organic moieties. Imidazoles have shown promise catalyzing the formation of cyclic carbonates from epoxides with CO₂. Typically, this synthesis route employs toxic reagents such as phosgene, liberating HCl. Therefore an alternative route with CO₂ is highly appealing. In this work we design active sites for CO₂ activation, by tethering substituted-imidazole organocatalytic species to the available Cr3+ metal nodes of a Cr-MIL-101 MOF, for the first time, to create a tailored species for carbon capture utilization applications. Our tailored design strategy combining a CO₂ sorbent, Cr-MIL-101, with an anchored imidazole results in a highly active and selective multifunctional catalyst, achieving turnover frequencies of over 750 hr-1. These findings demonstrate the synergy between the MOF framework and imidazoles for CO₂ utilization applications. Further, the effect of substrate variation has been explored yielding mechanistic insights into this process. Through characterization, we show that the structural and compositional integrity of the Cr-MIL-101 has been preserved on functionalizing the imidazoles. Further, we show the binding of the imidazoles to the Cr3+ metal nodes. This can be seen through our EPR study, where the distortion of the Cr3+ on binding to the imidazole shows the CO₂ binding site is close to the active imidazole. This has a synergistic effect, improving catalytic performance. We believe the combination of MOF support and organocatalyst allows many possibilities to generate new multifunctional catalysts for CO₂ utilisation. In conclusion, we have validated our design procedure, combining a known CO₂ sorbent, with an active imidazole species to create a unique tailored multifunctional catalyst for CO₂ utilization. This species achieves high activity and selectivity for the formation of cyclic carbonates and offers a sustainable alternative to traditional synthesis methods. This work represents a unique design strategy for CO₂ utilization while offering exciting possibilities for further work in characterization, computational modelling, and post-synthesis modification.

Keywords: carbonate, catalysis, MOF, utilisation

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18 Design of a Low-Cost, Portable, Sensor Device for Longitudinal, At-Home Analysis of Gait and Balance

Authors: Claudia Norambuena, Myissa Weiss, Maria Ruiz Maya, Matthew Straley, Elijah Hammond, Benjamin Chesebrough, David Grow

Abstract:

The purpose of this project is to develop a low-cost, portable sensor device that can be used at home for long-term analysis of gait and balance abnormalities. One area of particular concern involves the asymmetries in movement and balance that can accompany certain types of injuries and/or the associated devices used in the repair and rehabilitation process (e.g. the use of splints and casts) which can often increase chances of falls and additional injuries. This device has the capacity to monitor a patient during the rehabilitation process after injury or operation, increasing the patient’s access to healthcare while decreasing the number of visits to the patient’s clinician. The sensor device may thereby improve the quality of the patient’s care, particularly in rural areas where access to the clinician could be limited, while simultaneously decreasing the overall cost associated with the patient’s care. The device consists of nine interconnected accelerometer/ gyroscope/compass chips (9-DOF IMU, Adafruit, New York, NY). The sensors attach to and are used to determine the orientation and acceleration of the patient’s lower abdomen, C7 vertebra (lower neck), L1 vertebra (middle back), anterior side of each thigh and tibia, and dorsal side of each foot. In addition, pressure sensors are embedded in shoe inserts with one sensor (ESS301, Tekscan, Boston, MA) beneath the heel and three sensors (Interlink 402, Interlink Electronics, Westlake Village, CA) beneath the metatarsal bones of each foot. These sensors measure the distribution of the weight applied to each foot as well as stride duration. A small microntroller (Arduino Mega, Arduino, Ivrea, Italy) is used to collect data from these sensors in a CSV file. MATLAB is then used to analyze the data and output the hip, knee, ankle, and trunk angles projected on the sagittal plane. An open-source program Processing is then used to generate an animation of the patient’s gait. The accuracy of the sensors was validated through comparison to goniometric measurements (±2° error). The sensor device was also shown to have sufficient sensitivity to observe various gait abnormalities. Several patients used the sensor device, and the data collected from each represented the patient’s movements. Further, the sensors were found to have the ability to observe gait abnormalities caused by the addition of a small amount of weight (4.5 - 9.1 kg) to one side of the patient. The user-friendly interface and portability of the sensor device will help to construct a bridge between patients and their clinicians with fewer necessary inpatient visits.

Keywords: biomedical sensing, gait analysis, outpatient, rehabilitation

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17 Towards Consensus: Mapping Humanitarian-Development Integration Concepts and Their Interrelationship over Time

Authors: Matthew J. B. Wilson

Abstract:

Disaster Risk Reduction relies heavily on the effective cooperation of both humanitarian and development actors, particularly in the wake of a disaster, implementing lasting recovery measures that better protect communities from disasters to come. This can be seen to fit within a broader discussion around integrating humanitarian and development work stretching back to the 1980s. Over time, a number of key concepts have been put forward, including Linking Relief, Rehabilitation, and Development (LRRD), Early Recovery (ER), ‘Build Back Better’ (BBB), and the most recent ‘Humanitarian-Development-Peace Nexus’ or ‘Triple Nexus’ (HDPN) to define these goals and relationship. While this discussion has evolved greatly over time, from a continuum to a more integrative synergistic relationship, there remains a lack of consensus around how to describe it, and as such, the reality of effectively closing this gap has yet to be seen. The objective of this research was twofold. First, to map these four identified concepts (LRRD, ER, BBB & HDPN) used in the literature since 1995 to understand the overall trends in how this relationship is discussed. Second, map articles reference a combination of these concepts to understand their interrelationship. A scoping review was conducted for each concept identified. Results were gathered from Google Scholar by firstly inputting specific boolean search phrases for each concept as they related specifically to disasters each year since 1995 to identify the total number of articles discussing each concept over time. A second search was then done by pairing concepts together within a boolean search phrase and inputting the results into a matrix to understand how many articles contained references to more than one of the concepts. This latter search was limited to articles published after 2017 to account for the more recent emergence of HDPN. It was found that ER and particularly BBB are referred to much more widely than LRRD and HDPN. ER increased particularly in the mid-2000’s coinciding with the formation of the ER cluster, and BBB, whilst emerging gradually in the mid-2000s due to its usage in the wake of the Boxing Day Tsunami, increased significantly from about 2015 after its prominent inclusion in Sendai Framework. HDPN has only just started to increase in the last 4-5 years. In regards to the relationship between concepts, it was found the vast majority of all concepts identified were referred to in isolation from each other. The strongest relationship was between LRRD and HDPN (8% of articles referring to both), whilst ER-BBB and ER-HDPN both were about 3%, LRRD-ER 2%, and BBB-HDPN 1% and BBB-LRRD 1%. This research identified a fundamental issue around the lack of consensus and even awareness of different approaches referred to within academic literature relating to integrating humanitarian and development work. More research into synthesizing and learning from a range of approaches could work towards better closing this gap.

Keywords: build back better, disaster risk reduction, early recovery, linking relief rehabilitation and development, humanitarian development integration, humanitarian-development (peace) nexus, recovery, triple nexus

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16 Exploring the Success of Live Streaming Commerce in China: A Literature Analysis

Authors: Ming Gao, Matthew Tingchi Liu, Hoi Ngan Loi

Abstract:

Live streaming refers to the video contents generated by broadcasters and shared with viewers in real-time by uploading them to short-video platforms. In recent years, individual KOL broadcasters have successfully made use of live streams to sell a large amount of goods to the consumers. For example, Wei Ya, the Number 1 broadcaster in Taobao Live, sold products worth RMB 2.7 billion (USD 0.38 billion) in 2018. Regarding the success of live streaming commerce (LSC) in China, this study explores the elements of the booming LSC industry and attempts to explain the reasons behind its prosperity. A systematic review of industry reports and academic papers was conducted to summarize the latest findings in this field. And the results of this investigation showed that a live streaming eco-system has been established by the LSC players, namely, the platform, the broadcaster, the product supplier, and the viewer. In this eco-system, all players have complementary advantages and needs, and their close cooperation leads to a win-win situation. For instance, platforms and broadcasters have abundant internet traffic, which needs to be monetized, while product suppliers have mature supply chains and the need of promoting the products. In addition, viewers are attached to the LSC platforms to get product information, bargains, and entertainment. This study highlights the importance of the mass-personal hybrid communication nature of live streaming because its interpersonal communication feature increases consumers’ positive experiences, while its mass media broadcasting feature facilitates product promotion. Another innovative point of this study lies in its inclusion of the special characteristic of Chinese Internet culture - entertainment. The entertaining genres of the live streams created by broadcasters serve as down-to-earth approaches to reach their audiences easily. Further, the nature of video, i.e., the dynamic and salient stimulus, is emphasized in this study. Since video is more engaging, it can attract viewers in a quick and easy way. Meanwhile, the abundant, interesting, high-quality, and free short videos have added “stickiness” to platforms by retaining users and prolonging their staying time on the platforms. In addition, broadcasters’ important characters, such as physical attractiveness, humor, sex appeal, kindness, communication skills, and interactivity, are also identified as important factors that influence consumers’ engagement and purchase intention. In conclusion, all players have their own proper places in this live streaming eco-system, in which they work seamlessly to give full play to their respective advantages, with each player taking what it needs and offering what it has. This has contributed to the success of live streaming commerce in China.

Keywords: broadcasters, communication, entertainment, live streaming commerce, viewers

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15 Agent-Based Modeling Investigating Self-Organization in Open, Non-equilibrium Thermodynamic Systems

Authors: Georgi Y. Georgiev, Matthew Brouillet

Abstract:

This research applies the power of agent-based modeling to a pivotal question at the intersection of biology, computer science, physics, and complex systems theory about the self-organization processes in open, complex, non-equilibrium thermodynamic systems. Central to this investigation is the principle of Maximum Entropy Production (MEP). This principle suggests that such systems evolve toward states that optimize entropy production, leading to the formation of structured environments. It is hypothesized that guided by the least action principle, open thermodynamic systems identify and follow the shortest paths to transmit energy and matter, resulting in maximal entropy production, internal structure formation, and a decrease in internal entropy. Concurrently, it is predicted that there will be an increase in system information as more information is required to describe the developing structure. To test this, an agent-based model is developed simulating an ant colony's formation of a path between a food source and its nest. Utilizing the Netlogo software for modeling and Python for data analysis and visualization, self-organization is quantified by calculating the decrease in system entropy based on the potential states and distribution of the ants within the simulated environment. External entropy production is also evaluated for information increase and efficiency improvements in the system's action. Simulations demonstrated that the system begins at maximal entropy, which decreases as the ants form paths over time. A range of system behaviors contingent upon the number of ants are observed. Notably, no path formation occurred with fewer than five ants, whereas clear paths were established by 200 ants, and saturation of path formation and entropy state was reached at populations exceeding 1000 ants. This analytical approach identified the inflection point marking the transition from disorder to order and computed the slope at this point. Combined with extrapolation to the final path entropy, these parameters yield important insights into the eventual entropy state of the system and the timeframe for its establishment, enabling the estimation of the self-organization rate. This study provides a novel perspective on the exploration of self-organization in thermodynamic systems, establishing a correlation between internal entropy decrease rate and external entropy production rate. Moreover, it presents a flexible framework for assessing the impact of external factors like changes in world size, path obstacles, and friction. Overall, this research offers a robust, replicable model for studying self-organization processes in any open thermodynamic system. As such, it provides a foundation for further in-depth exploration of the complex behaviors of these systems and contributes to the development of more efficient self-organizing systems across various scientific fields.

Keywords: complexity, self-organization, agent based modelling, efficiency

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14 Pandemic-Related Disruption to the Home Environment and Early Vocabulary Acquisition

Authors: Matthew McArthur, Margaret Friend

Abstract:

The COVID-19 pandemic disrupted the stability of the home environment for families across the world. Potential disruptions include parent work modality (in-person vs. remote), levels of health anxiety, family routines, and caregiving. These disruptions may have interfered with the processes of early vocabulary acquisition, carrying lasting effects over the life course. Our justification for this research is as follows: First, early, stable, caregiver-child reciprocal interactions, which may have been disrupted during the pandemic, contribute to the development of the brain architecture that supports language, cognitive, and social-emotional development. Second, early vocabulary predicts several cognitive outcomes, such as numeracy, literacy, and executive function. Further, disruption in the home is associated with adverse cognitive, academic, socio-emotional, behavioral, and communication outcomes in young children. We are interested in how disruptions related to the COVID-19 pandemic are associated with vocabulary acquisition in children born during the first two waves of the pandemic. We are conducting a moderated online experiment to assess this question. Participants are 16 children (10F) ranging in age from 19 to 39 months (M=25.27) and their caregivers. All child participants were screened for language background, health history, and history of language disorders, and were typically developing. Parents completed a modified version of the COVID-19 Family Stressor Scale (CoFaSS), a published measure of COVID-19-related family stressors. Thirteen items from the original scale were replaced to better capture change in family organization and stability specifically related to disruptions in income, anxiety, family relations, and childcare. Following completion of the modified CoFaSS, children completed a Web-Based version of the Computerized Comprehension Task and the Receptive One Word Picture Vocabulary if 24 months or older or the MacArthur-Bates Communicative Development Inventory if younger than 24 months. We report our preliminary data as a partial correlation analysis controlling for age. Raw vocabulary scores on the CCT, ROWPVT-4, and MCDI were all negatively associated with pandemic-related disruptions related to anxiety (r12=-.321; r1=-.332; r9=-.509), family relations (r12=-.590*; r1=-.155; r9=-.468), and childcare (r12=-.294; r1=-.468; r9=-.177). Although the small sample size for these preliminary data limits our power to detect significance, this trend is in the predicted direction, suggesting that increased pandemic-related disruption across multiple domains is associated with lower vocabulary scores. We anticipate presenting data on a full sample of 50 monolingual English participants. A sample of 50 participants would provide sufficient statistical power to detect a moderate effect size, adhering to a nominal alpha of 0.05 and ensuring a power level of 0.80.

Keywords: COVID-19, early vocabulary, home environment, language acquisition, multiple measures

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13 Sensor and Sensor System Design, Selection and Data Fusion Using Non-Deterministic Multi-Attribute Tradespace Exploration

Authors: Matthew Yeager, Christopher Willy, John Bischoff

Abstract:

The conceptualization and design phases of a system lifecycle consume a significant amount of the lifecycle budget in the form of direct tasking and capital, as well as the implicit costs associated with unforeseeable design errors that are only realized during downstream phases. Ad hoc or iterative approaches to generating system requirements oftentimes fail to consider the full array of feasible systems or product designs for a variety of reasons, including, but not limited to: initial conceptualization that oftentimes incorporates a priori or legacy features; the inability to capture, communicate and accommodate stakeholder preferences; inadequate technical designs and/or feasibility studies; and locally-, but not globally-, optimized subsystems and components. These design pitfalls can beget unanticipated developmental or system alterations with added costs, risks and support activities, heightening the risk for suboptimal system performance, premature obsolescence or forgone development. Supported by rapid advances in learning algorithms and hardware technology, sensors and sensor systems have become commonplace in both commercial and industrial products. The evolving array of hardware components (i.e. sensors, CPUs, modular / auxiliary access, etc…) as well as recognition, data fusion and communication protocols have all become increasingly complex and critical for design engineers during both concpetualization and implementation. This work seeks to develop and utilize a non-deterministic approach for sensor system design within the multi-attribute tradespace exploration (MATE) paradigm, a technique that incorporates decision theory into model-based techniques in order to explore complex design environments and discover better system designs. Developed to address the inherent design constraints in complex aerospace systems, MATE techniques enable project engineers to examine all viable system designs, assess attribute utility and system performance, and better align with stakeholder requirements. Whereas such previous work has been focused on aerospace systems and conducted in a deterministic fashion, this study addresses a wider array of system design elements by incorporating both traditional tradespace elements (e.g. hardware components) as well as popular multi-sensor data fusion models and techniques. Furthermore, statistical performance features to this model-based MATE approach will enable non-deterministic techniques for various commercial systems that range in application, complexity and system behavior, demonstrating a significant utility within the realm of formal systems decision-making.

Keywords: multi-attribute tradespace exploration, data fusion, sensors, systems engineering, system design

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12 Wood Energy, Trees outside Forests and Agroforestry Wood Harvesting and Conversion Residues Preparing and Storing

Authors: Adeiza Matthew, Oluwadamilola Abubakar

Abstract:

Wood energy, also known as wood fuel, is a renewable energy source that is derived from woody biomass, which is organic matter that is harvested from forests, woodlands, and other lands. Woody biomass includes trees, branches, twigs, and other woody debris that can be used as fuel. Wood energy can be classified based on its sources, such as trees outside forests, residues from wood harvesting and conversion, and energy plantations. There are several policy frameworks that support the use of wood energy, including participatory forest management and agroforestry. These policies aim to promote the sustainable use of woody biomass as a source of energy while also protecting forests and wildlife habitats. There are several options for using wood as a fuel, including central heating systems, pellet-based systems, wood chip-based systems, log boilers, fireplaces, and stoves. Each of these options has its own benefits and drawbacks, and the most appropriate option will depend on factors such as the availability of woody biomass, the heating needs of the household or facility, and the local climate. In order to use wood as a fuel, it must be harvested and stored properly. Hardwood or softwood can be used as fuel, and the heating value of firewood depends on the species of tree and the degree of moisture content. Proper harvesting and storage of wood can help to minimize environmental impacts and improve wildlife habitats. The use of wood energy has several environmental impacts, including the release of greenhouse gases during combustion and the potential for air pollution from combustion by-products. However, wood energy can also have positive environmental impacts, such as the sequestration of carbon in trees and the reduction of reliance on fossil fuels. The regulation and legislation of wood energy vary by country and region, and there is an ongoing debate about the potential use of wood energy in renewable energy technologies. Wood energy is a renewable energy source that can be used to generate electricity, heat, and transportation fuels. Woody biomass is abundant and widely available, making it a potentially significant source of energy for many countries. The use of wood energy can create local economic and employment opportunities, particularly in rural areas. Wood energy can be used to reduce reliance on fossil fuels and reduce greenhouse gas emissions. Properly managed forests can provide a sustained supply of woody biomass for energy, helping to reduce the risk of deforestation and habitat loss. Wood energy can be produced using a variety of technologies, including direct combustion, co-firing with fossil fuels, and the production of biofuels. The environmental impacts of wood energy can be minimized through the use of best practices in harvesting, transportation, and processing. Wood energy is regulated and legislated at the national and international levels, and there are various standards and certification systems in place to promote sustainable practices. Wood energy has the potential to play a significant role in the transition to a low-carbon economy and the achievement of climate change mitigation goals.

Keywords: biomass, timber, charcoal, firewood

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11 Use of Extended Conversation to Boost Vocabulary Knowledge and Soft Skills in English for Employment Classes

Authors: James G. Matthew, Seonmin Huh, Frank X. Bennett

Abstract:

English for Specific Purposes, ESP, aims to equip learners with necessary English language skills. Many ESP programs address language skills for job performance, including reading job related documents and oral proficiency. Within ESP is English for occupational purposes, EOP, which centers around developing communicative competence for the globalized workplace. Many ESP and EOP courses lack the content needed to assist students to progress at work, resulting in the need to create lexical compilation for different professions. It is important to teach communicative competence and soft skills for real job-related problem situations and address the complexities of the real world to help students to be successful in their professions. ESP and EOP research is therefore trying to balance both profession-specific educational contents as well as international multi-disciplinary language skills for the globalized workforce. The current study will build upon the existing discussion by developing pedagogy to assist students in their career through developing a strong practical command of relevant English vocabulary. Our research question focuses on the pedagogy two professors incorporated in their English for employment courses. The current study is a qualitative case study on the modes of teaching delivery for EOP in South Korea. Two foreign professors teaching at two different universities in South Korea volunteered for the study to explore their teaching practices. Both professors’ curriculums included the components of employment-related concept vocabulary, business presentations, CV/resume and cover letter preparation, and job interview preparation. All the pre-made recorded video lectures, live online class sessions with students, teachers’ lesson plans, teachers’ class materials, students’ assignments, and midterm and finals video conferences were collected for data analysis. The study then focused on unpacking representative patterns in their teaching methods. The professors used their strengths as native speakers to extend the class discussion from narrow and restricted conversations to giving students broader opportunities to practice authentic English conversation. The methods of teaching utilized three main steps to extend the conversation. Firstly, students were taught concept vocabulary. Secondly, the vocabulary was then combined in speaking activities where students had to solve scenarios, and the students were required to expand on the given forms of words and language expressions. Lastly, the students had conversations in English, using the language learnt. The conversations observed in both classes were those of authentic, expanded English communication and this way of expanding concept vocabulary lessons into extended conversation is one representative pedagogical approach that both professors took. Extended English conversation, therefore, is crucial for EOP education.

Keywords: concept vocabulary, english as a foreign language, english for employment, extended conversation

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10 Application of MALDI-MS to Differentiate SARS-CoV-2 and Non-SARS-CoV-2 Symptomatic Infections in the Early and Late Phases of the Pandemic

Authors: Dmitriy Babenko, Sergey Yegorov, Ilya Korshukov, Aidana Sultanbekova, Valentina Barkhanskaya, Tatiana Bashirova, Yerzhan Zhunusov, Yevgeniya Li, Viktoriya Parakhina, Svetlana Kolesnichenko, Yeldar Baiken, Aruzhan Pralieva, Zhibek Zhumadilova, Matthew S. Miller, Gonzalo H. Hortelano, Anar Turmuhambetova, Antonella E. Chesca, Irina Kadyrova

Abstract:

Introduction: The rapidly evolving COVID-19 pandemic, along with the re-emergence of pathogens causing acute respiratory infections (ARI), has necessitated the development of novel diagnostic tools to differentiate various causes of ARI. MALDI-MS, due to its wide usage and affordability, has been proposed as a potential instrument for diagnosing SARS-CoV-2 versus non-SARS-CoV-2 ARI. The aim of this study was to investigate the potential of MALDI-MS in conjunction with a machine learning model to accurately distinguish between symptomatic infections caused by SARS-CoV-2 and non-SARS-CoV-2 during both the early and later phases of the pandemic. Furthermore, this study aimed to analyze mass spectrometry (MS) data obtained from nasal swabs of healthy individuals. Methods: We gathered mass spectra from 252 samples, comprising 108 SARS-CoV-2-positive samples obtained in 2020 (Covid 2020), 7 SARS-CoV- 2-positive samples obtained in 2023 (Covid 2023), 71 samples from symptomatic individuals without SARS-CoV-2 (Control non-Covid ARVI), and 66 samples from healthy individuals (Control healthy). All the samples were subjected to RT-PCR testing. For data analysis, we employed the caret R package to train and test seven machine-learning algorithms: C5.0, KNN, NB, RF, SVM-L, SVM-R, and XGBoost. We conducted a training process using a five-fold (outer) nested repeated (five times) ten-fold (inner) cross-validation with a randomized stratified splitting approach. Results: In this study, we utilized the Covid 2020 dataset as a case group and the non-Covid ARVI dataset as a control group to train and test various machine learning (ML) models. Among these models, XGBoost and SVM-R demonstrated the highest performance, with accuracy values of 0.97 [0.93, 0.97] and 0.95 [0.95; 0.97], specificity values of 0.86 [0.71; 0.93] and 0.86 [0.79; 0.87], and sensitivity values of 0.984 [0.984; 1.000] and 1.000 [0.968; 1.000], respectively. When examining the Covid 2023 dataset, the Naive Bayes model achieved the highest classification accuracy of 43%, while XGBoost and SVM-R achieved accuracies of 14%. For the healthy control dataset, the accuracy of the models ranged from 0.27 [0.24; 0.32] for k-nearest neighbors to 0.44 [0.41; 0.45] for the Support Vector Machine with a radial basis function kernel. Conclusion: Therefore, ML models trained on MALDI MS of nasopharyngeal swabs obtained from patients with Covid during the initial phase of the pandemic, as well as symptomatic non-Covid individuals, showed excellent classification performance, which aligns with the results of previous studies. However, when applied to swabs from healthy individuals and a limited sample of patients with Covid in the late phase of the pandemic, ML models exhibited lower classification accuracy.

Keywords: SARS-CoV-2, MALDI-TOF MS, ML models, nasopharyngeal swabs, classification

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